练习单光子发射计算机断层扫描为老年男性和老年女性提供了有效的风险分层
Uma S Valeti1, Todd D Miller, David O Hodge
1Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
Circulation
|April 6, 2005
概括
练习单光子发射计算机断层扫描 (SPECT) 通过心脏风险有效地分层老年患者,与杜克跑步机得分不同. 在SPECT中确定了低风险和高风险组,男性和女性的心脏死亡率不同.
科学领域:
- 心脏病学 心脏病学
- 核医学是一种核医学.
- 老年医学 老年医学
背景情况:
- 以前的研究表明,杜克跑步机得分在风险分层的老年患者中不足.
- 显然,需要一个更有效的非侵入性测试策略来评估这一群体的风险.
研究的目的:
- 为了评估运动-201单光子发射计算机断层扫描 (SPECT) 在老年患者 (年龄≥75岁) 的预后价值.
- 为了将SPECT的预测准确度与杜克跑步机得分进行比较.
- 根据SPECT结果,检查性别特异性结果.
主要方法:
- 一组247名老年患者 (108名女性,139名男性) 接受了运动-201 SPECT.
- 患者的随访时间平均为6.4年,以评估心脏病死亡.
- 分析的SPECT变量包括总压力评分 (SSS),总差分,肺吸收和左心室扩大.
主要成果:
- SPECT变量 (SSS,总差分,肺吸收,左心室扩大) 与心脏死亡有显著的相关性 (P<0.001到P=0.004).
- 杜克跑步机得分没有显著预测心脏病死亡 (P=NS).
- 在SPECT的SSS中,患者被分为低风险 (49%) 和高风险 (35%) 类别,每年心脏死亡率不同 (0.8%对5.8%).
- 对于女性 (P=0.012) 和男性 (P=0.003) 来说,心脏存活率根据SSS风险类别有显著差异.
结论:
- 运动SPECT有效地将老年患者分为临床上有用的低风险和高风险组.
- SPECT准确地预测了两性人的心脏结果,超过了杜克跑步机的得分.
- 运动SPECT可能成为能够运动的老年患者首选的初始非侵入性测试,等待进一步验证.
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