心电图门控（82）铷心肌灌注PET中左心室射血分数对血管扩张剂应激反应的决定因素。
Determinants of the response of left ventricular ejection fraction to vasodilator stress in electrocardiographically gated (82)rubidium myocardial perfusion PET.
作者信息
Brown Tracy L Y, Merrill Jennifer, Volokh Lana, Bengel Frank M
机构信息
Department of Radiology and Radiological Sciences, Division of Nuclear Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
出版信息
Eur J Nucl Med Mol Imaging. 2008 Feb;35(2):336-42. doi: 10.1007/s00259-007-0603-2. Epub 2007 Oct 2.
PURPOSE
Myocardial perfusion imaging with (82)Rb PET allows for ECG-gated studies to be obtained early after radiotracer injection, capturing ventricular function close to peak pharmacologic action of dipyridamole. This is different from gated SPECT and may potentially provide additional diagnostic information. We sought to identify potential correlates of the PET-derived ejection fraction response to vasodilator stress.
METHODS
One hundred ten consecutive patients undergoing (82)Rb PET myocardial perfusion imaging during evaluation for coronary artery disease were included. Using a GE Discovery STRx PET-CT scanner, ECG-gated images (eight bins) were obtained at rest and 4 min after dipyridamole infusion, 90 s after infusion of 1,480-2,220 MBq of (82)Rb. Summed rest, stress, and difference scores (SRS, SSS, and SDS) were determined using a five-point scoring system and 20-segment model. Ejection fraction was calculated using automated QGS software.
RESULTS
Significant reversibility (SDS > or = 4) was found in 23 patients (21%). Mean LVEF in all patients was 47 +/- 13% at rest and 53 +/- 13% during dipyridamole. LVEF increased in 89 patients, and decreased in 17 patients during vasodilation. The change in LVEF was inversely correlated with SDS (r = -0.26; p = 0.007). Additionally, it was inversely correlated with resting LVEF (r = -0.20; p = 0.03) and SSS (r = -0.25; p = 0.009). No significant correlations were observed with SRS, heart rate, blood pressure, age, hypertension, hypercholesterolemia, or pretest likelihood of disease. At multivariate regression analysis, SDS was an independent predictor of the change in LVEF.
CONCLUSIONS
Gated (82)Rb PET during pharmacologic stress allows for assessment of the functional response to vasodilation. The magnitude of LVEF increase is determined by stress perfusion/reversible perfusion defects. Functional response to hyperemia may thus be incorporated in future evaluations of diagnostic and prognostic algorithms based on (82)Rb PET.
目的
用（82）Rb正电子发射断层显像（PET）进行心肌灌注成像可在注射放射性示踪剂后早期获得心电图门控研究，捕捉接近双嘧达莫最大药理作用时的心室功能。这与门控单光子发射计算机断层显像（SPECT）不同，可能会提供额外的诊断信息。我们试图确定PET衍生的射血分数对血管扩张应激反应的潜在相关因素。
方法
纳入110例在评估冠状动脉疾病期间接受（82）Rb PET心肌灌注成像的连续患者。使用GE Discovery STRx PET-CT扫描仪，在静息状态下以及静脉输注双嘧达莫后4分钟、输注1480 - 2220 MBq（82）Rb后90秒获取心电图门控图像（8个时段）。使用五点评分系统和20节段模型确定静息、应激和差值评分（SRS、SSS和SDS）。使用自动QGS软件计算射血分数。
结果
23例患者（21%）发现有显著的可逆性（SDS≥4）。所有患者静息时的平均左心室射血分数（LVEF）为47±13%，双嘧达莫注射期间为53±13%。血管扩张期间，89例患者的LVEF升高，17例患者的LVEF降低。LVEF的变化与SDS呈负相关（r = -0.26；p = 0.007）。此外，它与静息LVEF（r = -0.20；p = 0.
Zotero 插件