運動耐性が高い患者における心筋 perfusion イメージングの予後値
S N Chatziioannou1, W H Moore, P V Ford
1Department of Radiology, Baylor College of Medicine, St. Luke's Episcopal Hospital/Texas Heart Institute, Houston 77030, USA. schatziioannou@sleh.com
Circulation
|February 23, 1999
まとめ
心筋 perfusion imaging (MPI) は,エクササイズ ECG (EECG) と異なり,高い運動耐性を持つ患者の心臓イベントを正確に予測します. MPIは,この集団における心臓のリスクを評価するための重要な予後ツールです.
科学分野:
- 心臓病学 心臓病学
- 診断用イメージング
- 予防性心臓病学 予防性心臓病学
背景:
- 高い運動耐性は,通常,心血管疾患の良好な予後を示します.
- 高い運動耐性を持つ患者における異常な心筋 perfusion imaging (MPI) の予後値は不明である.
- 運動心電図 (EECG) は一般的に使用されていますが,この患者グループでは制限があります.
研究 の 目的:
- 高い運動耐性を持つ患者のMPIとEECGの予後的有用性を比較する.
- MPIが,高いレベルの身体的運動を達成する個体において,有害な心臓イベントを予測できるかどうかを判断する.
- MPI と EECG の独立的および組み合わせた予測力を評価し,心臓のアウトカムに関する予測力を評価する.
主な方法:
- 388人の連続した患者を遡及的に分析した結果,MPIを施し,少なくともブルースのステージIVに達した.
- リヴァスキュラライゼーション,心筋梗塞,心疾患による死亡を含む不良心疾患の追跡評価.
- MPIとEECGの予測力を評価するためのコックス比例リスク回帰分析.
主要な成果:
- 157人の患者 (40.5%) が異常なMPI結果を示した.
- 異常なMPIは,心疾患の有害事象の有意に高い割合 (12.2%対1.7%,P<0.001) と関連していました.
- MPIは心臓病の予測に優れていた (相対リスク=8),EECGは予測力を示さなかった.
結論:
- 心筋 perfusion imaging (MPI) は,高い運動耐性を有する患者における不良心イベントの強力な予後指標として機能します.
- 運動心電図 (EECG) は,この特定の患者コホートにおける心臓イベントの有意な予測価値がない.
- MPI単独では,EMCG (デュークスコアを含む) とMPIを組み合わせるよりも優れた予後情報を提供します.
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