王威,赖图雅,王宁远,王鑫焱,辛倩,陈韵岱,高磊

• 1:中国人民解放军总医院第六医学中心心血管病医学部
• 2:内蒙古自治区鄂尔多斯市乌审旗蒙医综合医院
• 3:中国人民解放军93658部队

摘要(Abstract)：

冠状动脉钙化结节是导致急性冠状动脉综合征的原因之一，在特定群体中出现的概率并不低，且容易导致主要不良心血管事件。随着腔内影像技术和斑块修饰技术的发展，对钙化结节的诊断和治疗较既往有了明显的进步，但仍需进一步规范。本文就冠状动脉钙化结节的研究进展作一综述。

关键词(KeyWords)： 钙化结节;冠状动脉粥样硬化性心脏病;腔内影像;斑块修饰

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金面上项目（81970443）

作者(Author): 王威,赖图雅,王宁远,王鑫焱,辛倩,陈韵岱,高磊

参考文献(References)：

• [1] Roth GA, Mensah GA, Fuster V. The Global burden of cardiovascular diseases and risks:a compass for global action[J]. J Am Coll Cardiol, 2020, 76(25):2980-2981. DOI:10.1016/j.jacc.2020.11.021.
• [2] Virani SS, Alonso A, Aparicio HJ,et al. Heart disease and stroke statistics-2021 update:a report from the American Heart Association[J]. Circulation, 2021, 143(8):e254-e743.DOI:10.1161/CIR.0000000000000950.
• [3] Virmani R, Burke AP, Farb A, et al. Pathology of the vulnerable plaque[J]. J Am Coll Cardiol, 2006, 47(8Suppl):C13-18. DOI:10.1016/j.jacc.2005.10.065.
• [4] Sato Y, Finn AV, Virmani R. Calcified nodule:a rare but important cause of acute coronary syndrome with worse clinical outcomes[J]. Atherosclerosis, 2021, 318:40-42. DOI:10.1016/j.atherosclerosis.2020.12.009.
• [5] Jia H, Abtahian F, Aguirre AD,et al. In vivo diagnosis of plaque erosion and calcified nodule in patients with acute coronary syndrome by intravascular optical coherence tomography[J].J Am Coll Cardiol, 2013, 62(19):1748-1758. DOI:10.1016/j.jacc.2013.05.071.
• [6]胡盛寿.从老龄化时代来临看心血管外科未来发展[J].中华心血管病杂志，2021, 49(8):747-749. DOI:10.3760/cma.j.cn112148-20210704-00570.
• [7] Virmani R, Kolodgie FD, Burke AP, et al. Lessons from sudden coronary death:a comprehensive morphological classification scheme for atherosclerotic lesions[J]. Arterioscler Thromb Vasc Biol, 2000, 20(5):1262-1275. DOI:10.1161/01.atv.20.5.1262.
• [8] Torii S, Sato Y, Otsuka F, et al. Eruptive calcified nodules as a potential mechanism of acute coronary thrombosis and sudden death[J]. J Am Coll Cardiol, 2021, 77(13):1599-1611.DOI:10.1016/j.jacc.2021.02.016.
• [9] Xu Y, Mintz GS, Tam A,et al. Prevalence, distribution,predictors, and outcomes of patients with calcified nodules in native coronary arteries:a 3-vessel intravascular ultrasound analysis from Providing Regional Observations to Study Predictors of Events in the Coronary Tree(PROSPECT)[J].Circulation, 2012, 126(5):537-545. DOI:10.1161/CIRCULATIONAHA.111.055004.
• [10] Yonetsu T, Jang IK.Advances in intravascular imaging:new insights into the vulnerable plaque from imaging studies[J].Korean Circ J, 2018, 48(1):1-15.DOI:10.4070/kcj.2017.0182.
• [11] Mintz GS, Popma JJ, Pichard AD,et al. Patterns of calcification in coronary artery disease. A statistical analysis of intravascular ultrasound and coronary angiography in 1155lesions[J]. Circulation, 1995, 91(7):1959-1965. DOI:10.1161/01.cir.91.7.1959.
• [12] Nakamura N, Torii S, Tsuchiya H,et al. Formation of calcified nodule as a cause of early in-stent restenosis in patients undergoing dialysis[J]. J Am Heart Assoc, 2020, 9(19):e016595.DOI:10.1161/JAHA.120.016595.
• [13] Cardoso L, Weinbaum S. Microcalcifications, their genesis,growth, and biomechanical stability in fibrous cap rupture[J].Adv Exp Med Biol, 2018, 1097:129-155. DOI:10.1007/978-3-319-96445-4_7.
