López Milán D, Batista Cuéllar J F, Garzón E, González N, Pereztol Valdés O, Valdés García J A, Pérez Marcé E B, Perera Pintado A
Centro de Investigaciones Clínicas, Playa C. Habana, 11300, Cuba.
Rev Esp Med Nucl. 1998;17(6):419-26.
The incidence of atherosclerosis of the heart transplant in long term survivors is 38% at 5 years. In the present work, myocardial perfusion 201Tl-SPET was assessed as a non-invasive diagnostic method for the detection of postransplant coronary artery disease, as well as its efficiency with regard to other techniques. Twenty patients, aged (47 +/- 9) years old, who underwent heart transplantation at least 3 years earlier, were studied by 201Tl-SPET. Qualitative and quantitative analysis of the images were performed. It was found ischemia in 6 patients, 4 of them asymptomatics. In 5 of the 6 positive cases by SPET coronary stenosis was found by angiography. Kappa coefficient and percent of agreement were k = 0. 76 and Pe = 90%, respectively. There were no relationships among rejection crisis, sepsis by cytomegalovirus and coronary artery disease detected by using 201Tl-SPET (p > 0.05). The most relevant risk factors in the sample were hypertension and hyperlipidemia. Two patients died because of coronary artery disease. It was confirmed by necropsy findings. These results suggest that thallium-201 myocardial perfusion tomography could be useful to detect coronary artery disease in the transplanted heart.
心脏移植长期存活者中动脉粥样硬化的发生率在5年时为38%。在本研究中，对201Tl单光子发射计算机断层扫描（SPET）心肌灌注进行评估，作为检测移植后冠状动脉疾病的一种非侵入性诊断方法，以及其相对于其他技术的有效性。对20例至少在3年前接受心脏移植、年龄为（47±9）岁的患者进行了201Tl-SPET研究。对图像进行了定性和定量分析。发现6例患者存在心肌缺血，其中4例无症状。在SPET检查呈阳性的6例患者中，5例经血管造影发现冠状动脉狭窄。kappa系数和一致性百分比分别为k = 0.76和Pe = 90%。使用201Tl-SPET检测到的排斥反应、巨细胞病毒败血症与冠状动脉疾病之间无相关性（p>0.05）。样本中最相关的危险因素是高血压和高脂血症。2例患者死于冠状动脉疾病，尸检结果证实了这一点。这些结果表明，201Tl心肌灌注断层扫描可能有助于检测移植心脏中的冠状动脉疾病。
