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Comparative effect of iso-osmolar versus low-osmolar contrast media on vascular attenuation, image quality, and heart rate changes in coronary CT angiography: A systematic review and meta-analysis.

等渗对比剂与低渗对比剂对冠状动脉CT血管造影中血管衰减、图像质量和心率变化的比较效果: 系统综述和荟萃分析。

  • 影响因子:1.26
  • DOI:10.1016/j.clinimag.2020.01.016
  • 作者列表:"Alhelaly MM","Abdelhakim AM","Ellotf H","Khaled A","Soliman AM","Attia MM
  • 发表时间:2020-05-01
Abstract

OBJECTIVES:Comparison of iso-osmolar contrast media (IOCM) and low-osmolar contrast media (LOCM) for vascular attenuation, image quality, heart rate changes, and common patient discomfort symptoms. METHODS:We searched PubMed, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL). We included only randomized controlled trials. Screening, data extraction, and quality assessment were done by three independent authors. RevMan 5.3 software was used for meta-analysis. RESULTS:Nine studies (n = 1831 participants) were found eligible and included in the meta-analysis. There was no difference between the both contrast media for vascular attenuation (mean difference = -21.31; 95% confidence interval -49.81 to 7.19; p = 0.14), image quality (standardized mean difference = 0.13; 95% confidence interval -0.07 to 0.33; p = 0.19), heart rate variability (standardized mean difference = -0.61; 95% confidence interval -1.30 to 0.09; p = 0.09), heat sensation (risk ratio = 0.79; 95% confidence interval 0.56 to 1.11; p = 0.17), and nausea or vomiting (risk ratio = 0.82; 95% confidence interval 0.52 to 1.28; p = 0.38). Moreover, IOCM resulted in a heart rate that was lower by 0.9 beat per minute (bpm) compared to LOCM (mean difference = -0.92; 95% confidence interval -1.81 to -0.03; p = 0.04). CONCLUSIONS:Both IOCM and LOCM have similar vascular enhancement, image quality, heart rate variability, and similar risk for patient discomfort. Furthermore, IOCM resulted in a slightly lower heart rate by 0.9 bpm.

摘要

目的: 比较等渗造影剂 (IOCM) 和低渗造影剂 (LOCM) 对血管衰减、图像质量、心率变化和常见患者不适症状的影响。 方法: 我们检索了PubMed、Web of Science、Scopus和Cochrane中心对照试验注册中心 (Central)。我们只纳入随机对照试验。筛选、数据提取和质量评估由3位独立作者完成。采用RevMan 5.3软件进行meta分析。 结果: 发现9项研究 (n = 1831名参与者) 符合条件并纳入荟萃分析。对于血管衰减 (平均差 = -21.31; 95% 置信区间-49.81至7.19; p = 0.14),图像质量 (标准化平均差 = 0.13; 95% 置信区间-0.07至0.33; p = 0.19),心率变异性 (标准化平均差 = -0.61;95% 置信区间-1.30至0.09; p = 0.09),热感 (风险比 = 0.79; 95% 置信区间0.56至1.11; p = 0.17) 和恶心或呕吐 (风险比 = 0.82; 95% 置信区间0.52至1.28; p = 0.38)。此外,与LOCM相比,IOCM导致心率降低0.9次/分钟 (bpm) (平均差 = -0.92; 95% 置信区间-1.81至-0.03; p = 0.04)。 结论: IOCM和LOCM具有相似的血管增强、图像质量、心率变异性和相似的患者不适风险。此外,IOCM导致0.9 bpm的心率略微降低。

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影响因子:2.41
发表时间:2020-06-12
DOI:10.4244/EIJ-D-18-01138
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METHODS:AIMS:Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. METHODS AND RESULTS:Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. CONCLUSIONS:In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.

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影响因子:1.67
发表时间:2020-01-01
DOI:10.2174/1573403X15666190513105231
作者列表:["Dev M","Sharma M","Rana N"]

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心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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