GSMPI相位分析对AMI后左室收缩功能不全患者发生心力衰竭的预测价值

doi:10.12117/jccmi.2019.10.006

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摘要目的：探讨99mTc-甲氧基异丁腈门控心肌灌注断层显像（GSMPI）相位分析预测急性心肌梗死（AMI）血运重建术后左室收缩功能不全（LVSD）患者发生心力衰竭的临床价值。方法：回顾性分析2014年6月—2015年12月100例AMI血运重建术后3月内行GSMPI检查发现左室射血分数（LVEF）≤40%患者的相位参数，包括相位直方图带宽（PHB）和相位标准差（PSD），根据随访结果将患者分为心衰组（a组）和未心衰组（b组），对比两组的相关指标，以在随访期内发生心衰为阳性事件，应用ROC曲线获得预测患者发生心衰的PHB和PSD最佳阈值，心衰发生的独立预测因子采用多因素Logistic回归分析。结果：a组（42例）舒张末期容积（EDV）、收缩末期容积（ESV）、总静息积分（SRS）、总灌注缺损面积（TPD）、PHB及PSD均比b组（58例）大，差异具有显著性，a组LVEF比b组小，差异具有显著性；PHB和PSD最佳阈值分别是87和25.9，多因素Logistic回归分析显示PHB>87是本组患者发生心衰的独立危险因素，OR=4.936，95%CI：2.539～9.569。结论：相位参数PHB是AMI血运重建术后LVSD患者发生心力衰竭的独立预测因素。

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	徐显海
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	靳春荣
	李莉
	王若楠
	李思进

关键词 ：心室功能, 左, 心力衰竭, 充血性, 放射性核素显像

Abstract：Objective: To evaluate the predictive value of phase analysis of 99mTc-MIBI gated SPECT myocardial perfusion imaging(GSMPI) in patients with left ventricular systolic dysfunction(LVSD) after acute myocardial infarction(AMI) with post-revascularization. Methods: We retrospectively analyzed phase parameters of 100 patients with LVSD after AMI who underwent GSMPI and left ventricular ejection fraction(LVEF)≤40%, including phase histogram bandwidth(PHB) and phase standard deviation(PSD). The patients were divided into group with heart failure(group a) and group without heart failure(group b) according to follow-up results. The relevant parameters were compared between groups. ROC curve was used to evaluate optimal cutoff of PHB and PSD for predicting heart failure. Logistic regression model was used to evaluate independent predictors of heart failure. Results: End diastolic volume(EDV), end systolic volume(ESV), LVEF, summed rest score(SRS), total perfusion deficit(TPD), PHB and PSD showed significant difference between two groups. Optimal cutoffs of PHB and PSD were 87 and 25.9. PHB>87 was an independent predictor according to Logistic regression model. Conclusion: PHB of phase analysis was independent factor for predicting heart failure in patients of LVSD after AMI with post-revascularization.

Key words： Ventricular function, left Heart failure, congestive Radionuclide imaging

收稿日期: 2018-11-20

PACS:	Ｒ541.61
	Ｒ817.4

通讯作者: 李思进，山西医科大学第一医院核医学科，030001。E-mail：lisjnm123@163.com

作者简介: 徐显海（1990-），男，江西景德镇人，在读硕士研究生。E-mail：Xuxh1024@126.com

引用本文:

徐显海，郭小闪，武志芳，靳春荣，李莉，王若楠，李思进. GSMPI相位分析对AMI后左室收缩功能不全患者发生心力衰竭的预测价值[J]. 中国临床医学影像杂志, 2019, 30(10): 708-711.
XU Xian-hai, GUO Xiao-shan, WU Zhi-fang, JIN Chun-rong, LI Li, WANG Ruo-nan, LI Si-jin. Predictive value of GSMPI phase analysis in development of heart failure in patients with left ventricular systolic dysfunction after AMI. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(10): 708-711.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2019.10.006 或 http://www.jccmi.com.cn/CN/Y2019/V30/I10/708

[1]Gasior M, Gierlotka M, Pyka L, et al. Temporal trends in secondary prevention in myocardial infarction patients discharged with left ventricular systolic dysfunction in Poland[J]. Eur J Prev Cardiol, 2018, 25(9): 960-969.
[2]Hamalainen H, Hedman M, Laitinen T, et al. Reference values for left ventricular systolic synchrony according to phase analysis of ECG-gated myocardial perfusion SPECT[J]. Clin Physiol Funct Imaging, 2018, 38(1): 38-45.
[3]Pazhenkottil AP, Buechel RR, Husmann L, et al. Long-term prognostic value of left ventricular dyssynchrony assessment by phase analysis from myocardial perfusion imaging[J]. Heart, 2011, 97(1): 33-37.
[4]Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J]. J Am Coll Cardiol, 2013, 62(16): e147-239.
[5]王庆茹，刘仁光. 心肌梗死第三次全球统一定义——2012 ESC/ACCF/AHA/WHF专家共识要点解读[J]. 中国心脏起搏与心电生理杂志，2013，27（3）：269-270.
[6]李树恒，田月琴，孙晓昕，等. 应用心肌灌注/代谢显像探讨心肌损伤与左室机械运动不同步化的相关性[J]. 中华核医学与分子影像杂志，2017，37（10）：623-626.
[7]王建锋，王跃涛，张晓丽，等. 门控心肌灌注显像相位分析评价陈旧性心肌梗死患者左心室收缩同步性[J]. 中华心血管病杂志，2015，43（7）：599-604.
[8]Chen J, Garcia EV, Bax JJ, et al. SPECT myocardial perfusion imaging for the assessment of left ventricular mechanical dyssynchrony[J]. J Nucl Cardiol, 2011, 18(4): 685-94.
[9]Park S, Cheon GJ, Paeng JC, et al. Phase analysis of gated myocardial perfusion single-photon emission computed tomography after coronary artery bypass graft surgery: reflection of late reverse remodeling in patients with patent grafts after coronary artery bypass graft surgery[J]. Nucl Med Commun, 2016, 37(11): 1139-1147.
[10]Smit JM, Hermans MP, Dimitriu-Leen AC, et al. Long-term prognostic value of single-photon emission computed tomography myocardial perfusion imaging after primary PCI for STEMI[J]. Eur Heart J Cardiovasc Imaging, 2018, 19(11): 1287-1293.
[11]Sharir T, Kang X, Germano G, et al. Prognostic value of poststress left ventricular volume and ejection fraction by gated myocardial perfusion SPECT in women and men: gender-related differences in normal limits and outcomes[J]. J Nucl Cardiol, 2006, 13(4): 495-506.
[12]李婷，李剑明，汪娇，等. 核素显像评估不同阶段冠心病患者心脏收缩同步性的研究[J]. 中国临床医学影像杂志，2018，29（2）：97-101.
[13]杨虹波，钱菊英，姚康，等. SPECT门控心肌灌注显像相位图在冠状动脉慢性闭塞病变患者中的应用价值[J]. 中华核医学与分子影像杂志，2014，34（3）：166-169.
[14]李婷，徐文贵，李剑明，等. 探讨门控SPECT心肌灌注显像在慢性心衰患者心脏再同步化治疗中的临床应用价值[J]. 中国临床医学影像杂志，2015，26（5）：325-328.
[15]Azizian N, Rastgou F, Ghaedian T, et al. LV Dyssynchrony Assessed With Phase Analysis on Gated Myocardial Perfusion SPECT Can Predict Response to CRT in Patients With End-Stage Heart Failure[J]. Res Cardiovasc Med, 2014, 3(4): e20720.