• [14] Mizukoshi M, Kubo T, Takarada S, et al. Coronary superficial and spotty calcium deposits in culprit coronary lesions of acute coronary syndrome as determined by optical coherence tomography[J]. Am J Cardiol, 2013, 112(1):34-40.DOI:10.1016/j.amjcard.2013.02.048.
• [15] Lee T, Mintz GS, Matsumura M, et al. Prevalence,predictors, and clinical presentation of a calcified nodule as assessed by optical coherence tomography[J]. JACC Cardiovasc Imaging, 2017, 10(8):883-891.DOI:10.1016/j.jcmg.2017.05.013.
• [16] Okamura A, Okura H, Iwai S,et al. Incidence and prognostic impact of the calcified nodule in coronary artery disease patients with end-stage renal disease on dialysis[J]. Heart Vessels,2022, 37(10):1662-1668. DOI:10.1007/s00380-022-02076-1.
• [17] Yahagi K, Davis HR, Arbustini E, et al. Sex differences in coronary artery disease:pathological observations[J].Atherosclerosis, 2015, 239(1):260-267. DOI:10.1016/j.atherosclerosis.2015.01.017.
• [18] Isodono K, Fujii K, Fujimoto T, et al. The frequency and clinical characteristics of in-stent restenosis due to calcified nodule development after coronary stent implantation[J].Int J Cardiovasc Imaging, 2021, 37(1):15-23. DOI:10.1007/s10554-020-01952-z.
• [19] Tada T, Miura K, Ikuta A, et al. Prevalence, predictors,and outcomes of in-stent restenosis with calcified nodules[J].EuroIntervention, 2022, 17(16):1352-1361. DOI:10.4244/EIJ-D-21-00504.
• [20] Sugane H, Kataoka Y, Otsuka F, et al. Cardiac outcomes in patients with acute coronary syndrome attributable to calcified nodule[J]. Atherosclerosis, 2021, 318:70-75. DOI:10.1016/j.atherosclerosis.2020.11.005.
• [21] Doost A, Rankin J, Sapontis J,et al. Contemporary evidencebased diagnosis and management of severe coronary artery calcification[J]. Heart Lung Circ, 2022, 31(6):766-778.DOI:10.1016/j.hlc.2022.01.011.
• [22] Li J, Li J, Jian Z,et al. Serum marker and CT characteristics of coronary calcified nodule assessed by intravascular ultrasound[J].BMC Cardiovasc Disord, 2022, 22(1):475. DOI:10.1186/s12872-022-02931-z.
• [23] Grewal J, Ganz P, Selwyn A,et al. Usefulness of intravascular ultrasound in preventing stenting of hazy areas adjacent to coronary stents and its support of support spot-stenting[J].Am J Cardiol, 2001, 87(11):1246-1249.DOI:10.1016/s0002-9149(01)01513-2.
• [24] Okabe T, Weigold WG, Mintz GS,et al. Comparison of intravascular ultrasound to contrast-enhanced 64-slice computed tomography to assess the significance of angiographically ambiguous coronary narrowings[J]. Am J Cardiol, 2008,102(8):994-1001.DOI:10.1016/j.amjcard.2008.05.066.
• [25] Wang X, Matsumura M, Mintz GS, et al. In vivo calcium detection by comparing optical coherence tomography,intravascular ultrasound, and angiography[J]. JACC Cardiovasc Imaging, 2017, 10(8):869-879.DOI:10.1016/j.jcmg.2017.05.014.
• [26] Papaioannou TG, Kalantzis C, Katsianos E, et al. Personalized assessment of the coronary atherosclerotic arteries by intravascular ultrasound imaging:hunting the vulnerable plaque[J]. J Pers Med, 2019, 9(1):8. DOI:10.3390/jpm9010008.
• [27] Lee JB, Mintz GS, Lisauskas JB, et al. Histopathologic validation of the intravascular ultrasound diagnosis of calcified coronary artery nodules[J]. Am J Cardiol, 2011, 108(11):1547-1551.DOI:10.1016/j.amjcard.2011.07.014.
