应用[O]水 PET 评估存活心肌：实验性心肌梗死的验证研究。

Assessment of myocardial viability with [O]water PET: A validation study in experimental myocardial infarction.

机构信息

Turku PET Centre, University of Turku, Turku, Finland.

Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.

出版信息

J Nucl Cardiol. 2021 Aug;28(4):1271-1280. doi: 10.1007/s12350-019-01818-5. Epub 2019 Jul 17.

BACKGROUND

Assessment of myocardial viability is often needed in patients with chest pain and reduced ejection fraction. We evaluated the performance of reduced resting MBF, perfusable tissue fraction (PTF), and perfusable tissue index (PTI) in the assessment of myocardial viability in a pig model of myocardial infarction (MI).

METHODS AND RESULTS

Pigs underwent resting [O]water PET perfusion study 12 weeks after surgical (n = 16) or 2 weeks after catheter-based (n = 4) occlusion of the proximal left anterior descending coronary artery. MBF, PTF, and PTI were compared with volume fraction of MI in matched segments as assessed by triphenyl tetrazolium chloride staining of LV slices. MBF and PTF were lower in infarcted than non-infarcted segments. Segmental analysis of MBF showed similar area under the curve (AUC) of 0.85, 0.86, and 0.90 with relative MBF, PTF, and PTI for the detection of viable myocardium defined as infarct volume fraction of < 75%. Cut-off values of relative MBF of ≥ 67% and PTF of ≥ 66% resulted in accuracies of 90% and 81%, respectively.

CONCLUSIONS

Our results indicate that resting MBF, PTF, and PTI based on [O]water PET perfusion imaging are useful for the assessment of myocardial viability.

背景

胸痛伴射血分数降低的患者常需要评估心肌存活能力。我们评估了在心肌梗死（MI）猪模型中，静息 MBF、可灌注组织分数（PTF）和可灌注组织指数（PTI）降低在评估心肌存活能力中的性能。

方法和结果

猪在手术后 12 周（n = 16）或经导管闭塞左前降支近端 2 周（n = 4）后接受静息[O]水 PET 灌注研究。MBF、PTF 和 PTI 与 LV 切片三苯基四唑氯化物染色评估的 MI 容积分数相匹配的节段进行比较。与非梗死节段相比，梗死节段的 MBF 和 PTF 降低。MBF 的节段分析显示，相对 MBF、PTF 和 PTI 对存活心肌（定义为梗死容积分数 < 75%）检测的曲线下面积（AUC）相似，分别为 0.85、0.86 和 0.90。相对 MBF ≥ 67%和 PTF ≥ 66%的截断值导致准确性分别为 90%和 81%。