与EuroSCORE II相比,18-fluorodeoxyglucose正子发射断层扫描/计算机断层扫描心脏活力风险分层,用于左心室功能障碍患者的血管再循环
Brithika Yoganayaki Thangamuthu1, Indirani Elangovan1, Patel Asra1
1Department of Nuclear Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India.
概括
18-氧葡萄糖正子发射断层扫描/计算机断层扫描 (F18-FDG PET/CT) 比EuroSCORE II更好地预测左心室功能障碍患者进行冠状动脉旁路移植手术的术后死亡率. 这种心肌活力评估改善了风险分层,以获得更好的患者结果.
科学领域:
- 心血管成像 - 心血管成像
- 核医学就是核医学.
- 心脏外科手术风险评估
背景情况:
- 18-fluorodeoxyglucose正子发射断层扫描/计算机断层扫描 (F18-FDG PET/CT) 是为评估左心室 (LV) 缩功能障碍患者的心肌活力而建立的.
- 确定可行的心肌段可以指导重血管化决策,并通过降低死亡率和发病率来改善预后.
- 目前使用F18-FDG PET/CT用于这些患者的手术前风险分层仍然有限.
研究的目的:
- 用F18-FDG PET/CT.识别的冬眠活力心肌段 (HVM) 来预测外科手术期间的死亡率.
- 将HVM段的预测准确度与在接受冠状动脉旁路移植 (CABG) 的LV功能障碍患者中的EuroSCORE II进行比较.
主要方法:
- 一项前性观察性研究,涉及75名慢性缺血性冠状动脉疾病患者,射出分数≤40%.
- 心肌输液成像 (Tc-99m sesta-methoxyisobutylisonitrile SPECT/CT) 和心肌活力评估 (F18-FDG PET/CT) 在休息状态下进行.
- 通过EuroSCORE II对患者进行了分层,跟踪了CABG后30天的死亡率,并与HVM细分组进行了比较.
主要成果:
- F18-FDG PET/CT确定了<4个HVM段,对预测30天死亡率有85%的灵敏度 (曲线下的面积[AUC]=0.7).
- 欧罗斯科尔II仅显示了28.6%的灵敏度 (AUC = 0.4) 和低估的外科风险.
- 与预测相比,<4个HVM段的患者表现出5倍以上的观察到的死亡风险.
结论:
- 通过F18-FDG PET/CT评估的冬眠活跃心肌段独立预测术后死亡率.
- 将F18-FDG PET/CT可行性评估与EuroSCORE II集成,为LV功能障碍患者的CABG提供了卓越的手术前风险分层.
- 这种综合方法可以提高高风险心脏病患者重新血管化的决策能力.
相关概念视频
Imaging Studies for Cardiovascular System V: CT
45
Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
45
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
42
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
42
Imaging Studies for Cardiovascular System II:Types of Echocardiography
305
Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
305
Acute Coronary Syndrome III: Diagnostic Studies
10
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10
Imaging Studies II: Positron Emission Tomography and Scintigraphy
158
Positron Emission Tomography (PET) is a medical imaging technique that provides crucial insights into the body's physiological functions at a molecular level. It is an indispensable resource for diagnosing, staging, and monitoring various illnesses, notably cancer, neurological disorders, and cardiovascular conditions.
Fundamental Principles of PET
Fundamental Principles of PET
158
Imaging Studies for Cardiovascular System III: X-Ray
219
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
219
![Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography FDG-PET/CT](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F3777.jpg&w=3840&q=50)

