Molecular Function and Imaging Program, The National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute and the University of Ottawa, Ottawa, Ontario, Canada.
Can J Cardiol. 2012 Jan-Feb;28(1):54-61. doi: 10.1016/j.cjca.2011.09.012. Epub 2011 Dec 3.
Patients with left ventricular dysfunction whose management is directed by F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging may have a quality of life (QOL) benefit over standard care.
Among 430 patients randomized in the PET and Recovery Following Revascularization (PARR)-2 trial to FDG PET-assisted management vs standard, QOL scores were obtained using the European Quality of Life-5 Dimensions (EQ-5D) in 427 patients at baseline (FDG PET n = 216; standard n = 211) and 355 patients at 12-month follow-up (FDG PET n = 184; standard n = 171). EQ-5D scores between FDG PET and standard arms were compared using mixed model repeated measures (MMRM). Subgroup analysis compared EQ-5D scores between patients in FDG PET who adhered to PET recommendations (Adherence) vs standard using MMRM. Interaction of revascularization with management was assessed using a general linear model.
A trend toward higher EQ-5D scores in FDG PET was observed (P = 0.056). Subgroup analysis showed a significant difference favouring adherence (P = 0.04). Higher QOL at 6 months for FDG PET (P = 0.02) and Adherence (P = 0.02) were observed. For revascularization, an interaction with management (FDG PET vs standard) for QOL was observed (6 months: P = 0.01; 12 months: P = 0.1); Adherence (6 months: P = 0.01; 12 months: P = 0.1).
FDG PET-directed management improves QOL, at least in the short-term and with adherence to recommendations. This may relate to revascularization, and may indicate better treatment selection using FDG PET.
通过 F-18-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）成像指导左心室功能障碍患者的治疗，其生活质量（QOL）可能优于标准治疗。
在 PET 和再血管化后恢复（PARR）-2 试验中，430 名患者随机分为 FDG PET 辅助管理组和标准治疗组，其中 427 名患者在基线时（FDG PET 组 n=216，标准治疗组 n=211）和 355 名患者在 12 个月时（FDG PET 组 n=184，标准治疗组 n=171）获得了欧洲生活质量 5 维度（EQ-5D）评分。采用混合模型重复测量（MMRM）比较 FDG PET 和标准组之间的 EQ-5D 评分。采用 MMRM 比较 FDG PET 组中遵守 PET 建议的患者（依从性）与标准组之间的 EQ-5D 评分。采用一般线性模型评估血管重建术与治疗的交互作用。
FDG PET 组的 EQ-5D 评分呈上升趋势（P=0.056）。亚组分析显示，依从性显著优于标准治疗（P=0.04）。6 个月时 FDG PET（P=0.02）和依从性（P=0.02）的 QOL 更高。对于血管重建术，观察到与治疗的交互作用（FDG PET 与标准）对 QOL 的影响（6 个月：P=0.01；12 个月：P=0.1）；依从性（6 个月：P=0.01；12 个月：P=0.1）。
FDG PET 指导的治疗可改善 QOL，至少在短期和遵守建议的情况下如此。这可能与血管重建术有关，并且可能表明使用 FDG PET 进行更好的治疗选择。
