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使用新型非成像探测器对左心室功能进行连续在线监测:血管成形术后患者评估中的验证及临床应用

Continuous on-line monitoring of left ventricular function with a new nonimaging detector:validation and clinical use in the evaluation of patients post angioplasty.

作者信息

Breisblatt W M, Schulman D S, Follansbee W P

机构信息

Division of Cardiology, University of Pittsburgh School of Medicine, PA.

出版信息

Am Heart J. 1991 Jun;121(6 Pt 1):1609-17. doi: 10.1016/0002-8703(91)90003-z.

Abstract

A new miniaturized nonimaging radionuclide detector (Cardioscint, Oxford, England) was evaluated for the continuous on-line assessment of left ventricular function. This cesium iodide probe can be placed on the patient's chest and can be interfaced to an IBM compatible personal computer conveniently placed at the patient's bedside. This system can provide a beat-to-beat or gated determination of left ventricular ejection fraction and ST segment analysis. In 28 patients this miniaturized probe was correlated against a high resolution gamma camera study. Over a wide range of ejection fraction (31% to 76%) in patients with and without regional wall motion abnormalities, the correlation between the Cardioscint detector and the gamma camera was excellent (r = 0.94, SEE +/- 2.1). This detector system has high temporal (10 msec) resolution, and comparison of peak filling rate (PFR) and time to peak filling (TPFR) also showed close agreement with the gamma camera (PFR, r = 0.94, SEE +/- 0.17; TPFR, r = 0.92, SEE +/- 6.8). In 18 patients on bed rest the long-term stability of this system for measuring ejection fraction and ST segments was verified. During the monitoring period (108 +/- 28 minutes) only minor changes in ejection fraction occurred (coefficient of variation 0.035 +/- 0.016) and ST segment analysis showed no significant change from baseline. To determine whether continuous on-line measurement of ejection fraction would be useful after coronary angioplasty, 12 patients who had undergone a successful procedure were evaluated for 280 +/- 35 minutes with the Cardioscint system.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

一种新型的小型非成像放射性核素探测器(心脏闪烁探测器,牛津,英国)被用于评估左心室功能的连续在线监测。这种碘化铯探头可放置在患者胸部,并能方便地与置于患者床边的IBM兼容个人计算机连接。该系统能逐搏或门控测定左心室射血分数并进行ST段分析。在28例患者中,将这种小型探头与高分辨率γ相机检查结果进行了对比。在有和没有节段性室壁运动异常的患者中,在很宽的射血分数范围(31%至76%)内,心脏闪烁探测器与γ相机之间的相关性非常好(r = 0.94,标准误±2.1)。该探测器系统具有高时间分辨率(10毫秒),峰值充盈率(PFR)和达到峰值充盈时间(TPFR)的比较也显示与γ相机结果高度一致(PFR,r = 0.94,标准误±0.17;TPFR,r = 0.92,标准误±6.8)。在18例卧床休息的患者中,验证了该系统测量射血分数和ST段的长期稳定性。在监测期间(108±28分钟),射血分数仅发生轻微变化(变异系数0.035±0.016),ST段分析显示与基线相比无显著变化。为了确定冠状动脉成形术后连续在线测量射血分数是否有用,使用心脏闪烁探测器系统对12例手术成功的患者进行了280±35分钟的评估。(摘要截短于250字)

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