Heart Failure Center, The First Hospital of Hebei Medical University, Hebei Medical University, 89 Donggang Road, Shijiazhuang, 050031, Hebei, China.
Department of Cardiology, The Second Hospital of Hebei Medical University, 215 Heping Road, Shijiazhuang, 050000, Hebei, China.
Ann Nucl Med. 2024 Jun;38(6):418-427. doi: 10.1007/s12149-024-01912-w. Epub 2024 Mar 11.
This study aimed to explore the characteristics of abdominal aortic blood flow in patients with heart failure (HF) using Tc-diethylenetriaminepentaacetic acid (DTPA) renal scintigraphy. We investigated the ability of renal scintigraphy to measure the cardiopulmonary transit time and assessed whether the time-to-peak of the abdominal aorta (TTPa) can distinguish between individuals with and without HF.
We conducted a retrospective study that included 304 and 37 patients with and without HF (controls), respectively. All participants underwent Tc-DTPA renal scintigraphy. The time to peak from the abdominal aorta's first-pass time-activity curve was noted and compared between the groups. The diagnostic significance of TTPa for HF was ascertained through receiver operating characteristic (ROC) analysis and logistic regression. Factors influencing the TTPa were assessed using ordered logistic regression.
The HF group displayed a significantly prolonged TTPa than controls (18.5 [14, 27] s vs. 11 [11, 13] s). Among the HF categories, HF with reduced ejection fraction (HFrEF) exhibited the longest TTPa compared with HF with mildly reduced (HFmrEF) and preserved EF (HFpEF) (25 [17, 36.5] s vs. 17 [15, 23] s vs. 15 [11, 17] s) (P < 0.001). The ROC analysis had an area under the curve of 0.831, which underscored TTPa's independent diagnostic relevance for HF. The diagnostic precision was enhanced as left ventricular ejection fraction (LVEF) declined and HF worsened. Independent factors for TTPa included the left atrium diameter, LVEF, right atrium diameter, velocity of tricuspid regurgitation, and moderate to severe aortic regurgitation.
Based on Tc-DTPA renal scintigraphy, TTPa may be used as a straightforward and non-invasive tool that can effectively distinguish patients with and without HF.
本研究旨在通过 Tc-二乙三胺五乙酸（DTPA）肾闪烁显像探讨心力衰竭（HF）患者腹主动脉血流特征。我们研究了肾闪烁显像测量心肺转流时间的能力，并评估腹主动脉达峰时间（TTPa）是否可以区分 HF 患者和非 HF 患者。
我们进行了一项回顾性研究，纳入 304 例 HF 患者（HF 组）和 37 例非 HF 患者（对照组）。所有患者均接受 Tc-DTPA 肾闪烁显像。记录腹主动脉首过时间-活性曲线的达峰时间，并比较两组之间的差异。通过受试者工作特征（ROC）分析和逻辑回归确定 TTPa 对 HF 的诊断意义。采用有序逻辑回归评估影响 TTPa 的因素。
HF 组的 TTPa 明显长于对照组（18.5[14,27]s 比 11[11,13]s）。在 HF 各亚组中，射血分数降低性心力衰竭（HFrEF）的 TTPa 最长，与射血分数轻度降低性心力衰竭（HFmrEF）和射血分数保留性心力衰竭（HFpEF）相比（25[17,36.5]s 比 17[15,23]s 比 15[11,17]s）（P<0.001）。ROC 分析的曲线下面积为 0.831，表明 TTPa 对 HF 具有独立的诊断意义。随着左心室射血分数（LVEF）降低和 HF 恶化，诊断精度提高。TTPa 的独立影响因素包括左心房直径、LVEF、右心房直径、三尖瓣反流速度和中重度主动脉瓣反流。
基于 Tc-DTPA 肾闪烁显像，TTPa 可作为一种简单、无创的工具，有效区分 HF 患者和非 HF 患者。
