Ahmad M, Logan K W, Martin R H
Am J Cardiol. 1979 Jul;44(1):13-7. doi: 10.1016/0002-9149(79)90244-3.
Thirty survivors of acute myocardial infarction with 3+ or 4+ positive technetium-99m pyrophosphate myocardial scintigrams were followed up for 28 +/- 3.1 months (mean +/- standard deviation). Three patient groups were identified from the pattern of radioactive uptake in the scintigram: Group I, 16 patients with focal uptake (anterior in 7, lateral in 2, posterior in 3 and inferior in 4); Group II, 6 patients with anterior myocardial infarction and a doughnut pattern of uptake; Group III, 8 patients with nontransmural myocardial infarction and a diffuse pattern of uptake. Late complications developed in all patients with the doughnut pattern of uptake compared with 43 percent of patients with the focal pattern and 12 percent of patients with the diffuse pattern. After discharge from the hospital, five of six patients with a doughnut pattern of uptake died (mean survival time 9.8 months after the initial myocardial infarction). This mortality rate (83 percent) was significantly greater than that of patients with a focal (mortality rate 6 percent) or diffuse (no mortality) pattern of uptake. The doughnut pattern of technetium-99m pyrophosphate myocardial uptake in patients with acute myocardial infarction appears to identify a subgroup of patients with a very poor long-term prognosis.
对30例急性心肌梗死幸存者进行了随访，这些患者的锝-99m焦磷酸盐心肌闪烁扫描结果为3+或4+阳性，随访时间为28±3.1个月（均值±标准差）。根据闪烁扫描图上放射性摄取模式确定了三组患者：第一组，16例有局灶性摄取（7例在前壁，2例在侧壁，3例在后壁，4例在下壁）；第二组，6例有前壁心肌梗死且摄取呈环形模式；第三组，8例有非透壁性心肌梗死且摄取呈弥漫性模式。与局灶性摄取模式患者中的43%和弥漫性摄取模式患者中的12%相比，所有摄取呈环形模式的患者均出现了晚期并发症。出院后，摄取呈环形模式的6例患者中有5例死亡（首次心肌梗死后平均生存时间为9.8个月）。该死亡率（83%）显著高于局灶性摄取模式患者（死亡率6%）或弥漫性摄取模式患者（无死亡）。急性心肌梗死患者中锝-99m焦磷酸盐心肌摄取呈环形模式似乎确定了一组长期预后非常差的患者亚组。
