缺血性心肌病患者的短时间运动-休息与长时间心肌灌注门控SPECT方案

Revista Espa?ola de Medicina Nuclear (English Edition) Pub Date : 2010-01-01 DOI:10.1016/S1578-200X(10)70046-2

J. Candell-Riera , G. Romero-Farina , S. Aguadé-Bruix , J. Castell-Conesa , V. Aliaga , G. Cuberas-Borrós , D. García-Dorado

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引用次数: 3

摘要

目的分析缺血性心肌病(ICM)患者短时间1天运动休息与长时间2天门控SPECT(单光子发射计算机断层扫描)方案的左收缩心室功能和心肌灌注特征。方法采用心肌灌注门控SPECT对40例(59.6±8.9岁，女性3例)IHD(左室射血分数(EF)≤40%)患者进行前瞻性研究。在为期一天的运动-休息研究(门控SPECT-1)后5 - 10天，患者被召回进行第二次休息研究(门控SPECT-2)，以比较两种方案之间EF和灌注总休息评分(ΔSRS=SRS1-SRS2)和总差异评分(ΔSDS=SDS1-SDS2)的差异。结果26例(65%)患者的静息门控SPECT-1(短方案)和静息门控SPECT-2(长方案)的EF升高(34% vs 37%， P = 0.008)， 11例(27.5%)患者的EF升高≥5%。EF≥5%升高和未升高患者的临床和冠状动脉造影变量无显著差异。在多变量分析中，ΔSRS (95% CI: - 1.1至- 29.2)和ΔSDS(0.179-1.236)是两项研究中EF增加的预测因子。结论短时间运动-休息方案可低估ICM患者的EF。令人震惊的是，在短时间内，休息时的图像被之前的运动图像污染了，这可以解释这些结果。

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Short exercise-rest versus long myocardial perfusion gated SPECT protocols in patients with ischemic cardiomyopathy

Objective

The purpose of this study was to analyze left systolic ventricular function and myocardial perfusion characteristics between short one day exercise-rest and long two days gated SPECT (Single Photon Emission Computed Tomography) protocols in patients with ischemic cardiomyopathy (ICM).

Methods

A prospective study of 40 patients (59.6 ± 8.9 years, 3 women) with IHD (left ventricular ejection fraction (EF) ≤ 40%) was performed with myocardial perfusion gated SPECT. From 5 to 10 days after a one-day exercise-rest study (gated SPECT-1), patients were called back for a second rest study (gated SPECT-2) in order to compare EF and differences in perfusion summed rest score (ΔSRS=SRS1-SRS2) and summed difference score (ΔSDS=SDS1-SDS2) between both protocols.

Results

Between rest-gated SPECT-1 (short protocol) and rest-gated SPECT-2 (long protocol) EF increased (34% vs 37%, P = 0.008) in 26 patients (65%), and in 11 patients (27.5%) the increase was ≥ 5%. There were no significant differences in clinical and coronary angiography variables between patients with and without increase of the EF ≥ 5%. In the multivariate analysis, ΔSRS (95% CI: −1.1 to −29.2) and ΔSDS (0.179–1.236) were predictors for this EF increase between both studies.

Conclusions

Exercise-rest short protocol can underestimate EF in patients with ICM. Stunning but also contamination of rest images by previous exercise images in a short protocol could explain these results.

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Revista Espa?ola de Medicina Nuclear (English Edition)

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