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SPECT 心肌灌注成像可识别出有 COVID-19 病史但无冠状动脉疾病的患者的心肌缺血。

SPECT myocardial perfusion imaging identifies myocardial ischemia in patients with a history of COVID-19 without coronary artery disease.

机构信息

Department of Cardiology, University of Health Sciences Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.

Department of Nuclear Medicine, University of Health Sciences Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.

出版信息

Int J Cardiovasc Imaging. 2022 Feb;38(2):447-456. doi: 10.1007/s10554-021-02477-9. Epub 2021 Nov 22.

Abstract

We aimed to examine the effect of a history of COVID-19 on myocardial ischemia in single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients who presented with shortness of breath and/or chest pain after recovery. For this single-center retrospective study, patients who presented at cardiology outpatient clinics and had SPECT-MPI were screened. A total of 1888 patients were included in the study, 340 of whom had a history of COVID-19. 64 patients with > 50% stenosis on coronary angiography were excluded from the study. The primary outcome of the study was abnormal MPI. In the study population, the median age was 56 (49-64 IQR) years, and 1127 (65%) of the patients were female. Abnormal MPI was detected in 77 patients (23%) in the COVID-19 group and in 244 patients (16%) in the non-COVID-19 group. After adjustment was performed for clinical predictors using Bayesian logistic regression, an important association was found between the presence of a confirmed prior COVID-19 infection and abnormal MPI (posterior median odds ratio, 1.70 [95% CrI, 1.20-2.40], risk difference, 9.6% [95% CrI, 1.8%, 19.7%]). In SPECT-MPI, ischemia rates were observed to be higher in COVID-19 group and it was found that a confirmed prior COVID-19 might predict of abnormal MPI.

摘要

我们旨在研究在经历过 COVID-19 康复后的患者中,因呼吸急促和/或胸痛就诊并进行单光子发射计算机断层扫描(SPECT)心肌灌注成像(MPI)时,COVID-19 病史对心肌缺血的影响。这项单中心回顾性研究筛选了在心脏病门诊就诊并进行 SPECT-MPI 的患者。共纳入 1888 例患者,其中 340 例有 COVID-19 病史。有 64 例患者因冠状动脉造影显示 > 50%的狭窄而被排除在研究之外。该研究的主要结局是 MPI 异常。在研究人群中,中位年龄为 56(49-64 IQR)岁,1127 名(65%)患者为女性。在 COVID-19 组中,77 例(23%)患者的 MPI 异常,而非 COVID-19 组中有 244 例(16%)患者的 MPI 异常。使用贝叶斯逻辑回归对临床预测因子进行调整后,发现有确诊的既往 COVID-19 感染与 MPI 异常之间存在重要关联(后验中位数优势比,1.70 [95%CrI,1.20-2.40],风险差异,9.6% [95%CrI,1.8%,19.7%])。在 SPECT-MPI 中,COVID-19 组的缺血率更高,并且发现确诊的既往 COVID-19 可能预测 MPI 异常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e48/8608361/628457ece965/10554_2021_2477_Fig1_HTML.jpg

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