Yao S S, Rozanski A
Department of Medicine, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10019, USA.
Prog Cardiovasc Dis. 2001 Jan-Feb;43(4):281-302. doi: 10.1053/pcad.2001.20466.
The use of myocardial perfusion single photon emission computed tomography (SPECT) has undergone considerable expansion and evolution over the past 2 decades. Although myocardial perfusion imaging was first conceived as a noninvasive diagnostic tool for determining the presence or absence of coronary artery disease, its prognostic value is now well established. Thus, identification of patients at risk for future cardiac events has become a primary objective in the noninvasive evaluation of patients with chest pain syndromes and among patients with known coronary artery disease. In particular, the ability of myocardial perfusion SPECT to identify patients at low (< 1%), intermediate (1% to 5%) or high (> 5%) risk for future cardiac events is essential to patient management decisions. Moreover, previous studies have conclusively shown the incremental prognostic value of myocardial perfusion SPECT over clinical and treadmill exercise data in predicting future cardiac events. This report addresses the current role and new developments, with respect to the use of myocardial perfusion imaging, in determining patient risk for cardiac events and the cost-effective integration of such information into patient management decisions.
在过去20年中，心肌灌注单光子发射计算机断层扫描（SPECT）的应用有了显著的扩展和发展。尽管心肌灌注成像最初被视为一种用于确定是否存在冠状动脉疾病的非侵入性诊断工具，但其预后价值现已得到充分确立。因此，识别未来有心脏事件风险的患者已成为胸痛综合征患者和已知冠状动脉疾病患者无创评估的主要目标。特别是，心肌灌注SPECT识别未来心脏事件低风险（<1%）、中风险（1%至5%）或高风险（>5%）患者的能力对于患者管理决策至关重要。此外，先前的研究已确凿表明，在预测未来心脏事件方面，心肌灌注SPECT比临床和跑步机运动数据具有更高的预后价值。本报告阐述了心肌灌注成像在确定患者心脏事件风险方面的当前作用和新进展，以及将此类信息经济有效地整合到患者管理决策中的情况。
