Relation between postexercise abnormal heart rate recovery and myocardial damage evidenced by gated single-photon emission computed tomography.
Relation between postexercise abnormal heart rate recovery and myocardial damage evidenced by gated single-photon emission computed tomography.
复制标题
门控单光子发射计算机断层扫描证明运动后异常心率恢复与心肌损伤之间的关系。
DOI：
10.1016/j.amjcard.2005.11.078
复制
发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Adriana J Soares
中科院分区：
文献类型：
--
作者：
R. Lima;A. De Lorenzo;Adriana J Soares
运动后心率恢复异常（HRR）与心源性死亡率增加有关。门控心肌灌注单光子发射计算机断层扫描（SPECT）同时评价心肌灌注和功能的能力可能有助于确定参与这一发现的可能机制。本研究调查了异常HRR与其他心血管事件风险指标之间的关系。前瞻性入组了在静息时接受运动/锝-99 m甲氧基异丁基异腈门控心肌灌注SPECT的患者（n = 1，296，784例男性; 57 ± 11岁）。运动平板试验根据活动受限的布鲁斯方案进行。HRR是从运动期间的最大心率减去运动平板试验后恢复后第一分钟的心率获得的。采用17节段左心室模型对心肌灌注SPECT进行半定量分析。使用定量门控SPECT软件自动计算左心室射血分数。在我们的研究中，与HRR正常的患者相比，HRR异常的患者年龄更大，更常见糖尿病和高血压，既往有心肌梗死和心肌血运重建，静息心率和灌注缺损定量评分更高，左心室射血分数更低，左心室容积更大。在多变量分析中，年龄（p <0.0001）、静息心率（p <0.0001）、左心室射血分数（p <0.0001）和静息灌注缺损范围和严重程度（p = 0.038）是异常HRR的独立预测因素。总之，HRR异常与静息时左心室射血分数降低、灌注缺损范围和严重程度显著相关，但与心肌缺血的门控SPECT标记物无关。因此，HRR异常可能反映心肌损伤。
Abnormal heart rate recovery (HRR) after exercise has been associated with increased cardiac mortality. The ability of gated myocardial perfusion single-photon emission computed tomography (SPECT) to evaluate myocardial perfusion and function simultaneously might make it helpful in determining possible mechanisms that are involved in this finding. This study investigated the association between abnormal HRR and other indicators of risk for cardiovascular events. Patients (n = 1,296, 784 men; 57 ± 11 years of age) who underwent exercise/technetium-99m sestamibi gated myocardial perfusion SPECT at rest were prospectively enrolled. Exercise treadmill testing was performed according to a symptom-limited Bruce’s protocol. HRR was obtained from the subtraction of heart rate in the first minute of recovery after exercise treadmill testing from maximal heart rate during exercise. Myocardial perfusion SPECT was semi-quantitatively analyzed using a 17-segment left ventricular model. Left ventricular ejection fraction was automatically calculated using quantitative gated SPECT software. In our study, patients with abnormal HRR were older, more frequently diabetic, and hypertensive and had previous myocardial infarction and myocardial revascularization, higher heart rate at rest and perfusion defect quantification scores, lower left ventricular ejection fraction, and larger left ventricular volumes than did patients with normal HRR. In multivariable analysis, age (p <0.0001), heart rate at rest (p <0.0001), left ventricular ejection fraction (p <0.0001), and perfusion defect extent and severity at rest (p = 0.038) were independent predictors of abnormal HRR. In conclusion, abnormal HRR was significantly associated with lower left ventricular ejection fraction and with perfusion defect extent and severity at rest, but not with gated SPECT markers of myocardial ischemia. Therefore, abnormal HRR may reflect myocardial damage.
DOI：
--
发表时间：
1995-11
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
--
作者：
G. Germano;H. Kiat;P. Kavanagh;M. Moriel;M. Mazzanti;H. Su;K. V. Train;D. Berman
通讯作者：
G. Germano;H. Kiat;P. Kavanagh;M. Moriel;M. Mazzanti;H. Su;K. V. Train;D. Berman