静息及腺苷负荷心肌灌注成像时的QT离散度与心肌危险评分的相关性

QT dispersion at rest and during adenosine stress myocardial perfusion imaging correlation with Myocardial Jeopardy Score.

作者信息

Pradhan J, Vankayala H, Niraj A, Kumaravelu P, Trivedi M, Thatai D, Afonso L

机构信息

Department of Internal Medicine, Wayne State University, Detroit, MI 48201, USA.

出版信息

Clin Cardiol. 2008 May;31(5):205-10. doi: 10.1002/clc.20153.

DOI:10.1002/clc.20153

PMID:18473373

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6653464/

Abstract

BACKGROUND

The usefulness of QT dispersion (QTd) during adenosine myocardial perfusion imaging (MPI) to predict severity of coronary artery disease (CAD) has not been studied.

METHODS

Eighty-eight patients referred for diagnostic cardiac catheterization after abnormal MPI were included. Thirty-four patients with no stenosis (Duke Score = 0) were included in Group 1, and 54 patients with significant CAD (Duke Score > or = 2) formed Group 2. Resting and stress QTd and prolongation in QTd (delta QTd) were measured and evaluated as independent predictors for severity of CAD.

RESULTS

Resting QTd was higher in Group 2 as compared with Group 1. During peak infusion of adenosine, QTd was significantly prolonged in Group 1 but remained unchanged, or fixed, in Group 2. In addition, in patients with significant CAD, resting QTd positively correlated with the Duke Score. On multiple regression analysis; independent predictors for significant CAD (odds ratio [OR], 95% confidence interval [CI], p-value) were resting QTd (4.9, 95% CI 1.1-21.6, < 0.05 for fourth Quartile compared with first Quartile) and delta QTd (4.0, 1.4-11.2, < 0.01 for first and second Quartiles compared with third and fourth Quartiles).

CONCLUSION

In patients with abnormal stress MPI, prolonged resting QTd, and fixation of QTd during stress are independent predictors of significant CAD. In addition, resting QTd correlate with the Duke Jeopardy Score and therefore, may have independent prognostic value.

摘要

背景

腺苷心肌灌注成像（MPI）期间QT离散度（QTd）预测冠状动脉疾病（CAD）严重程度的效用尚未得到研究。

方法

纳入88例MPI异常后接受诊断性心导管检查的患者。第1组纳入34例无狭窄患者（杜克评分=0），第2组纳入54例患有严重CAD的患者（杜克评分≥2）。测量静息和负荷状态下的QTd以及QTd延长值（ΔQTd），并将其评估为CAD严重程度的独立预测指标。

结果

与第1组相比，第2组的静息QTd更高。在腺苷峰值输注期间，第1组的QTd显著延长，而第2组的QTd保持不变或固定。此外，在患有严重CAD的患者中，静息QTd与杜克评分呈正相关。多元回归分析显示；CAD严重程度的独立预测指标（比值比[OR]，95%置信区间[CI]，p值）为静息QTd（4.9，95%CI 1.1-21.6，与第一四分位数相比，第四四分位数的p<0.05）和ΔQTd（4.0，1.4-11.2，与第三和第四四分位数相比，第一和第二四分位数的p<0.01）。