铊-201心肌灌注闪烁图在评价主动脉-冠状动脉大隐静脉搭桥手术中的应用

Thallium-201 myocardial perfusion scintigrams in the evaluation of aorto-coronary saphenous bypass surgery.

作者信息

Verani M S, Marcus M L, Spoto G, Rossi N P, Ehrhardt J C, Razzak M A

出版信息

J Nucl Med. 1978 Jul;19(7):765-72.

Abstract

The effect of aorto-coronary bypass graft surgery (CBG) upon regional myocardial perfusion (RMP) was studied in 23 patients using thallium-201 myocardial perfusing imaging after exercise. We compared the changes in RMP with the clinical status and ECG's during graded treadmill exercise (GTX) before and after CBG. After CBG, the New York Heart Association's "functional class" improved from 3.2 +/- 0.1 (mean +/- SE) to 1.2 +/- 0.2, p less than 0.005. The GTX performance of the patients was also significantly improved postoperatively as judged by the total exercise time (11.7 +/- 0.6 min postop, compared with 7.2 +/- 0.5 min preop; p less than 0.005). Postoperative improved Tl-201 scintigrams were observed in 19 patients, but in only nine patients did the perfusion distribution return to normal. Thus, Tl-201 exercise scintigrams following CBG demonstrate improved RMP in most patients. Failure of regional myocardial perfusion to improve postoperatively, however, does not preclude marked alleviation of angina and improved exercise tolerance.

摘要

在23例患者中，利用运动后铊-201心肌灌注显像研究了主动脉冠状动脉搭桥手术（CBG）对局部心肌灌注（RMP）的影响。我们比较了CBG前后分级平板运动（GTX）期间RMP的变化以及临床状况和心电图。CBG后，纽约心脏协会的“功能分级”从3.2±0.1（均值±标准误）改善至1.2±0.2，p<0.005。根据总运动时间判断，患者术后的GTX表现也显著改善（术后为11.7±0.6分钟，术前为7.2±0.5分钟；p<0.005）。19例患者术后铊-201闪烁显像改善，但只有9例患者的灌注分布恢复正常。因此，CBG后的铊-201运动闪烁显像显示大多数患者的RMP有所改善。然而，术后局部心肌灌注未能改善并不排除心绞痛明显缓解和运动耐量提高。