Abnormal subendocardial perfusion in cardiac syndrome X detected by cardiovascular magnetic resonance imaging
Abnormal subendocardial perfusion in cardiac syndrome X detected by cardiovascular magnetic resonance imaging
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DOI：
10.1056/nejmoa012369
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发表时间：
2002-06-20
影响因子：
158.5
通讯作者：
Pennell, DJ
中科院分区：
文献类型：
--
作者：
Panting, JR;Gatehouse, PD;Pennell, DJ
背景：在心脏综合征X（以典型心绞痛、运动试验结果异常、冠状动脉正常为特征的综合征）中，常规调查未发现胸痛是由心肌缺血引起的。磁共振技术具有更高的分辨率，因此可能更敏感。方法：我们对20名X综合征患者和10名匹配的对照组在静息和腺苷输注期间进行心肌灌注心血管磁共振成像。定量灌注分析采用归一化心肌信号增强上斜率，得出心肌灌注指数和心肌灌注储备指数（定义为应激时心肌灌注指数与静止时心肌灌注指数之比）。结果：对照组中，加入腺苷后两层心肌灌注指数均升高（心内膜下心肌灌注指数从平均值[+/-SD] 0.12+/-0.03增至0.16+/-0.03 [P=0.02]，心内膜下心肌灌注指数从0.11+/-0.02增至0.17+/-0.05 [P=0.002]）；X综合征患者心内膜下心肌灌注指数无明显变化（0.13+/-0.02 vs. 0.14+/-0.03， P=0.11； P=0.09），心内膜下心肌灌注指数升高(从0.11+/-0.02到0.20+/-0.04，P=0.09
Background: In cardiac syndrome X (a syndrome characterized by typical angina, abnormal exercise-test results, and normal coronary arteries), conventional investigations have not found that chest pain is due to myocardial ischemia. Magnetic resonance techniques have higher resolution and therefore may be more sensitive.Methods: We performed myocardial-perfusion cardiovascular magnetic resonance imaging in 20 patients with syndrome X and 10 matched controls, both at rest and during an infusion of adenosine. Quantitative perfusion analysis was performed by using the normalized upslope of myocardial signal enhancement to derive the myocardial perfusion index and the myocardial-perfusion reserve index (defined as the ratio of the myocardial perfusion index during stress to the index at rest).Results: In the controls, the myocardial perfusion index increased in both myocardial layers with adenosine (in the subendocardium, from a mean [+/-SD] of 0.12+/-0.03 to 0.16+/-0.03 [P=0.02]; in the subepicardium, from 0.11+/-0.02 to 0.17+/-0.05 [P=0.002]); in patients with syndrome X, the myocardial perfusion index did not change significantly in the subendocardium (0.13+/-0.02 vs. 0.14+/-0.03, P=0.11; P=0.09 as compared with controls) but increased in the subepicardium (from 0.11+/-0.02 to 0.20+/-0.04, P