摘要
目的研究18F脱氧葡萄糖(^(18)F-FDG)正电子发射断层显像(PET)/CT检测冬眠心肌数量与冠心病患者心肌存活状况及左心室功能的关系。方法选取我院收治的168例老年冠心病患者作为研究对象。入组后1周内行18F-FDG PET/CT心肌灌注代谢显像检测,评估冬眠心肌数量、心肌存活状况,通过超声心电图检测左心室功能指标。以冬眠心肌数量中位值分为高冬眠心肌数量组(90例)和低冬眠心肌数量组(78例)。采用Pearson相关性分析冬眠心肌数量与左心室功能及心肌存活状况的相关性,通过ROC曲线分析各指标联合预测血运重建术后预后价值。结果168例老年冠心病患者冬眠心肌数量为12.34%~27.43%,高冬眠心肌数量组瘢痕心肌数量显著高于低冬眠心肌数量组(P<0.01)。高冬眠心肌数量组左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)水平显著低于低冬眠心肌数量组,而LVEF显著高于低冬眠心肌数量组(P<0.01)。高冬眠心肌数量组心肌代谢情况及心肌存活指数均优于低冬眠心肌数量组(P<0.01)。Pearson相关性分析显示,冬眠心肌数量与心肌存活指数、LVEF呈正相关(r=0.638,P=0.000;r=0.645,P=0.000),与LVESV、LVEDV呈负相关(r=-0.592,P=0.000;r=-0.538,P=0.000)。ROC曲线分析显示,三者联合检测曲线下面积明显高于冬眠心肌数量、心肌存活指数、LVEF的单独检测。结论^(18)F-FDG PET/CT检测冬眠心肌数量与冠心病患者心肌存活状况及左心室功能指标水平存在相关性,联合检测可有效预测血运重建术后疗效。
Objective To study the relationship of ^(18)F-FDG PET/CT-detected hibernating cardiac muscle with myocardial survival and left ventricular function in elderly CHD patients.Methods One hundred and sixty-eight elderly CHD patients,who underwent ^(18)F-FDG PET/CT myocardial perfusion metabolic imaging and echocardiography in our hospital for detecting their cardiac muscle and left ventricular function within 1 week after admission,were divided into highly-hibernating cardiac muscle group(n=90)and lowly-hibernating cardiac muscle group(n=78).The relationship of hibernating cardiac muscle with myocardial survival and left ventricular function in elderly CHD patients was analyzed by Pearson correlation analysis.The value of ^(18)F-FDG PET/CT myocardial perfusion metabolic imaging and echocardiography in predicting the revascularization in elderly CHD patients was analyzed by ROC curve analysis.Results The hibernating cardiac muscle in 168 CHD patients accounted for 12.34%-27.43%.The number of scarred cardiac muscles was significantly larger in highly-hibernating cardiac muscle group than in lowly-hibernating cardiac muscle group(P<0.01).The LVESV and LVEDV were significantly smaller while the LVEF was significantly higher in highly-hibernating cardiac muslce group than in lowly-hi-bernating cardiac muscle group(P<0.01).The myocardial metabolism was faster and the myocardial survival rate was higher in highly-hibernating cardiac muscle group than in lowly-hibernating cardiac muscle group(P<0.01).Pearson correlation analysis showed that hibernating cardiac muscle was positively related with myocardial survival and LVEF and negatively related with LVESV and LVEDV in elderly CHD patients(r=0.638,r=0.645,P=0.000;r=-0.592,r=-0.538,P=0.000).ROC curve analysis displayed that the AUC for combined detection of hibernating cardiac muscles,myocardial survival and left ventricular function was significantly larger than that for detection of hibernating cardiac muscle,myocardial survival and LVEF respectively in predicting CHD.Conclusion 18F-FDG PET/CT-detected hibernating cardiac muscle is related with myocardial survival and left ventricular function in elderly CHD patients.Combined detection of hibernating cardiac muscle,myocardial survival and left ventricular function can effectively predict the postoperative revascularization in CHD patients.
作者
张艳辉
孟祥
从国彬
郑吟诗
蒋凯
权红军
Zhang Yanhui;Meng Xiang;Cong Guobin;Zheng Yinshi;Jiang Kai;Quan Hongjun(Teaching and Research Section of Imaging,Shangqiu Medical College Medical Technology School,Shangqiu 476000,Henan Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2021年第2期156-159,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
冬眠
冠心病
氟脱氧葡萄糖F18
心室功能
左
hibernation
coronary disease
fluorodeoxyglucose F18
ventricular function,left
