DPD量化的预后影响 transthyretin 心脏粉症
René Rettl1, Franz Duca1, Christina Kronberger1
1Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
量化心脏[99mTc]-3,3-二相-1,2-propanodicarboxylic 酸 (DPD) 吸收在心脏氨基粉症中 (ATTR-CA) 揭示了晚期疾病的严重程度. 较高的DPD吸收与心脏功能低下和不良结果有关,有助于预后分层.
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:
- 晶氨酸心肌粉症 (ATTR-CA) 是一种影响心脏的渐进性疾病.
- 准确的诊断和预后对于管理ATTR-CA.至关重要.
- 在ATTR-CA诊断中使用心脏[99mTc]-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) 扫描仪.
研究的目的:
- 评估左心室 (LV) DPD摄入量与ATTR-CA患者心肌结构/功能之间的关联.
- 评估量化LV DPD吸收对患者结局的预后影响.
主要方法:
- 分析了100名具有Perugini级别2或3 DPD吸收的ATTR-CA患者.
- 进行了定量DPD单光子发射计算机断层扫描/计算机断层扫描 (SPECT/CT) 和斑点跟踪心声扫描.
- 患者被分为低 (≤5.4) 和高 (>5.4) DPD保留指数队列.
主要成果:
- DPD保留指数与LV全球纵向菌株 (LV-GLS),右心室自由壁纵向菌株 (RV-FW-LS),LV静脉功能,NT-proBNP,Troponin T,6分钟步行距离 (6MWD) 和国家粉症中心 (NAC) 阶段相关.
- 患有高DPD的患者表现出更严重的心脏功能障碍,生物标志物升高,运动能力降低和疾病晚期.
- 高度的DPD吸收与不良结果相关,包括全因死亡或心力衰竭住院治疗 (HR: 2.873,P = 0.003).
结论:
- 在ATTR-CA中提升的定量LV DPD吸收表明疾病严重程度已晚.
- 定量DPD吸收是ATTR-CA患者预后分层的一个有价值的工具.
- DPD量化有助于识别患有不良事件风险较高的患者.
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