VALUE OF METABOLIC IMAGING WITH POSITRON EMISSION TOMOGRAPHY FOR EVALUATING PROGNOSIS IN PATIENTS WITH CORONARY-ARTERY DISEASE AND LEFT-VENTRICULAR DYSFUNCTION
VALUE OF METABOLIC IMAGING WITH POSITRON EMISSION TOMOGRAPHY FOR EVALUATING PROGNOSIS IN PATIENTS WITH CORONARY-ARTERY DISEASE AND LEFT-VENTRICULAR DYSFUNCTION
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DOI：
10.1016/0002-9149(94)90327-1
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发表时间：
1994-03-15
影响因子：
2.8
通讯作者：
MADDAHI, J
中科院分区：
文献类型：
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作者：
DICARLI, MF;DAVIDSON, M;MADDAHI, J
冠状动脉疾病（CAD）和严重左心室（LV）功能不全的患者具有高但可变的年死亡率，其中一些可能受益于心肌血运重建术。本研究旨在评估正电子发射断层扫描（PET）的预后价值，以及其与药物治疗或血运重建术选择的相关性，以预测CAD合并左室功能障碍患者心力衰竭症状的生存和改善。连续93例冠心病血管造影患者，平均左室射血分数为0.25，使用N-13氨和18-F脱氧葡萄糖进行心脏PET研究，以评估低灌注但存活的心肌（“错配模式”），平均随访13.6个月。50名患者接受了治疗，43名患者接受了血运重建术。Cox模型分析显示，不匹配程度对生存有负面影响（p = 0.02），而血运重建对生存有积极影响（p = 0.04）。错配患者接受药物治疗的年生存率低于无错配患者（50% vs 92%, p = 0.007）。错配患者行血运重建术的生存率高于药物治疗的患者（88比50%，p = 0.03）。错配的存在也预示着血运重建术后心力衰竭症状的改善(p
Patients with coronary artery disease (CAD) and severe left ventricular (LV) dysfunction have a high but variable annual mortality and some may benefit from myocardial revascularization. This study aimed to evaluate the prognostic value of positron emission tomography (PET), and its interrelation with the choice of medical therapy or revascularization for predicting survival and improvement in symptoms of heart failure in patients with CAD and LV dysfunction. Ninety-three consecutive patients with angiographic CAD and a mean LV ejection fraction of 0.25 who underwent cardiac PET studies for assessment of hypoperfused yet viable myocardium (''mismatch pattern'') using N-13 ammonia and 18-F deoxyglucose were followed up for an average of 13.6 months. Fifty patients underwent medical treatment and 43 underwent revascularization. The Cox model analysis showed that the extent of mismatch had a negative effect (p = 0.02), whereas revascularization had a positive effect on survival (p = 0.04). The annual survival probability of patients with mismatch receiving medical therapy was lower than of those without mismatch (50 vs 92%, p = 0.007). Patients with mismatch who underwent revascularization had a higher survival rate than those treated medically (88 vs 50%, p = 0.03). The presence of mismatch also predicted improvement in heart failure symptoms after revascularization (p