解放军医学院学报2017，Vol.38Issue(11)：1018-1021,1025,5.DOI:10.3969/j.issn.2095-5227.2017.11.005
运动负荷99mTc-MIBI SPECT心肌灌注显像对左心室射血分数＞45％的怀疑心肌缺血患者的预后价值
Prognostic value of exercise stress 99mTc-MIBI SPECT myocardial perfusion imaging in patients suspected of coronary artery disease and LVEF ＞ 45％
张琳 1严松彪 2陈晖 2高红 1胡智芳2
作者信息
- 1. 首都医科大学附属北京友谊医院心脏中心,北京100050
- 2. 首都医科大学附属北京妇产医院内科,北京 100026
- 折叠
摘要
Abstract
Objective To assess the predicting value of exercise stress 99m-technetium myocardial perfusion single-photon emission computed tomography (MPS,SPECT) for major adverse cardiovascular events (MACEs) in patients suspected of coronary artery disease (CAD) and LVEF ＞ 45％.Methods Patients who were suspected of CAD admitted to Beijing Friendship Hospital from June 2013 to March 2016 were enrolled in this study.All patients had undergone exercise 99mTc-sestamibi MPS for evaluation of ischemia,then were divided into two groups according to summed stress score (SSS):SSS 0-7 group and SSS ≥ 8 group.The patients were followed up by telephone to record the occurrence of MACEs.Results A total of 295 patients were enrolled,243 patients (male/female 133/110) were in SSS 0-7 group and 52 (male/female 40/12) were in SSS ≥ 8 group.Compared with SSS 0-7 score group,SSS ≥ 8 score group had higher proportion of males,typical symptoms of angina pectoris,history of myocardial infarction and abnormal wall motion (All P ＜ 0.05),greater echocardiographic left ventricular end diastolic diameter and left ventricular end systolic diameter (All P ＜ 0.05),and lower left ventricular ejection fraction (P=0.000).The incidence of MACEs in SSS 0-7 score group was 16％ (n=39),versus 25％ (n=13) in SSS ≥ 8 score group,with no significant difference (P=0.124).There was no statistically significant difference in the incidences of cardiac death,non-fatal myocardial rehospitalization infarction,rehospitalization for angina pectoris,and revascularization between the two groups.The cumulative survival rate was lower in SSS ≥ 8 group compared with SSS 0-7 group by Kaplan-Meier curve (P=0.042).The incidence of cardiac events (including cardiac death and non-fatal myocardial infarction) of SSS 0-7 group was 1％,which was 2％ in SSS ≥ 8 group.Conclusion Exercise myocardial perfusion imaging can be applied for evaluating cardiovascular risk of patients suspected of myocardial ischemia and LVEF ＞ 45％.MPI indicates that SSS ≥ 8 is an indication of revascularization therapy.关键词
负荷心肌灌注显像/冠心病/主要心血管不良事件Key words
stress myocardial perfusion imaging/coronary artery disease/major adverse cardiovascular events分类
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张琳,严松彪,陈晖,高红,胡智芳..运动负荷99mTc-MIBI SPECT心肌灌注显像对左心室射血分数＞45％的怀疑心肌缺血患者的预后价值[J].解放军医学院学报,2017,38(11):1018-1021,1025,5.
