Candell-Riera J, Llevadot J, Santana C, Castell J, Aguadé S, Armadans L, Bermejo B, Oller G, García-del-Castillo H, Soler-Peter M, Soler-Soler J
Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
J Nucl Cardiol. 2001 Mar-Apr;8(2):122-8. doi: 10.1067/mnc.2001.109928.
We evaluate the prognostic value of stress echo and gated single photon emission computed tomography (SPECT) after a first uncomplicated acute myocardial infarction.
We used predischarge maximal subjective exercise echocardiography and gated SPECT with technetium 99m tetrofosmin to prospectively study 103 patients younger than 70 years with a first acute myocardial infarction. During a 12-month follow-up period, 2 patients died, 9 had heart failure, and 29 had ischemic complications (4 reinfarction and 25 angina). Predictive variables for heart failure in multivariate analysis were ejection fraction evaluated by echocardiography (odds ratio [OR] 8.5, P =.016) or by gated SPECT (OR 10.7, P =.009). Predictive variables for ischemic complications in multivariate analysis were less than 5 metabolic equivalents (METS) in exercise test (OR 5.2, P =.007) and greater than 15% ischemic extent in the polar map (OR 3.6, P =.04) of SPECT.
Exercise echocardiography and Tc-99m tetrofosmin gated SPECT were predictive for heart failure, but exercise SPECT was the only test with predictive power for ischemic complications.
我们评估了首次无并发症急性心肌梗死后负荷超声心动图和门控单光子发射计算机断层扫描（SPECT）的预后价值。
我们采用出院前最大主观运动超声心动图和锝99m替曲膦门控SPECT对103例年龄小于70岁的首次急性心肌梗死患者进行前瞻性研究。在12个月的随访期内，2例患者死亡，9例发生心力衰竭，29例发生缺血性并发症（4例再梗死和25例心绞痛）。多因素分析中，心力衰竭的预测变量为超声心动图评估的射血分数（比值比[OR]8.5，P = 0.016）或门控SPECT评估的射血分数（OR 10.7，P = 0.009）。多因素分析中，缺血性并发症的预测变量为运动试验中小于5代谢当量（METS）（OR 5.2，P = 0.007）和SPECT极坐标图中缺血范围大于15%（OR 3.6，P = 0.04）。
运动超声心动图和锝99m替曲膦门控SPECT对心力衰竭具有预测价值，但运动SPECT是唯一对缺血性并发症具有预测能力的检查。
