タリウム-201が静止状態と運動中の心筋 perfusion イメージング. 冠動脈疾患における心電図に対する比較感度
Circulation
|January 1, 1977
まとめ
タルリウム-201を用いた心筋 perfusion imaging (MPI) は,冠動脈疾患 (CAD) の一時性缺血の検出において,ECGよりも敏感である. MPIは,異常な静止状態のECGを持つ患者,または目標心拍数に達できない患者にとって特に有用です.
科学分野:
- 心臓病学 心臓病学
- 核医学は,核医学である.
- 診断用イメージング
背景:
- 暫定性心筋不全症は,冠動脈疾患 (CAD) の重要な指標である.
- 電気心臓図 (ECG) は,運動による缺血を検出するための標準的なツールです.
- 心筋 perfusion imaging (MPI) は,心臓の血流を評価するための代替的なイメージング方式を提供します.
研究 の 目的:
- タルリウム-201 MPIの感受性を,CADの患者における一時性イシュケミアの検出のための12リードEKGと比較する.
- 患者の特定のサブグループにおけるMPIとECGの診断パフォーマンスを評価するために,ベースラインのECG異常または運動制限を有する患者を含む.
主な方法:
- Thallium-201 MPIは,20人の正常な被験者およびCADの63人の患者に休息状態およびピーク運動中に実施されました.
- 休息と運動の間,同時に12リードのECGが記録されました.
- 発血不全の検出に対する感度がMPIとECGの間で比較され, perfusion defects,STセグメントのうつ,胸痛を考慮した.
主要な成果:
- MPIは,CAD患者の56%で運動誘発の perfusion defects を検出したが,ECG (P <0.02) で不全性STセグメントうつ病の38%と比較した.
- MPIの感受性の上昇は,初期にEKGの異常があった患者,および予測された最大心拍数の85%を達成しなかった患者によって引き起こされた.
- 単血管性疾患では,MPIはECGよりも高い感度を示した (P <0.02).
結論:
- 運動タリウム-201 MPIは,CADの診断のための従来の運動心電図検査の貴重な補足です.
- MPIは,異常な静止状態のECG,運動誘発性不律症,または適切な運動強度を達成できない患者に特に有益です.
- その利点にもかかわらず,ECG,MPI,および胸痛の評価の組み合わせは,CAD患者の11%でまだイシュケミアを特定できませんでした.
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