Homma S, Kaul S, Boucher C A
Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston.
J Nucl Med. 1987 Oct;28(10):1531-5.
We studied 306 patients with chest pain (262 with coronary artery disease and 44 with no coronary artery disease) to determine which of 23 clinical, exercise, thallium, and angiographic variables best discriminate between patients with increased lung/heart ratios of thallium versus those with normal ratios. Normal lung/heart ratio values were defined using an additional 45 subjects with less than 1% probability of coronary artery disease. The number of diseased vessels was the best discriminator between patients with increased ratios versus those with normal ratios. Double product at peak exercise, number of segments with abnormal wall motion, patient gender, and duration of exercise were also significant discriminators. Using discriminant function analysis these variables could correctly identify 81% of cases with increased lung/heart ratios and 72% of cases with normal ratios. These results indicate that an increased lung/heart ratio of thallium reflects exercise-induced left ventricular dysfunction and affords a better understanding of why this thallium parameter is a powerful prognostic indicator in patients with chest pain.
我们研究了306例胸痛患者（262例患有冠状动脉疾病，44例无冠状动脉疾病），以确定23项临床、运动、铊及血管造影变量中哪些能最好地区分铊肺/心比值升高的患者与比值正常的患者。使用另外45例冠状动脉疾病可能性小于1%的受试者来定义正常肺/心比值。病变血管数量是区分比值升高患者与比值正常患者的最佳指标。运动高峰时的双重乘积、室壁运动异常节段数、患者性别及运动持续时间也是重要的区分指标。使用判别函数分析，这些变量能正确识别81%的铊肺/心比值升高病例和72%的比值正常病例。这些结果表明，铊肺/心比值升高反映了运动诱发的左心室功能障碍，并有助于更好地理解为何该铊参数是胸痛患者强有力的预后指标。
