Ozdemir Semra, Yener Ali Ümit, Barutcu Ahmet, Tan Yusuf Z, Çelik Fatmanur
Departments of aNuclear Medicine bCardiovascular Surgery cCardiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
Nucl Med Commun. 2015 Jul;36(7):738-46. doi: 10.1097/MNM.0000000000000309.
In this study, we aimed to assess the presence and prevalence of paradoxical septal motion (PSM) by myocardial perfusion-gated single-photon emission computed tomography (SPECT) imaging in patients undergoing coronary artery bypass grafting (CABG).
A total of 172 patients (145 men and 27 women, with a mean age of 64.81 ± 8.93 years) undergoing CABG surgery were included in the study. All selected scintigraphic studies of the patients undergoing CABG were reprocessed. Semiquantitative interpretation of septal perfusion, wall motion, and wall thickening was performed with QPS and QGS programs. Phase analysis parameters were also obtained using the Emory Cardiac Toolbox. According to myocardial perfusion-gated SPECT results, the patients were trichotomized as follows: group 1 (nonischemic PSM): regular perfusion and thickening of the septal wall and abnormal motion of the septal wall; group 2 (ischemic PSM): abnormal perfusion, motion, and thickening of the septal wall; group 3 (non-PSM): normal perfusion, motion, and thickening of the septal wall. The data in each of the three groups were compared using Student's t-test and one-way analysis of variance.
No PSM (normal perfusion, motion, and thickening of the septal wall) was observed in 19.2% of patients undergoing CABG, whereas nonischemic PSM (regular perfusion and thickening of the septal wall and abnormal motion of the septal wall) was observed in 60.5% of patients and ischemic PSM (abnormal perfusion, motion and thickening of the septal wall) was seen in 20.3% of patients.
According to our study results, PSM is fairly common in patients undergoing CABG. It will be beneficial to use myocardial perfusion scintigraphy-gated SPECT, which is a noninvasive examination method, to identify the presence of PSM and investigate whether it is accompanied by ischemia or infarction.
在本研究中，我们旨在通过心肌灌注门控单光子发射计算机断层扫描（SPECT）成像评估冠状动脉旁路移植术（CABG）患者中矛盾性室间隔运动（PSM）的存在情况和患病率。
本研究纳入了172例行CABG手术的患者（145例男性和27例女性，平均年龄64.81±8.93岁）。对所有入选的行CABG患者的闪烁扫描研究进行重新处理。使用QPS和QGS程序对室间隔灌注、室壁运动和室壁增厚进行半定量分析。还使用埃默里心脏工具箱获得相位分析参数。根据心肌灌注门控SPECT结果，将患者分为三组：第1组（非缺血性PSM）：室间隔壁灌注和增厚正常，但室间隔壁运动异常；第2组（缺血性PSM）：室间隔壁灌注、运动和增厚均异常；第3组（非PSM）：室间隔壁灌注、运动和增厚均正常。使用学生t检验和单因素方差分析对三组中的数据进行比较。
19.2%的行CABG患者未观察到PSM（室间隔壁灌注、运动和增厚正常），而60.5%的患者观察到非缺血性PSM（室间隔壁灌注和增厚正常，但室间隔壁运动异常），20.3%的患者观察到缺血性PSM（室间隔壁灌注、运动和增厚均异常）。
根据我们的研究结果，PSM在行CABG的患者中相当常见。使用心肌灌注闪烁扫描门控SPECT这种无创检查方法来识别PSM的存在并研究其是否伴有缺血或梗死将是有益的。
