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利用心肌门控单光子发射计算机断层扫描评估重型无症状β地中海贫血患者的心肌灌注和功能。

Evaluation of myocardial perfusion and function in patients with asymptomatic beta-thalassemia major using myocardial gated single-photon-emission computed tomography.

作者信息

Omrani Abdolmajid, Rahimzadeh Parivash, Aba Ali, Jafari Esmail, Amini Abdullatif, Assadi Majid

机构信息

Department of Pediatrics , Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.

Jam Tohid Hospital, Bushehr Province, Bushehr, Iran.

出版信息

World J Nucl Med. 2020 Dec 12;20(2):145-149. doi: 10.4103/wjnm.WJNM_89_20. eCollection 2021 Apr-Jun.

Abstract

This study was conducted to evaluate the cardiac perfusion and function of patients with beta-thalassemia major (TM) usingTc-MIBI cardiac gated single-photon-emission computed tomography (SPECT) and to compare the obtained indices with echocardiographic and hematological parameters. Patients with TM who were referred for regular blood transfusion and periodic checkup were included in this study. A questionnaire containing demographic and medical data was provided for all patients by an expert pediatrician. All of the patients were on Desferal chelation therapy and none of them had clinical signs of heart failure. Myocardial gated perfusion SPECT, echocardiography, and complete blood tests were performed for each patient. In total, 24 patients including 14 men (58.3%) and 10 women (41.7%) aged 15-36 years with a mean age of 24.3 ± 6.5 years' old were enrolled in this study. Myocardial perfusion scan (MPS) was normal in all patients. The mean value of the measured left ventricular ejection fraction (LVEF) was 58.88 ± 13.45%. There was no significant association between measured LVEF on scan and echocardiography ( > 0.05). In terms of hematological results, there was a significant association between the hemoglobin and ferritin level and the amount of blood transfusion ( = 0.02 and = 0.00, respectively). According to the results of myocardial perfusion imaging (MPI), cardiac perfusion and LVEF were within normal limits in all asymptomatic patients. In the absence of any perfusion abnormality, the use of MPI in patients with asymptomatic beta-TM is not recommended for diagnosing myocardial ischemia.

摘要

本研究旨在使用锝-甲氧基异丁基异腈(Tc-MIBI)门控心肌单光子发射计算机断层扫描(SPECT)评估重型β地中海贫血(TM)患者的心脏灌注和功能,并将所得指标与超声心动图和血液学参数进行比较。本研究纳入了因定期输血和定期检查而前来就诊的TM患者。由专业儿科医生为所有患者提供一份包含人口统计学和医学数据的问卷。所有患者均接受去铁胺螯合治疗,且均无心力衰竭的临床症状。对每位患者进行心肌门控灌注SPECT、超声心动图检查和全血细胞检查。本研究共纳入24例患者,其中14例男性(58.3%)和10例女性(41.7%),年龄在15 - 36岁之间,平均年龄为24.3±6.5岁。所有患者的心肌灌注扫描(MPS)均正常。测得的左心室射血分数(LVEF)平均值为58.88±13.45%。扫描测得的LVEF与超声心动图之间无显著相关性(>0.05)。在血液学结果方面,血红蛋白和铁蛋白水平与输血量之间存在显著相关性(分别为=0.02和=0.00)。根据心肌灌注成像(MPI)结果,所有无症状患者的心脏灌注和LVEF均在正常范围内。在无任何灌注异常的情况下,不建议对无症状β-TM患者使用MPI来诊断心肌缺血。

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