Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
J Nucl Cardiol. 2020 Oct;27(5):1443-1451. doi: 10.1007/s12350-019-01954-y. Epub 2019 Nov 25.
Rb-82 positron emission tomography (PET) myocardial perfusion imaging (MPI) is a robust tool for the evaluation of coronary artery disease (CAD). However, gastric uptake and spillover can be seen in 10% of Rb-82 PET MPI studies, commonly affecting the inferior wall, and can preclude the accurate identification of myocardial ischemia. We sought to understand the relationship between Rb-82 gastric uptake and the use of proton pump inhibitors (PPI).
600 consecutive patients who presented for a clinically indicated Rb-82 PET MPI study were prospectively enrolled. In addition to the clinical history, PPI use was ascertained (medication, dose, frequency and duration of use, and time of last dose). Patients were categorized as PPI and non-PPI users. Rb-82 uptake in the gastrium, myocardium, and liver were measured at rest. Absolute uptake values and gastric:hepatic ratios were compared in PPI and non-PPI users.
Of 600 enrolled patients, 181 (30.2%) patients were using PPI. The gastric Rb-82 uptake in PPI users was 23% higher than non-PPI users (146 ± 52 kBq/cc vs 119 ± 40 kBq/cc, respectively; P < 0.001). The resting gastric:hepatic Rb-82 uptake ratio was also 23% higher in PPI vs non-PPI users (2.7 ± 1.0 vs 2.2 ± 0.8, respectively; P < 0.001).
The gastric uptake of Rb-82 appears to be greater in patients actively using PPI and may identify a group who might be at greater risk of non-diagnostic Rb-82 PET MPI.
铷-82 正电子发射断层扫描（PET）心肌灌注成像（MPI）是评估冠状动脉疾病（CAD）的有力工具。然而，在 10%的铷-82 PET MPI 研究中可以看到胃摄取和溢出，通常影响下壁，并可能导致心肌缺血的准确识别。我们试图了解铷-82 胃摄取与质子泵抑制剂（PPI）使用之间的关系。
前瞻性纳入 600 例因临床指征而行铷-82 PET MPI 研究的连续患者。除了临床病史外，还确定了 PPI 的使用情况（药物、剂量、使用频率和持续时间以及最后一次剂量的时间）。患者分为 PPI 和非 PPI 用户。在休息时测量胃、心肌和肝脏中的铷-82 摄取量。比较 PPI 和非 PPI 用户的绝对摄取值和胃：肝比值。
在纳入的 600 例患者中，有 181 例（30.2%）患者正在使用 PPI。PPI 使用者的胃铷-82 摄取量比非 PPI 使用者高 23%（分别为 146 ± 52 kBq/cc 和 119 ± 40 kBq/cc，P < 0.001）。PPI 与非 PPI 使用者的静息胃：肝铷-82 摄取比值也高 23%（分别为 2.7 ± 1.0 和 2.2 ± 0.8，P < 0.001）。
积极使用 PPI 的患者的胃铷-82 摄取量似乎更大，可能会识别出一组可能更有可能出现铷-82 PET MPI 非诊断性的患者。
