Cecil M P, Pilcher W C, Eisner R L, Chu T H, Merlino J D, Patterson R E
Carlyle Fraser Heart Center, Emory/Crawford Long Hospital, Department of Medicine (Cardiology), Atlanta, Georgia 30365.
Am J Cardiol. 1994 Jul 1;74(1):43-6. doi: 10.1016/0002-9149(94)90489-8.
Hypertension is common in patients undergoing stress and delayed single-photon emission computed tomography (SPECT) thallium-201 myocardial perfusion imaging. Investigators have reported that patients with end-stage renal disease and left ventricular hypertrophy due to hypertension have diminished lateral/septal count ratios on stress and delayed imaging mimicking lateral myocardial infarction in approximately 35% of patients. Subsequently, hypertension has been cited as a frequent cause of thallium-201 artifacts. The purpose of this study was to compare myocardial SPECT thallium-201 distribution in a broader group of patients with left ventricular hypertrophy resulting from hypertension with normal file subjects in order to determine the prevalence of abnormal studies and to compare the lateral/septal count ratio. Average counts in all myocardial regions in the male study group (n = 16) were compared with those in the normal male file patients (n = 49), with particular attention to the lateral and septal walls. In the group of 16 men with hypertension and left ventricular hypertrophy, as a whole, the mean lateral/septal wall count ratio was 4.4% lower (1.09 +/- 0.07) than that in the normal file (1.14 +/- 0.07; p < 0.01). At 3-hour delay, the ratio was virtually the same in the study group (1.06 +/- 0.09) as in the normal file (1.08 +/- 0.06; p = NS). Most important, for clinical purposes no patient had a defect, defined as a lateral/septal count ratio > 2.0 SD below normal limits. All thallium-201 studies were interpreted as normal. In conclusion, myocardial thallium-201 distribution is normal in patients with left ventricular hypertrophy due to hypertension.
高血压在接受应激及延迟单光子发射计算机断层扫描（SPECT）铊-201心肌灌注显像的患者中很常见。研究人员报告称，患有终末期肾病且因高血压导致左心室肥厚的患者，在应激和延迟显像时，其外侧/间隔计数比值降低，约35%的患者表现类似外侧心肌梗死。随后，高血压被认为是铊-201伪影的常见原因。本研究的目的是比较更广泛的因高血压导致左心室肥厚的患者群体与正常档案受试者的心肌SPECT铊-201分布情况，以确定异常检查的发生率，并比较外侧/间隔计数比值。将男性研究组（n = 16）所有心肌区域的平均计数与正常男性档案患者（n = 49）的平均计数进行比较，特别关注外侧壁和间隔壁。在16名患有高血压和左心室肥厚的男性患者组中，总体而言，外侧/间隔壁计数平均比值比正常档案组低4.4%（1.09±0.07）（正常档案组为1.14±0.07；p<0.01）。延迟3小时时，研究组的比值（1.06±0.09）与正常档案组（1.08±0.06；p =无显著性差异）几乎相同。最重要的是，从临床角度来看，没有患者出现定义为外侧/间隔计数比值低于正常下限2.0标准差的缺损。所有铊-201检查结果均被解释为正常。总之，因高血压导致左心室肥厚的患者，其心肌铊-201分布正常。
