门控 SPECT 评估的左心室不同步和室壁运动异常作为缺血性辅助标志物。
Left ventricular dyssynchrony and abnormalities in wall motion, assessed by gated-SPECT as ischemic auxiliary markers.
机构信息
Department of Nuclear Cardiology, Hospital Italiano de La Plata, La Plata, Argentina.
Departament of Nuclear Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No 1, Colonia Sección XVI, Del. Tlalpan, 14080, Mexico City, Mexico.
出版信息
J Nucl Cardiol. 2020 Dec;27(6):2261-2268. doi: 10.1007/s12350-018-01544-4. Epub 2018 Dec 4.
INTRODUCTION
Left ventricular dyssynchrony (LVD) quantified by gated myocardial perfusion studies (MPS), through phase analysis (PA), has shown controversial results in myocardial stunning.
OBJECTIVES
Assessment of LVD and regional wall motion abnormalities (RWMA) in normal and ischemic patients.
METHODS
A cohort of 172 patients were studied. Summed Stress Score (SSS), Summed Resting Score (SRS), and Summed Difference Score (SDS) were evaluated. Group 1-patients with normal MPS (N = 133) and Group 2-patients with myocardial ischemia in the MPS (N = 39). LVD was evaluated through PA and RWM by visual analysis.
RESULTS
SSS 0 vs 9.8 ± 3.9 P = .0001; SDS 0 vs 9.8 ± 3.9 P = .0001; SRS 0 vs 0 P = NS, in G1 and G2. Significant differences were found in LVD between G1 and G2, bandwidth 36 ± 14 vs 63 ± 46 P = .0001; standard deviation 16 ± 10 vs 26 ± 15 P = .0001. In G1, 16% had LVD vs RWMA in 0%, P = .0001 and in G2, 59% with LVD vs 33% with RWMA, P = .03. Sensitivity for LVD 59% and for RWMA 33%, P = .03 and specificity for LVD 83% and for RWMA 100%, P = .0001.
CONCLUSION
Ischemic patients have LVD post-stress due to myocardial stunning. LVD measured by PA could be a useful tool to identify ischemia.
简介
通过相位分析（PA）对门控心肌灌注研究（MPS）量化的左心室不同步（LVD）在心肌顿抑中显示出有争议的结果。
目的
评估正常和缺血患者的 LVD 和局部壁运动异常（RWMA）。
方法
研究了 172 例患者。评估了总和应激评分（SSS）、总和静息评分（SRS）和总和差评分（SDS）。第 1 组-门控心肌灌注研究正常的患者（N=133）和第 2 组-门控心肌灌注研究有心肌缺血的患者（N=39）。通过 PA 和视觉分析评估 LVD 和 RWM。
结果
SSS 0 与 9.8±3.9 P=0.0001；SDS 0 与 9.8±3.9 P=0.0001；SRS 0 与 0 P=NS，在 G1 和 G2 中。在 G1 和 G2 之间，LVD 存在显著差异，带宽 36±14 与 63±46 P=0.0001；标准差 16±10 与 26±15 P=0.0001。在 G1 中，16%的患者 LVD 与 RWMA 为 0%，P=0.0001，在 G2 中，59%的患者 LVD 与 33%的患者 RWMA，P=0.03。LVD 的敏感性为 59%，RWMA 的敏感性为 33%，P=0.03，LVD 的特异性为 83%，RWMA 的特异性为 100%，P=0.0001。
结论
应激后缺血患者存在心肌顿抑导致的 LVD。PA 测量的 LVD 可能是识别缺血的有用工具。
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