INFARCT SIZE AFTER ACUTE MYOCARDIAL-INFARCTION MEASURED BY QUANTITATIVE TOMOGRAPHIC TC-99M SESTAMIBI IMAGING PREDICTS SUBSEQUENT MORTALITY
INFARCT SIZE AFTER ACUTE MYOCARDIAL-INFARCTION MEASURED BY QUANTITATIVE TOMOGRAPHIC TC-99M SESTAMIBI IMAGING PREDICTS SUBSEQUENT MORTALITY
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DOI：
10.1161/01.cir.92.3.334
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发表时间：
1995-08-01
期刊：
影响因子：
37.8
通讯作者：
GIBBONS, RJ
中科院分区：
文献类型：
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作者：
MILLER, TD;CHRISTIAN, TF;GIBBONS, RJ
Tc-99m sestamibi是最近开发的一种放射性同位素，已用于测量危险心肌和梗死面积。这些测量与随后的患者预后之间的关系尚未得到证实。方法与结果连续274例急性心肌梗死患者在到达医院时（在再灌注治疗前测量有危险的心肌）和出院时（测量挽救心肌的数量和最终梗死面积）分别接受Tc-99m sestamibi成像。对sestamibi图像上的缺陷大小进行量化，使用从左心室五个代表性切片生成的周向计数剖面曲线中峰值计数的60%作为阈值。出院后对患者进行随访，以评估最终梗死面积与随后死亡率之间的关系。测量的中位缺损大小在入院时为左心室的27%（范围，0%至77%），出院时为左心室的12%（范围，0%至68%）。几乎一半的患者最终梗死面积小于或等于10%。心肌抢救的中位数为9%（范围-31% ~ 75%）。在中位随访12个月期间，有10例死亡（7例心源性死亡，3例非心源性死亡），1例院外心脏骤停复苏。梗死面积与总死亡率（chi(2)=8.66， P= 0.003）和心脏死亡率(chi(2)=11.89， P
Background Tc-99m sestamibi is a recently developed radioisotope that has been used to measure myocardium at risk and infarct size. The relation between these measurements and subsequent patient outcome has not yet been demonstrated.Methods and Results Two hundred seventy-four consecutive patients with acute myocardial infarction underwent tomographic Tc-99m sestamibi imaging on arrival at the hospital (to measure myocardium at risk before reperfusion therapy) and at hospital discharge (to measure the amount of salvaged myocardium and final infarct size). Defect size on the sestamibi images was quantified using a threshold value of 60% of peak counts from the circumferential count profile curves generated for five representative slices of the left ventricle. Patients were followed after hospital discharge to evaluate the association between final infarct size and subsequent mortality. The median defect size measured was 27% of the left ventricle at presentation to the hospital (range, 0% to 77%) and was 12% of the left ventricle at hospital discharge (range, 0% to 68%). Almost one half of the patients had a final infarct size of less than or equal to 10%. The median amount of myocardium salvaged was 9% (range, -31% to 75%). During a median duration of follow-up of 12 months, there were 10 deaths (7 cardiac and 3 noncardiac) and 1 resuscitated out-of-hospital cardiac arrest. There was a significant association between infarct size and overall mortality (chi(2)=8.66, P=.003) and cardiac mortality (chi(2)=11.89, P