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pozitron发射断层心肌 perfusion 成像对患者选择再血管化的影响
Krishna K Patel1, A Iain McGhie2, Kevin F Kennedy2
1Icahn School of Medicine at Mount Sinai, New York, New York, USA; Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
阳位子发射断层扫描 (PET) 心肌输液成像 (MPI) 显示,缺少左心室喷射分数 (LVEF) 储备可以确定受益于再血管化的患者. 这一发现对没有先前冠状动脉疾病的患者尤为重要.
科学领域:
- 心脏病学 心脏病学
- 核医学就是核医学.
- 医疗成像医学成像
背景情况:
- 阳位子发射断层扫描 (PET) 心肌 perfusion 影像 (MPI) 量化左心室喷射率 (LVEF) 在峰值应力.
- PET LVEF 储备 (LVEF-R) 在心血管评估中具有诊断和预后价值.
研究的目的:
- 确定PET LVEF 储备 (LVEF-R) 是否识别了在重血管化后生存率改善的患者.
- 在接受PET MPI的患者中评估LVEF-R的预后意义.
主要方法:
- 对14649名接受82Rb休息/压力PET MPI的患者进行了回顾性分析.
- 调整后的考克斯模型评估了LVEF-R,已知的冠状动脉疾病 (CAD) 和90天再血管化结果之间的关系.
- 这项研究排除了已知心肌病患者.
主要成果:
- 在已知CAD,LVEF-R和90天再血管化 (P = 0.025) 之间发现了显著的三向相互作用.
- 在没有先前CAD的患者中,LVEF-R ≤0确定的患者从90天的再血管化中获得生存益处 (相互作用P = 0.005).
- 这种预后值独立于缺血百分比和心肌流量储备.
结论:
- 在PET MPI上血管扩张应激期间缺乏LVEF增高或LVEF下降,可以识别出及时重血管化的受益患者.
- 这一发现在没有心肌梗塞史或先前再血管化的患者中具有意义.
- 用PET对缺血的多参数评估可以优化成像后的患者管理.
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