Xu Bin, Liu Lu, Abdu Fuad A, Yin Guoqing, Mohammed Abdul-Quddus, Xu Siling, Lv Xian, Fan Rui, Feng Cailin, Shi Tingting, Zhang Wen, Xu Yawei, Cai Haidong, Yu Fei, Che Wenliang
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Medical College of Soochow University, Soochow University, Suzhou, China.
Front Cardiovasc Med. 2021 Jul 15;8:700027. doi: 10.3389/fcvm.2021.700027. eCollection 2021.
Diastolic dysfunction (DD) with normal systolic function has been elucidated to be associated with heart failure and worse prognosis. The recently introduced single photon emission computed tomography (SPECT) with dedicated cardiac cadmium-zinc-telluride (CZT) cameras (D-SPECT) is a novel method to quantitate left ventricular functional parameters. We aimed to evaluate the prognostic value of DD derived from D-SPECT in coronary artery disease (CAD) patients with normal ejection fraction. All CAD patients who underwent D-SPECT and invasive coronary angiography within 3 months were considered. DD was defined as peak filling rate (PFR) <2.1 end diastolic volume (EDV, ml)/s according to the D-SPECT results. Patients were divided into three groups: group 1 ( = 226)-normal PFR; group 2 ( = 67)-ischemia-related DD (abnormal stress PFR and normal rest PFR); and group 3 ( = 106)-rest DD (abnormal rest PFR). The primary clinical endpoint of the present study was a composite of heart failure events (HFE). A total of 399 consecutive CAD patients with normal systolic function undergoing stress D-SPECT were analyzed. The incidence rates of HFE among the three groups were 4.0, 7.5, and 11.3%, respectively. Cox regression analysis showed that the multivariate predictors of HFE were rest PFR, diabetes mellitus, obesity, and old age. DD derived from D-SPECT in CAD patients with normal ejection fraction is predictive of HFE.
舒张功能障碍（DD）伴正常收缩功能已被证实与心力衰竭及更差的预后相关。最近推出的配备专用心脏碲化镉锌（CZT）相机的单光子发射计算机断层扫描（SPECT）（D-SPECT）是一种定量左心室功能参数的新方法。我们旨在评估D-SPECT得出的DD在射血分数正常的冠心病（CAD）患者中的预后价值。纳入了所有在3个月内接受D-SPECT和有创冠状动脉造影的CAD患者。根据D-SPECT结果，DD被定义为峰值充盈率（PFR）<2.1舒张末期容积（EDV，毫升）/秒。患者被分为三组：第1组（n = 226）——PFR正常；第2组（n = 67）——缺血相关DD（应激PFR异常而静息PFR正常）；第3组（n = 106）——静息DD（静息PFR异常）。本研究的主要临床终点是心力衰竭事件（HFE）的复合终点。对总共399例连续接受应激D-SPECT且收缩功能正常的CAD患者进行了分析。三组中HFE的发生率分别为4.0%、7.5%和11.3%。Cox回归分析表明，HFE的多变量预测因素是静息PFR、糖尿病、肥胖和老年。射血分数正常的CAD患者中由D-SPECT得出的DD可预测HFE。
