心臟血管支架置放後的心肌灌注掃描及心臟超音波報告分析-心臟血管專科

心臟相關檢查報告？

何醫師您好，前幾年有做過冠狀動脈血管支架置放，近期後續追踪做了心肌灌注掃描與心臟超音波，報告如下：心肌灌注掃描：*The baseline ECG showed right bundle branch block. There was no ST-T change during dipyridamole infusion.*The initial and 4-hour delayed images showed(1) moderate to severe reversible perfusion defects at basal septum anterior lateral and inferior walls;(2) transient post-stress LV dilatation;(3) the lung-heart ratio was within normal limit.*Visual semiquantitative analysis (5-point scale in AHA 17-segment model): summed stress score (SSS)=24 summed stress percent (SS%)=35%*Gated SPECT (8 frames per cardiac cycle estimated by QGS method):- Post-stress LVEF = 42%; resting LVEF = 49%.- Post-stress LV EDV = 103 ml ESV = 60 ml; resting LV EDV = 82 ml ESV = 42 ml.- Regional wall motion: transient post-stress global hypokinesia.心臟超音波：Dilated left ventricle. There are regional wall motion abnormalities as specified.The LV systolic function is preserved. The transmitral spectral Doppler flow pattern is suggestive of impaired LV relaxation.Aortic regurgitation: mild-moderate. Mitral regurgitation: mild-moderate. Tricuspid regurgitation: mild. Pulmonic regurgitation: mild. Pulmonary hypertension: mild.想請教醫師，從這兩份報告看起來，是否有比較嚴重的問題？
是否需要做進一步的心導管檢查？
另外，心臟超音波檢查結果有瓣膜閉鎖不全的情況，請問這個狀況算嚴重嗎？
是否需要進一步的治療？
謝謝醫師撥空解答。