Zavadovsky Konstantin V, Krivonogov Nikolay G, Lishmanov Yuri B
Nuclear Medicine Department, Federal State Budgetary Institution "Research Institute for Cardiology" of Siberian Branch under the Russian Academy of Medical Science, 111a Kievskaya Str., Tomsk, 634012, Russia,
Ann Nucl Med. 2014 Aug;28(7):632-7. doi: 10.1007/s12149-014-0861-6. Epub 2014 Jun 6.
According to the international registry ICOPER, right ventricular (RV) dysfunction is the most significant predictor of mortality in patients with pulmonary embolism (PE).
To identify the most informative indicators of gated blood pool single photon emission computer tomography (GBP-SPECT) for evaluation of RV function in patients with PE.
A total of 52 patients were included in the study. The main group (n = 37) comprised patients with PE, and the comparison group (n = 15) patients suffering from coronary heart disease (NYHA class I-II). All patients received GBP-SPECT, and assessment of plasma levels of endothelin-1, stable nitric oxide (NO) metabolites, and 6-keto-PG F1α.
In patients with PE, RV end-systolic volume, stroke volume, ejection fraction, peak ejection rate, peak filling rate, and mean filling rate were significantly lower in comparison with patients without PE. In patients with PE, the levels of endothelin-1, 6-keto-PG F1α, and stable NO metabolites were increased in comparison with patients without PE.
GBP-SPECT facilitates verification of RV dysfunction in patients without massive PE or severe pulmonary hypertension. Dissociation between the volume of PE and degree of RV dysfunction may be caused by an unbalance between humoral vasoactive factors.
根据国际登记处ICOPER的数据，右心室（RV）功能障碍是肺栓塞（PE）患者死亡率的最重要预测指标。
确定门控心血池单光子发射计算机断层扫描（GBP-SPECT）用于评估PE患者右心室功能的最具信息量的指标。
本研究共纳入52例患者。主要组（n = 37）包括PE患者，比较组（n = 15）为患有冠心病（纽约心脏协会I-II级）的患者。所有患者均接受GBP-SPECT检查，并评估血浆内皮素-1、稳定型一氧化氮（NO）代谢产物和6-酮-前列腺素F1α的水平。
与无PE的患者相比，PE患者的右心室收缩末期容积、每搏输出量、射血分数、峰值射血率、峰值充盈率和平均充盈率显著降低。与无PE的患者相比，PE患者的内皮素-1、6-酮-前列腺素F1α和稳定型NO代谢产物水平升高。
GBP-SPECT有助于在无大面积PE或严重肺动脉高压的患者中验证右心室功能障碍。PE体积与右心室功能障碍程度之间的分离可能是由体液血管活性因子失衡引起的。
