運動タリウムトモグラフィーは,高リスクの無症状集団における将来の臨床的に顕在化した冠動脈心疾患を予測します
R S Blumenthal1, D M Becker, T F Moy
1Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Circulation
|March 1, 1996
まとめ
運動タリウムシンチグラフィーは,早発性CHD患者の無症状の兄弟姉妹の冠動脈疾患 (CHD) リスクを効果的に特定します. この検査は,45歳以上の男性兄弟にとって特に有用です.
科学分野:
- 心臓病学 心臓病学
- 予防医学は,予防的な医療です.
- 診断用イメージング
背景:
- 標準的な運動テストは,低リスクの無症状の個体における冠動脈疾患 (CHD) の予測に限界があります.
- 早期性心血管疾患の患者の兄弟姉妹は,隠された心血管疾患の有病率のある高リスクグループを表しています.
- この集団における隠されたCHDの早期発見は,臨床的に有利です.
研究 の 目的:
- 将来の臨床性心血管疾患の予測における運動タリウムスシンチグラフィの有効性を評価する.
- 早期性心血管疾患を有する個人の無症状の兄弟姉妹におけるこの診断ツールの有用性を評価する.
- テストがよりリスクの高い集団でよりうまく機能するかどうかを判断する.
主な方法:
- 運動タリウムスシンチグラフィーは,60歳未満の264人の無症状で,兄弟に早発性心血管疾患の anamnesisがある個人に実施されました.
- 臨床的なCHDイベントの発生率を記録するために,追跡期間は平均6.2年でした.
- 異常な検査結果 (エクササイズEKGとタリウムスキャン) は,将来のCHD発症と相関していました.
主要な成果:
- 264人の兄弟姉妹のうち19人が,平均6.2年の追跡期間で臨床的CHDを発症しました.
- 異常なタリウムスキャンは,女性 (9%) よりも男性 (29%) により頻繁に見られた.
- 異常なタリウムスキャンは,特に45歳以上の男性で14.5の相対的なリスクを生むコンコンダントな異常検査で,将来のCHD (相対リスク4.7) を有意に予測しました.
結論:
- 運動タリウムスシンチグラフィは,早発性CHD患者の無症状の兄弟姉妹のリスク評価に役立つツールです.
- この検査は,45歳以上の男性兄弟にとって特に有益です.
- このアプローチは,臨床的症状が現れる前に,隠されたCHDを有する個人を特定するのに役立ちます.
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