Early dipyridamole stress myocardial SPECT to detect residual stenosis of infarct related artery: comparison with coronary angiography and fractional flow reserve.
Early dipyridamole stress myocardial SPECT to detect residual stenosis of infarct related artery: comparison with coronary angiography and fractional flow reserve.
复制标题
DOI：
10.3904/kjim.2002.17.1.7
复制
发表时间：
2002-03
期刊：
影响因子：
--
通讯作者：
Lee WH
中科院分区：
文献类型：
--
作者：
Seo JK;Kwan J;Suh JH;Kim DH;Lee KH;Hyun IY;Choe WS;Park KS;Lee WH
急性心肌梗死（AMI）后早期梗塞相关动脉（IRA）残余狭窄的检测对于介入血运重建的临床决策至关重要。本研究的目的是评估早期双嘧达莫应激心肌 SPECT 检测 AMI 后功能和发光学上显着的 IRA 残余狭窄的相关性。连续 25 名 AMI 患者（M:F=19:6，年龄：56±13 岁）在发作后 5 天内接受了 SPECT 和冠状动脉造影。 FFR < 0.75 且直径狭窄 (DST) > 70% 的梗塞相关动脉被认为具有功能和形态学上显着的残余狭窄。如果与应力图像相比，SPECT 静息图像上梗塞节段的灌注评分改善超过一级，则定义为可逆性灌注缺陷。平均 FFR 和 DST 分别为 0.76±0.14 和 74±15%。 SPECT 显示与 FFR 和 DST 均无显着相关性，Kendall 系数分别为 0.28 (p=0.05) 和 0.13 (p=0.35)。 SPECT 检测功能性和形态学上显着残余狭窄的敏感性和特异性分别为 92%、31% 和 83%、29%。 AMI 后早期双嘧达莫应激心肌 SPECT 似乎不是检测功能和发光学上显着的 IRA 残余狭窄的有用的非侵入性测试。
The detection of residual stenosis of infarct related artery (IRA) at early stage after acute myocardial infarction (AMI) is crucial in clinical decision making for interventional revascularization. The aim of this study was to evaluate the relevancy of early dipyridamole stress myocardial SPECT to detect functionally and luminologically significant residual stenosis of IRA after AMI. Twenty five consecutive patients (M:F=19:6, age: 56±13yrs) with AMI underwent SPECT and coronary angiography within 5 days of the attack. Infarct related arteries with FFR < 0.75 and diameter stenosis (DST) >70% were regarded to have functionally and morphologically significant residual stenosis. Reversible perfusion defect was defined if there was improvement of the perfusion score more than one grade in infarct segments on rest images of SPECT compared with stress images. Mean FFR and DST were 0.76±0.14 and 74±15%. SPECT showed no significant correlation with both FFR and DST with Kendall’s coefficiency of 0.28 (p=0.05) and 0.13 (p=0.35). The sensitivity and specificity of SPECT to detect functionally and morphologically significant residual stenosis were 92%, 31% and 83%, 29%. The early dipyridamole stress myocardial SPECT after AMI does not seem to be a useful non-invasive test for the detection of functionally and luminologically significant residual stenosis of IRA.