通过定量心电图门控单光子发射计算机断层扫描评估左心室收缩/舒张功能：与超声心动图和血浆脑钠肽分析的比较

Left ventricular systolic/diastolic function evaluated by quantitative ECG-gated SPECT: comparison with echocardiography and plasma BNP analysis.

作者信息

Nakae Ichiro, Matsuo Shinro, Koh Terue, Mitsunami Kenichi, Horie Minoru

机构信息

Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta, Otsu 520-2192, Japan.

出版信息

Ann Nucl Med. 2005 Sep;19(6):447-54. doi: 10.1007/BF02985571.

DOI:10.1007/BF02985571

PMID:16248380

Abstract

OBJECTIVE

The aim of this study was to evaluate the left ventricular (LV) functional parameters calculated using quantitative electrocardiography (ECG)-gated myocardial perfusion single photon emission computed tomography (QGS). In addition to LV systolic parameters, diastolic parameters were compared with those by ultrasound echocardiography (UCG) and also with plasma B-type natriuretic peptide (BNP) concentrations.

METHODS

We examined 46 patients with various forms of heart disease. By the QGS data with 16 framing data acquisition using technetium (Tc)-99m methoxyisobutylisonitrile (MIBI) perfusion, we calculated the following parameters: LV end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), peak filling rate (PFR), filling rate during the first third of the filling time (1/3FR) and first third filling fraction (1/3FF). By UCG, we measured mitral early to atrial (E/A) wave velocity ratio and pulmonary venous inflow systolic/diastolic (S/D) ratio as diastolic functional parameters. Plasma BNP concentrations were also measured.

RESULTS

There was a significant correlation between LVEDV, ESV and EF measured by QGS and UCG (EDV, r = 0.71, p < 0.001; ESV, r = 0.82, p < 0.001; EF, r = 0.75, p < 0.001). The PFR, 1/3FR and 1/3FF obtained by QGS correlated positively with E/A ratio (PFR, r = 0.54, p < 0.001; 1/3FR, r = 0.61, p < 0.001; 1/3FF, r = 0.42, p < 0.01) and negatively with S/D ratio (PFR, r = -0.40, p < 0.01; 1/3FR, r = -0.38, p < 0.05; 1/3FF, r = -0.39, p < 0.01) obtained by UCG. Plasma BNP concentrations in EF < 50% patients were greater than those in EF > or = 50% patients (335.2 +/- 60.2 vs. 101.2 +/- 41.3 pg/ml, p < 0.01, both n = 17). Plasma BNP levels were also compared between higher and lower 1/3FF patients matched for LVEF. Plasma BNP concentrations in 1/3FF < 35% patients were significantly greater than those in 1/3FF > or = 35% patients (312.9 +/- 62.5 vs. 120.5 +/- 32.8 pg/ml, p < 0.05, both n = 14).

CONCLUSIONS

The degree of LV systolic and diastolic dysfunctions evaluated by QGS correlated with that by UCG or BNP. The QGS functional parameters offer useful information regarding cardiac failure.

摘要

目的

本研究旨在评估使用定量心电图（ECG）门控心肌灌注单光子发射计算机断层扫描（QGS）计算的左心室（LV）功能参数。除左心室收缩参数外，还将舒张参数与超声心动图（UCG）测量的参数以及血浆B型利钠肽（BNP）浓度进行比较。

方法

我们检查了46例患有各种形式心脏病的患者。通过使用锝（Tc）-99m甲氧基异丁基异腈（MIBI）灌注进行16帧数据采集的QGS数据，我们计算了以下参数：左心室舒张末期容积（EDV）、收缩末期容积（ESV）、射血分数（EF）、峰值充盈率（PFR）、充盈时间前三分之一期间的充盈率（1/3FR）和前三分之一充盈分数（1/3FF）。通过UCG，我们测量二尖瓣早期与心房（E/A）波速度比值以及肺静脉血流收缩期/舒张期（S/D）比值作为舒张功能参数。还测量了血浆BNP浓度。

结果

QGS和UCG测量的左心室舒张末期容积、收缩末期容积和射血分数之间存在显著相关性（舒张末期容积，r = 0.71，p < 0.001；收缩末期容积，r = 0.82，p < 0.001；射血分数，r = 0.75，p < 0.001）。QGS获得的峰值充盈率、1/3FR和1/3FF与E/A比值呈正相关（峰值充盈率，r = 0.54，p < 0.001；1/3FR，r = 0.61，p < 0.001；1/3FF，r = 0.42，p < 0.01），与UCG获得的S/D比值呈负相关（峰值充盈率，r = -0.40，p < 0.01；1/3FR，r = -0.38，p < 0.05；1/3FF，r = -0.39，p < 0.01）。射血分数<50%的患者血浆BNP浓度高于射血分数≥50%的患者（335.2±60.2对101.2±41.3 pg/ml，p < 0.01，两组n = 17）。还比较了左心室射血分数匹配的前三分之一充盈分数较高和较低患者的血浆BNP水平。前三分之一充盈分数<35%的患者血浆BNP浓度显著高于前三分之一充盈分数≥35%的患者（312.9±62.5对120.5±32.8 pg/ml, p < 0.05，两组n = 14）。