Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts; and.
J Nucl Med. 2013 Oct;54(10):1748-54. doi: 10.2967/jnumed.113.120063. Epub 2013 Aug 12.
Our objective was to study the diagnostic performance of regadenoson (82)Rb myocardial perfusion PET imaging to detect obstructive coronary artery disease (CAD).
We studied 134 patients (mean age, 63 ± 12 y; mean body mass index, 31 ± 9 kg/m(2)) without known CAD (96 with coronary angiography and 38 with low pretest likelihood of CAD). Stress left ventricular ejection fraction (LVEF) minus rest LVEF defined LVEF reserve. The Duke score was used to estimate the anatomic extent of jeopardized myocardium.
Regadenoson PET had a high sensitivity, 92% (95% confidence interval [CI], 83%-97%), in detecting obstructive CAD, with a normalcy rate of 97% (95% CI, 86%-99%), specificity of 77% (54/70 patients; 95% CI, 66%-86%), and area under the receiver-operator-characteristic curve of 0.847 (95% CI, 0.774-0.903; P < 0.001). Regadenoson PET demonstrated high sensitivity to detect CAD in patients with single-vessel CAD (89%; 95% CI, 70%-98%). The mean LVEF reserve was significantly higher in patients with normal myocardial perfusion imaging results (6.5% ± 5.4%) than in those with mild (4.3 ± 5.1, P = 0.03) and moderate to severe reversible defects (-0.2% ± 8.4%, P = 0.001). Also, mean LVEF reserve was significantly higher in patients with a low likelihood of CAD (7.2% ± 4.5%, P < 0.0001) and mild or moderate jeopardized myocardium than in those with significant jeopardized myocardium (score ≥ 6), -2.8% ± 8.3%.
Regadenoson (82)Rb myocardial perfusion imaging is accurate for the detection of obstructive CAD. LVEF reserve is high in patients without significant ischemia or significant angiographic jeopardized myocardium.
我们的目的是研究雷加登松（82）Rb 心肌灌注 PET 成像在检测阻塞性冠状动脉疾病（CAD）中的诊断性能。
我们研究了 134 例无已知 CAD 的患者（平均年龄 63 ± 12 岁；平均体重指数 31 ± 9 kg/m2），其中 96 例进行了冠状动脉造影检查，38 例进行了低 CAD 术前可能性检查。压力左心室射血分数（LVEF）减去休息 LVEF 定义 LVEF 储备。Duke 评分用于估计受危心肌的解剖范围。
雷加登松 PET 在检测阻塞性 CAD 方面具有高灵敏度，92%（95%置信区间[CI]，83%-97%），正常率为 97%（95%CI，86%-99%），特异性为 77%（54/70 例患者；95%CI，66%-86%），受体操作特征曲线下面积为 0.847（95%CI，0.774-0.903；P<0.001）。雷加登松 PET 在单支 CAD 患者中具有较高的 CAD 检测灵敏度（89%；95%CI，70%-98%）。心肌灌注成像结果正常的患者的平均 LVEF 储备明显更高（6.5%±5.4%），而轻度（4.3 ± 5.1，P=0.03）和中度至重度可逆性缺陷患者（-0.2%±8.4%，P=0.001）。此外，低 CAD 可能性患者（7.2%±4.5%，P<0.0001）和轻度或中度受危心肌患者的平均 LVEF 储备明显高于严重受危心肌患者（评分≥6），为-2.8%±8.3%。
雷加登松（82）Rb 心肌灌注成像可准确检测阻塞性 CAD。无明显缺血或明显血管造影受危心肌的患者 LVEF 储备较高。