• [28] Fujino A, Mintz GS, Matsumura M, et al. A new optical coherence tomography-based calcium scoring system to predict stent underexpansion[J]. EuroIntervention, 2018, 13(18):e2182-e2189.DOI:10.4244/EIJ-D-17-00962.
• [29] Ali ZA, Galougahi KK. Shining light on calcified lesions,plaque stabilisation and physiologic significance:new insights from intracoronary OCT[J]. EuroIntervention, 2018, 13(18):e2105-e2108. DOI:10.4244/EIJV13I18A346.
• [30] Alfonso F, Cuesta J, Bastante T,et al. In-stent restenosis caused by a calcified nodule:a novel pattern of neoatherosclerosis[J].Can J Cardiol, 2016, 32(6):830.e1-e3. DOI:10.1016/j.cjca.2015.08.014.
• [31] Kaihara T, Higuma T, Kotoku N, et al. Calcified nodule protruding into the lumen through stent struts:an in vivo OCT analysis[J]. Cardiovasc Revasc Med, 2020, 21(11s):116-118. DOI:10.1016/j.carrev.2020.03.015.
• [32] Prati F, Gatto L, Fabbiocchi F, et al. Clinical outcomes of calcified nodules detected by optical coherence tomography:a sub-analysis of the CLIMA study[J]. EuroIntervention,2020, 16(5):380-386. DOI:10.4244/EIJ-D-19-01120.
• [33] Zhang M, Matsumura M, Usui E, et al. Intravascular ultrasound-derived calcium score to predict stent expansion in severely calcified lesions[J]. Circ Cardiovasc Interv, 2021, 14(10):e010296. DOI:10.1161/CIRCINTERVENTIONS.120.010296.
• [34]王思琦，李琪，滕伟利，等.冠状动脉血管内超声对严重钙化病变斑块旋磨术终点判断的评价研究[J].中国介入心脏病学杂志，2021, 29(9):490-494. DOI:10.3969/j.issn.1004-8812.2021.09.003.
• [35]曹成富，马玉良，李琪，等.光学相干断层成像指导钙化病变介入治疗策略[J].中国介入心脏病学杂志，2021, 29(6):345-349. DOI:10.3969/j.issn.1004-8812.2021.06.011.
• [36] Shlofmitz RA, Galougahi KK, Jeremias A, et al. Calcium modification in percutaneous coronary interventions[J]. Interv Cardiol Clin, 2022, 11(4):373-381. DOI:10.1016/j.iccl.2022.06.001.
• [37] Vera-Vera S, Garcia A, Jimenez-Valero S, et al. Excimer laser coronary atherectomy to treat calcified lesions[J]. Interv Cardiol, 2022, 17:e14. DOI:10.15420/icr.2022.10.
• [38] Rozenbaum Z, Takahashi T, Kobayashi Y, et al.Contemporary technologies to modify calcified plaque in coronary artery disease[J]. Prog Cardiovasc Dis, 2021, 69:18-26.DOI:10.1016/j.pcad.2021.07.003.
• [39] Yasumura K, Bagga S, Vengrenyuk Y, et al.“Shaking” or“Shaving” to treat massive coronary nodular calcification?[J].JACC Cardiovasc Interv, 2022, 15(19):e209-e211.DOI:10.1016/j.jcin.2022.05.049.
• [40] Masuda H, Kuramitsu S, Ito T, et al. Outcomes of paclitaxelcoated balloon angioplasty for in-stent calcified nodule:an optical coherence tomography study[J]. Catheter Cardiovasc Interv, 2022, 100(6):990-999. DOI:10.1002/ccd.30418.
• [41] Furuse E, Tanabe J, Tajiri M, et al. In-stent restenosis caused by calcified nodule 11 years after paclitaxel eluting stent implantation treated with drug-coated balloon following rotational atherectomy[J]. Cardiovasc Interv Ther, 2020, 35(3):302-303.DOI:10.1007/s12928-019-00597-7.
• [42] Shiraishi J, Kataoka E, Ozawa T, et al. Angiographic and clinical outcomes after stent-less coronary intervention using rotational atherectomy and drug-coated balloon in patients with de novo lesions[J]. Cardiovasc Revasc Med, 2020, 21(5):647-653. DOI:10.1016/j.carrev.2019.08.020.
• [43] Matsuda Y, Ashikaga T, Sasaoka T, et al. Ostial left circumflex lesion with calcified nodule successfully treated with excimer laser coronary atherectomy and drug-coated balloon[J].J Cardiol Cases, 2020, 22(1):32-35.DOI:10.1016/j.jccase.2020.04.004.