Hasnie Usman A, Bhambhvani Pradeep, Iskandrian Ami E, Hage Fadi G
Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Division of Molecular Imaging and Therapeutics, Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Eur J Nucl Med Mol Imaging. 2021 Jul;48(8):2447-2454. doi: 10.1007/s00259-020-05123-z. Epub 2021 Jan 8.
The aim of this study is to evaluate the rate of abnormal myocardial perfusion imaging (MPI) studies at a single medical center during the COVID-19 pandemic compared to prior to the pandemic.
We retrospectively studied stress single-photon emission computed tomography (SPECT)-MPI studies performed during the peak of COVID-19 restrictions at the University of Alabama Medical Center in comparison to the same time period in 2019.
SPECT-MPI volume was reduced from 553 per month in 2019 to 105 per month in 2020. The proportion of abnormal SPECT-MPI for the 2020 cohort (61 ± 13 years, 48% men, 41% black) was not different from the 2019 cohort (62 ± 12 years, 48% men, 42% black) (31% vs. 27%, p = 0.4). Similar proportion of patients in the 2 cohorts had abnormal myocardial perfusion, moderate-large perfusion defects, myocardial ischemia, myocardial scar, and abnormal left ventricular ejection fraction. The proportion of abnormal SPECT-MPIs was not different based on whether patients were evaluated face-to-face or by telemedicine (28% vs. 27%, p > 0.9) but was higher for cardiology providers (40% vs. 20%, p < 0.001).
There was a significant reduction in the number of SPECT-MPI studies performed during the peak restrictions from the pandemic. Despite this restriction, the rate of abnormal studies remained stable. Our study suggests that it remains difficult to predict which patients will have abnormal SPECT-MPI even when providers and stress laboratories are forced to prioritize the performance of studies to high-yield patients.
本研究旨在评估在新冠疫情期间，与疫情之前相比，单一医疗中心异常心肌灌注成像（MPI）检查的发生率。
我们回顾性研究了阿拉巴马大学医学中心在新冠疫情限制高峰期进行的负荷单光子发射计算机断层扫描（SPECT）-MPI检查，并与2019年同期进行对比。
SPECT-MPI检查量从2019年的每月553例降至2020年的每月105例。2020年队列（年龄61±13岁，男性占48%，黑人占41%）的异常SPECT-MPI比例与2019年队列（年龄62±12岁，男性占48%，黑人占42%）相比无差异（31%对27%，p = 0.4）。两个队列中具有异常心肌灌注、中度至重度灌注缺损、心肌缺血、心肌瘢痕和异常左心室射血分数的患者比例相似。基于患者是接受面对面评估还是远程医疗评估，异常SPECT-MPI的比例无差异（28%对27%，p > 0.9），但心脏病学提供者评估的比例更高（40%对20%，p < 0.001）。
疫情高峰期进行的SPECT-MPI检查数量显著减少。尽管有此限制，异常检查的发生率仍保持稳定。我们的研究表明，即使提供者和负荷检查实验室被迫优先为高收益患者进行检查，仍难以预测哪些患者的SPECT-MPI会异常。
