Regional perfusion, glucose metabolism, and wall motion in patients with chronic electrocardiographic Q wave infarctions: evidence for persistence of viable tissue in some infarct regions by positron emission tomography.
Regional perfusion, glucose metabolism, and wall motion in patients with chronic electrocardiographic Q wave infarctions: evidence for persistence of viable tissue in some infarct regions by positron emission tomography.
复制标题
慢性心电图 Q 波梗塞患者的区域灌注、葡萄糖代谢和室壁运动：通过正电子发射断层扫描证明某些梗塞区域存活组织持续存在的证据。
DOI：
10.1161/01.cir.73.5.951
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发表时间：
1986
期刊：
影响因子：
37.8
通讯作者：
Schelbert,HR
中科院分区：
文献类型：
--
作者：
Brunken,R;Tillisch,J;Schwaiger,M;Child,JS;Marshall,R;Mandelkern,M;Phelps,ME;Schelbert,HR
采用13n -氨和18f -2-脱氧葡萄糖正电子发射断层扫描评估20例慢性心电图Q波31个区域的灌注和葡萄糖利用。根据先前公布的标准，梗死区域是通过区域灌注和葡萄糖利用的一致减少来确定的，缺血区域是通过灌注减少区域葡萄糖利用的保留来确定的。31个区域中只有10个（32%）显示心肌梗死。相反，正电子断层扫描显示6个区域缺血（20%），15个区域正常（48%）。即使重新分配和巩固Q波区域以增强心电图的特异性，在大多数（54%）区域仍注意到18f -2脱氧葡萄糖的摄取。心电图ST-T变化和相关壁运动异常的严重程度都不能可靠地区分断层扫描识别的缺血和梗死区域。因此，正电子断层扫描显示在很大比例的慢性心电图Q波区域存在持续的组织代谢，而常用的临床试验并不能可靠地区分灌注不足但有活力的区域和断层扫描确定的心肌梗死区域。
Positron-emission tomography with 13N-ammonia and 18F-2-deoxyglucose was used to assess regional perfusion and glucose utilization in 31 chronic electrocardiographic Q wave regions in 20 patients. With previously published criteria, regions of infarction were identified by a concordant reduction in regional perfusion and glucose utilization, and regions of ischemia were identified by preservation of glucose utilization in regions of diminished perfusion. Only 10 of the 31 regions (32%) exhibited myocardial infarction tomographically. In contrast, positron tomography revealed ischemia in six regions (20%) and was normal in 15 regions (48%). Even when Q wave regions were reassigned and consolidated to enhance the specificity of the electrocardiogram, uptake of 18F-2-deoxyglucose was noted in the majority (54%) of the regions. Neither electrocardiographic ST-T changes nor severity of associated wall motion abnormality reliably distinguished tomographically identified regions of ischemia from infarction. Thus positron tomography reveals evidence of persistent tissue metabolism in a high proportion of chronic electrocardiographic Q wave regions, and commonly used clinical tests do not reliably distinguish hypoperfused but viable regions from tomographically defined regions of myocardial infarction.