Myocardial Blood Flow Quantified by Low-Dose Dynamic CT Myocardial Perfusion Imaging Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction
Myocardial Blood Flow Quantified by Low-Dose Dynamic CT Myocardial Perfusion Imaging Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction
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DOI：
10.3348/kjr.2018.0729
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发表时间：
2019-05-01
影响因子：
4.8
通讯作者：
Zhang, Jiayin
中科院分区：
文献类型：
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作者：
Pan, Jingwei;Yuan, Mingyuan;Zhang, Jiayin
目的：目的：探讨ST段抬高型心肌梗死（STEMI）患者动态CT心肌灌注成像（MPI）定量心肌血流量（MBF）与肌钙蛋白水平及左室功能的关系。所有患者均接受动态CT-MPI检查。超声心动图检测各组患者血清高敏肌钙蛋白T（hs-TnT）水平及左室射血分数（LVEF）。纳入了26例患者（427个节段）进行分析。来自动态CT-MPI的各种定量参数进行了分析，以确定是否有一个hs-TnT水平和LVEF之间的相关性入院，并再次在6个月mark.Results：平均辐射剂量为动态CT-MPI为3.2 +/- 1.1毫西弗。与参照区域相比，切除区域的MBF（30.5 +/- 7.4 mL/min/100 mL vs 73.4 +/- 8.1 mL/min/100 mL，p < 0.001）和心肌血容量（MBV）（2.8 +/- 0.9 mL/100 mL vs 4.2 +/- 1.1 mL/100 mL，p = 0.044）显著降低。MBF与hs-TnT峰值水平相关性最好（r =-0.682，p = 0.001），MBV与hs-TnT峰值水平中度相关（r = 0.437，p = 0.026），其他指标与hs-TnT水平相关性不显著。在与左室功能的相关性方面，入院时（r = 0.469，p = 0.016）和6个月时（r = 0.585，p = 0.001），只有MBF与LVEF有显著相关性。此外，MBF较低的患者在入院时和6个月时往往会出现LV功能受损。
Objective: To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI).Materials and Methods: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark.Results: The mean radiation dose for dynamic CT-MPI was 3.2 +/- 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 +/- 7.4 mL/min/100 mL versus 73.4 +/- 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 +/- 0.9 mL/100 mL versus 4.2 +/- 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = -0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = 0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001).Conclusion: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.