Incremental value of Rubidium-82 positron emission tomography for prognostic assessment of known or suspected coronary artery disease
Incremental value of Rubidium-82 positron emission tomography for prognostic assessment of known or suspected coronary artery disease
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DOI：
10.1016/s0002-9149(97)00537-7
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发表时间：
1997-10-01
影响因子：
2.8
通讯作者：
Lauer, MS
中科院分区：
文献类型：
--
作者：
Marwick, TH;Shan, K;Lauer, MS
心肌灌注显像使用正电子发射断层扫描（PET）可能更准确的诊断冠状动脉疾病（CAD）比传统成像。本研究的目的是评估PET研究的685例患者（年龄62 +/- 11岁，199例女性）灌注异常对预后的影响，并评估这些数据与临床和血管造影结果对预后的影响的增量价值。在双嘧达莫作用前后进行铷(Rb)-82 PET检测。在227例（33%）患者中检测到短暂性缺陷，84例（12%）患者中检测到中度或更严重的缺陷（占左心室的15%）。435例（64%）存在静息缺陷，216例（32%）存在中度或更严重的缺陷。心肌异常灌注的总范围较小（PET后3个月）。正常扫描的无事件生存率为90%，而小缺陷患者为87%，中度缺陷患者为75%，广泛缺陷患者为76%（对数秩卡方30，p < 0.0001）。功能等级、冠心病程度、灌注缺陷的存在和程度（静息时和应激时）是心源性死亡和总心脏事件的独立预测因子。在顺序Cox比例风险模型中，PET的结果比临床和血管造影评估的结果要高。因此，心肌损伤和损害的存在和程度是Rb-82 PET患者预后的独立和递增预测因素。(C) 1997年由摘录医学公司。
Myocardial perfusion imaging using positron emission tomography (PET) may be more accurate for the diagnosis of coronary artery disease (CAD) than conventional imaging. The purpose of this study was to evaluate the prognostic implications of perfusion abnormalities in 685 patients (age 62 +/- 11 years, 199 women) studied by PET, and to assess the incremental value of these data in relation to prognostic implications of clinical and angiographic findings. Rubidium (Rb)-82 PET was performed before and after dipyridamole stress. Transient defects were detected in 227 patients (33%), and were moderate or greater in severity (>15% of the left ventricle) in 84 (12%). Resting defects were present in 435 (64%) and were moderate or greater in severity in 216 (32%). The total extent of abnormally perfused myocardium was small (3 months after PET). Normal scans had a 90% event-free survival, compared with 87% in patients with small, 75% with moderate, and 76% with extensive defects (log rank chi-square 30, p < 0.0001). Functional class, extent of CAD, and the presence and extent of perfusion defects (bath at rest and during stress) were independent predictors of cardiac death and total cardiac events. In sequential Cox proportional-hazards models, the results of PET were incremental to those of clinical and angiographic evaluation. Thus, the presence and extent of damaged and jeopardized myocardium are independent and incremental predictors of outcome in patients undergoing Rb-82 PET. (C) 1997 by Excerpta Medica, Inc.