Lee Jong Eun, Park Hye Mi, Lim Yongwhan, Jeong Won Gi, Kim Yun-Hyeon
Taehan Yongsang Uihakhoe Chi. 2022 Jan;83(1):42-53. doi: 10.3348/jksr.2021.0170. Epub 2022 Jan 21.
The clinical concept of coronary artery disease (CAD) has seen a paradigm shift over the last decade. CAD is mostly a progressive disease, and patients with CAD can develop acute coronary syndromes at any point in disease progression. In this clinical context, a new term, "chronic coronary syndrome," was published in the 2019 European Society of Cardiology guidelines, reflecting the importance of early diagnosis and active management. Recent advances have been made in the evaluation of CAD using coronary CT angiography (CCTA). The clinical usefulness of CCTA in patients with stable angina or chronic coronary syndrome begins with the detection of early asymptomatic CAD. The characterization of atherosclerotic plaque and its role in determining treatment strategies for CAD have been demonstrated for all stages of the disease. This review describes the pathophysiology of stable angina to aid in the understanding of the clinical applications of CCTA.
在过去十年中,冠状动脉疾病(CAD)的临床概念发生了范式转变。CAD大多是一种渐进性疾病,CAD患者在疾病进展的任何阶段都可能发生急性冠状动脉综合征。在此临床背景下,2019年欧洲心脏病学会指南中发布了一个新术语“慢性冠状动脉综合征”,反映了早期诊断和积极管理的重要性。使用冠状动脉CT血管造影(CCTA)评估CAD方面取得了最新进展。CCTA在稳定型心绞痛或慢性冠状动脉综合征患者中的临床效用始于早期无症状CAD的检测。对于疾病的所有阶段,动脉粥样硬化斑块的特征及其在确定CAD治疗策略中的作用均已得到证实。本综述描述了稳定型心绞痛的病理生理学,以帮助理解CCTA的临床应用。