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CT减弱校正改善了肥胖患者的心脏SPECT的定量风险预测

Attila Feher^1,2, Konrad Pieszko³, Aakash Shanbhag³

¹Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, Dana 3, P.O. Box 208017, New Haven, CT, 06520, USA. attila.feher@yale.edu.

European journal of nuclear medicine and molecular imaging

|November 4, 2023

概括

与未经纠正的sTPD (NC-sTPD) 相比,CT减弱校正的压力总 perfusion deficit (AC-sTPD) 在接受SPECT MPI的肥胖患者中更好地预测主要不良心脏事件 (MACE). 这凸显了CT减弱校正对改善心脏风险评估在这个人群中的重要性.

科学领域:

心血管成像 - 心血管成像
核心脏病学核心脏病学
无线电学 (Radiomics) 是一种无线电学.

背景情况:

肥胖与心血管风险增加有关,并可能影响心肌输液成像 (MPI) 的准确性.
电化 (CZT) SPECT/CT MPI用于诊断冠状动脉疾病和评估心脏风险.
精确量化 perfusion 缺陷对于风险分层至关重要.

研究的目的:

为了比较CT减弱校正压力总 perfusion deficit (AC-sTPD) 与非校正压力TPD (NC-sTPD) 在主要心脏不良事件 (MACE) 的预测值.
在接受CZT SPECT MPI的肥胖患者中评估这些指标的预后性能.

主要方法:

分析了4585名接受CZT SPECT/CT MPI治疗的患者队列.
使用生存分析评估了AC-sTPD和NC-sTPD与MACE (死亡率,心肌梗塞,晚期再血管) 的关联.
使用曲线下的面积 (AUC) 和净重新分类指数来评估预测准确度.

主要成果:

在BMI≥35kg/m2的患者中,与NC-sTPD不同的是,AC-sTPD≥3%与明显更差的无MACE存活率相关 (HR:2.23,p=0.002).
在肥胖患者中,AC-sTPD对预测2年MACE的AUC高于NC-sTPD (0.631对0.541,p=0.01).
与NC-sTPD相比,AC-sTPD在BMI≥35kg/m2的患者中提供了显著的增量预后值.

结论:

CT减弱校正显著改善了压力总 perfusion deficit 的预后值,用于对肥胖患者 (BMI ≥ 35 kg/m2) 的 MACE 预测.
在特定的患者群体中,AC-sTPD在识别高风险心脏事件方面优于NC-sTPD.
这些发现强调了CT衰减校正在CZT SPECT MPI中对增强心脏风险分层的临床重要性.

关键词:

减弱校正的纠正减弱校正的纠正混合成像技术混合成像技术心肌输液是心肌输液.肥胖问题肥胖问题预测预后预测预测斯佩克特 (Spectre) 是一个运动场.

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