Roig E, Chomka E V, Castaner A, Campo A, Heras M, Rich S, Brundage B H
Department of Medicine, University of Illinois College of Medicine, Chicago.
J Am Coll Cardiol. 1989 Apr;13(5):1073-81. doi: 10.1016/0735-1097(89)90263-5.
Ultrafast computed tomography permits the assessment of global and regional left ventricular function during exercise. To evaluate the feasibility of using this new technique for the diagnosis of coronary artery disease, 27 patients undergoing cardiac catheterization for diagnosis of chest pain were evaluated. Fifteen patients had significant (greater than 50%) coronary artery stenosis by quantitative coronary angiography. One vessel disease was found in 12 patients and multivessel disease in 3. Fourteen (93%) of the 15 patients with significant coronary stenosis had a decrease in ultrafast computed tomographic ejection fraction during exercise from (mean +/- SD) 65 +/- 7% to 60 +/- 7% (p less than 0.001). The tomographic ejection fraction increased greater than 5% units during exercise in 10 (83%) of the 12 patients with normal coronary arteries. The mean tomographic ejection fraction in this group was 68 +/- 6% at rest and 75 +/- 6% at peak exercise (p less than 0.001). Regional wall motion was quantified by analyzing the segmental ejection fraction of 12 30 degree pie segments at each tomographic level of the left ventricle. A new regional wall motion abnormality developed during exercise in 12 (86%) of 14 patients with coronary artery disease; one patient was excluded because of a technical problem in data storage. Eleven (93%) of the 12 patients with normal coronary arteries had normal wall motion during exercise. In no patient with ischemic heart disease were both variables, ejection fraction response and regional wall motion, normal. Exercise ultrafast computed tomography appears to be a useful technique for the evaluation of coronary artery disease in patients with chest pain and predominant single vessel coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)
超速计算机断层扫描可用于评估运动期间左心室的整体和局部功能。为评估使用这项新技术诊断冠状动脉疾病的可行性，对27例因胸痛接受心脏导管检查的患者进行了评估。通过定量冠状动脉造影，15例患者存在显著（大于50%）的冠状动脉狭窄。12例患者为单支血管病变，3例为多支血管病变。15例有显著冠状动脉狭窄的患者中，14例（93%）运动期间超速计算机断层扫描射血分数从（平均±标准差）65±7%降至60±7%（p<0.001）。12例冠状动脉正常的患者中，10例（83%）运动期间断层射血分数增加超过5个百分点。该组静息时平均断层射血分数为68±6%，运动峰值时为75±6%（p<0.001）。通过分析左心室每个断层水平12个30度扇形节段的节段射血分数来量化局部室壁运动。14例冠状动脉疾病患者中，12例（86%）运动期间出现新的局部室壁运动异常；1例患者因数据存储技术问题被排除。12例冠状动脉正常的患者中，11例（93%）运动期间室壁运动正常。在缺血性心脏病患者中，射血分数反应和局部室壁运动这两个变量均无正常者。运动超速计算机断层扫描似乎是评估胸痛且以单支冠状动脉疾病为主的患者冠状动脉疾病的一种有用技术。（摘要截短至250字）
