13N-ammonia myocardial blood flow and uptake: relation to functional outcome of asynergic regions after revascularization.
13N-ammonia myocardial blood flow and uptake: relation to functional outcome of asynergic regions after revascularization.
复制标题
13N-氨心肌血流量和摄取：与血运重建后不协同区域的功能结果相关。
DOI：
10.1016/s0735-1097(98)00630-5
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发表时间：
1999
影响因子：
24
通讯作者：
V. Dilsizian
中科院分区：
文献类型：
--
作者：
Anastasia N. Kitsiou;S. Bacharach;Marissa L. Bartlett;G. Srinivasan;Ronald M. Summers;A. Quyyumi;V. Dilsizian
方法26例慢性冠状动脉疾病和左心室功能不全患者在血运重建前接受13 N-氨和18 F-脱氧葡萄糖（FDG）的联合治疗。正电子发射断层扫描和铊单光子发射计算机断层扫描。使用门控心脏磁共振成像或门控放射性核素血管造影评估血管重建前后室壁运动异常。在107个最初的运动不协调区域中，61个（57%）室壁运动改善，46个在血管重建后仍然异常。与血运重建后未改善的区域相比，改善区域的平均绝对心肌血流量显著更高（0.63 ± 0.27 vs. 0.52 ± 0.25 ml/min/g，p < 0.04）。同样，与血运重建后未改善的区域（分别为67 ± 24%和71 ± 25%，p < 0.001）相比，血运重建后改善的区域（分别为90 ± 20%和94 ± 25%）的晚期13 N-氨摄取和FDG摄取的幅度显著更高。然而，与绝对血流量（ROC曲线下面积= 0.63，p < 0.05）相比，晚期13 N-氨摄取是血运重建后功能改善的显著更好的预测因子（ROC曲线下面积= 0.79）。此外，有一个线性关系late 13 N-氨摄取和FDG摄取（r = 0.68，p < 0.001），以及铊摄取（r = 0.76，p < 0.001）在所有asynergic regions.CONCLUSIONSThese数据表明，超出其价值作为灌注示踪剂，late 13 N-氨摄取提供了有用的信息，关于功能恢复后血管重建。13 N-氨、FDG和铊摄取之间的平行关系支持这样一个概念，即从晚期图像测量的13 N-氨摄取可以提供关于细胞膜完整性和心肌活力的重要见解。
OBJECTIVESIn this study we determined whether13N-ammonia uptake measured late after injection provides additional insight into myocardial viability beyond its value as a myocardial blood flow tracer.BACKGROUNDMyocardial accumulation of13N-ammonia is dependent on both regional blood flow and metabolic trapping.METHODSTwenty-six patients with chronic coronary artery disease and left ventricular dysfunction underwent prerevascularization13N-ammonia and18F-deoxyglucose (FDG) positron emission tomography, and thallium single-photon emission computed tomography. Pre- and postrevascularization wall-motion abnormalities were assessed using gated cardiac magnetic resonance imaging or gated radionuclide angiography.RESULTSWall motion improved in 61 of 107 (57%) initially asynergic regions and remained abnormal in 46 after revascularization. Mean absolute myocardial blood flow was significantly higher in regions that improved compared to regions that did not improve after revascularization (0.63 ± 0.27 vs. 0.52 ± 0.25 ml/min/g, p < 0.04). Similarly, the magnitude of late13N-ammonia uptake and FDG uptake was significantly higher in regions that improved (90 ± 20% and 94 ± 25%, respectively) compared to regions that did not improve after revascularization (67 ± 24% and 71 ± 25%, p < 0.001 for both, respectively). However, late13N-ammonia uptake was a significantly better predictor of functional improvement after revascularization (area under the receiver operating characteristic [ROC] curve = 0.79) when compared to absolute blood flow (area under the ROC curve = 0.63, p < 0.05). In addition, there was a linear relationship between late13N-ammonia uptake and FDG uptake (r = 0.68, p < 0.001) as well as thallium uptake (r = 0.76, p < 0.001) in all asynergic regions.CONCLUSIONSThese data suggest that beyond its value as a perfusion tracer, late13N-ammonia uptake provides useful information regarding functional recovery after revascularization. The parallel relationship among13N-ammonia, FDG, and thallium uptake supports the concept that uptake of13N-ammonia as measured from the late images may provide important insight regarding cell membrane integrity and myocardial viability.
影响因子：
37.8
作者：
VOMDAHL, J;EITZMAN, DT;SCHWAIGER, M
通讯作者：
SCHWAIGER, M