[利用心电图门控心肌灌注单光子发射计算机断层扫描评估小心脏的左心室舒张功能：与超声心动图的比较]
[Assessment of Left Ventricular Diastolic Function Using ECG-gated Myocardial Perfusion SPECT in Small Heart: Comparison with Ultrasound Echocardiography].
作者信息
Chono Taiki, Onoguchi Masahisa, Hashimoto Akiyoshi
机构信息
Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital.
Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University.
出版信息
Nihon Hoshasen Gijutsu Gakkai Zasshi. 2018;74(6):572-579. doi: 10.6009/jjrt.2018_JSRT_74.6.572.
BACKGROUND
Assessment of left ventricular (LV) diastolic function is important because it is possible to detect early sign of myocardial ischemia by this assessment. The purpose of this study was to compare between electrocardiogram (ECG) -gated myocardial perfusion single photon emission computed tomography (G-SPECT) and ultrasound echocardiography in assessment of LV diastolic function in the small heart (SH).
METHODS
The study population consisted of 144 patients who underwent both G-SPECT and ultrasound echocardiography. Peak filling rate (PFR), one-third mean filling rate (1/3 MFR) and the ratio of time to PFR to the RR interval (TPFR/RR) were calculated by quantitative gated SPECT (QGS) and heart risk view-F (HRV-F). Peak early mitral annular velocity (e') was used as the reference standard of LV diastolic function.
RESULTS
There were 33 patients with end-systolic volume (ESV) of ≤10 ml (SH10), 51 patients with ESV of 11-20 ml (SH 20) and 60 patients with ESV of >20 ml (normal-sized heart: NH). In SH10, PFR calculated by QGS was not correlated with e'. However, that by HRV-F was significantly correlated with e' (r=0.47, p=0.006). On the other hand, 1/3 MFR and TPFR/RR calculated by QGS and HRV-F were not correlated with e' in SH10 and SH20. PFR, 1/3 MFR and TPFR/RR calculated by QGS and HRV-F were correlated with e' in NH.
背景
左心室舒张功能评估很重要，因为通过该评估有可能检测到心肌缺血的早期迹象。本研究的目的是比较心电图（ECG）门控心肌灌注单光子发射计算机断层扫描（G-SPECT）和超声心动图在评估小心脏（SH）左心室舒张功能方面的差异。
方法
研究人群包括144例4名同时接受G-SPECT和超声心动图检查的患者。通过定量门控SPECT（QGS）和心脏风险视图-F（HRV-F）计算峰值充盈率（PFR）、三分之一平均充盈率（1/3 MFR）以及达到PFR的时间与RR间期的比值（TPFR/RR）。二尖瓣环早期峰值速度（e'）用作左心室舒张功能的参考标准。
结果
有33例患者的收缩末期容积（ESV）≤10 ml（SH10），51例患者的ESV为11 - 20 ml（SH20），60例患者的ESV>20 ml（正常大小心脏：NH）。在SH10中，QGS计算的PFR与e'不相关。然而，HRV-F计算的PFR与e'显著相关（r = 0.47，p = 0.006）。另一方面，在SH10和SH20中，QGS和HRV-F计算的1/3 MFR和TPFR/RR与e'不相关。在NH中，QGS和HRV-F计算的PFR、1/3 MFR和TPFR/RR与e'相关。
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