Normal limits of ejection fraction and volumes determined by gated SPECT in clinically normal patients without cardiac events: a study based on the J-ACCESS database
Normal limits of ejection fraction and volumes determined by gated SPECT in clinically normal patients without cardiac events: a study based on the J-ACCESS database
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DOI：
10.1007/s00259-006-0321-1
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发表时间：
2007-07-01
影响因子：
9.1
通讯作者：
Nishimura, Tsunehiko
中科院分区：
文献类型：
--
作者：
Nakajima, Kenichi;Kusuoka, Hideo;Nishimura, Tsunehiko
目的定量门控单光子发射计算机断层扫描（SPECT）在测量心脏主要功能参数方面具有很高的准确性和精密度。我们假设EF和LV容量的正常值可能因国籍而异，并且需要针对研究人群的最佳阈值。方法在J-ACCESS（日本基于门控SPECT的预后调查）研究中，来自117家医院的4,670名连续登记的患者中，共选择268名（149名女性，119名男性），这些患者在过去3年内没有基线心脏疾病，也没有发生过心脏事件。使用Tc-99m-tetrofosmin进行门控SPECT研究，并使用雪松西奈医学中心的定量门控SPECT （QGS）软件进行分析。计算并总结射血分数（EF）、舒张末期容积（EDV）、收缩末期容积（ESV）和卒中容积（SV）以及EDV、ESV和SV按体表面积归一化（EDVI、ESVI和SVI）的结果，得出正常限值。结果女性和男性的EF分别为74 +/- 9%和63 +/- 7% （p < 0.0001）。女性的EDV、ESV和SV明显小于男性。基于多元回归线性模型，EF、EDVI、ESVI的主要和次要预测因子为性别和年龄。通过逐步多元回归分析，体重是EDV、ESV、SV和SVI的第三个具有统计学意义的预测因子。年龄与体重无共线性关系。日本研究人群的重要因素包括女性小心脏发生率高和年龄相对较高（女性平均年龄+/- SD为64.1 +/- 10.0岁，男性为60.9 +/- 11.7岁）。结论门控SPECT与QGS测定的EF和体积受性别和年龄的显著影响，体重是体积的第三个预测因子。此外，对于所研究的人口来说，正常限度是如此具体，因此应该采用适合有关研究的标准。
Purpose Quantitative gated single-photon emission computed tomography ( SPECT) is known to have high accuracy and precision for measurement of the principal cardiac functional parameters. We hypothesised that normal values for EF and LV volumes may differ among nationalities, and that optimal threshold values specific to the study population are required.Methods Among 4,670 consecutively registered patients for a J-ACCESS ( Japanese investigation regarding prognosis based on gated SPECT) study from 117 hospitals, a total of 268 ( 149 women, 119 men) were selected who had no baseline cardiac diseases and had experienced no cardiac events during the preceding 3-year period. A gated SPECT study was performed with Tc-99m-tetrofosmin and analysed with Cedars Sinai Medical Center's quantitative gated SPECT (QGS) software. The results in respect of ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV), and EDV, ESV and SV normalised by body surface area (EDVI, ESVI and SVI), were calculated and summarised to obtain normal limits.Results EF for women and men was 74 +/- 9% and 63 +/- 7%, respectively (p < 0.0001). EDV, ESV and SV were significantly smaller in women than in men. Based on multiple regressions for linear models, the primary and secondary predictors of EF, EDVI, ESVI were gender and age. By stepwise multiple regression analysis, a statistically significant third predictor for EDV, ESV, SV and SVI was body weight. No colinearity was found between age and body weight. Important factors for the studied Japanese population included a high incidence of small hearts in women and the relatively advanced age of the population ( the mean age +/- SD was 64.1 +/- 10.0 years for women and 60.9 +/- 11.7 years for men).Conclusion EF and volumes determined by gated SPECT with QGS were significantly affected by gender and age, with body weight as a third predictor for volumes. Moreover, the normal limits were so specific for the population studied that standards appropriate for the study in question should be utilised.