Relationship of transient ischemic dilation in dipyridamole myocardial perfusion imaging and stress-induced changes of functional parameters evaluated by Tl-201 gated SPECT
Relationship of transient ischemic dilation in dipyridamole myocardial perfusion imaging and stress-induced changes of functional parameters evaluated by Tl-201 gated SPECT
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DOI：
10.1016/j.nuclcard.2005.03.004
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发表时间：
2005-05-01
影响因子：
2.4
通讯作者：
Yang, KT
中科院分区：
文献类型：
--
作者：
Hung, GU;Lee, KW;Yang, KT
背景本研究评估是否短暂性缺血性扩张（TID）的左心室缺血性顿抑，表现为应力诱导的左心室射血分数（LVEF）的降低和室壁运动的恶化，通过使用潘生丁应力和再分配铊201门控单光子发射计算机断层扫描（SPECT）。包括92名连续接受双嘧达莫TI-201门控SPECT的患者。TID比率处于最高四分位数的患者被定义为患有TID。TID患者的舒张末期容积（EDV）和收缩末期容积（ESV）在潘生丁负荷显像上均显著大于再分布显像（P <0.001）。ESV的扩张程度远大于EDV。在无TID的患者中，EDV和ESV在应激后均降低（P <0.001）。TID患者在潘生丁负荷显像上的平均LVEF低于再分布显像（P <0.001）。无TID的患者在潘生丁负荷显像上的平均LVEF高于再分布显像（P <0.001）。TID患者在潘生丁负荷显像上的整体室壁运动较再分布显像明显恶化（P <0.001），而无TID患者则无此现象。TID与缺血性顿抑显著相关，ESV扩大是导致TID的重要因素。
Background. This study assessed whether transient ischemic dilation (TID) of the left ventricle is related to ischemic stunning, manifested by stress-induced decrease of left ventricular ejection fraction (LVEF) and worsening of wall motion, by use of dipyridamole-stress and redistribution thallium 201 gated single photon emission computed tomography (SPECT).Methods and Results. Ninety-two consecutive patients undergoing dipyridamole TI-201 gated SPECT were included. Patients with a TID ratio in the highest quartile were defined as having TID. In patients with TID, end-diastolic volume (EDV) and end-systolic volume (ESV) were both significantly greater on dipyridamole-stress images than on redistribution images (P < .001). The degree of enlargement was much greater for ESV than EDV. In patients without TID, EDV and ESV were both decreased after stress (P < .001). Patients with TID had a lower mean LVEF on dipyridamole-stress images than on redistribution images (P < .001). Patients without TID had a higher mean LVEF on dipyridamole-stress images than on redistribution images (P < .001). Patients with TID had a significant worsening of global wall motion on dipyridamole-stress images than on redistribution images (P < .001), but patients without TID did not.Conclusion. TID was significantly correlated with ischemic stunning, and the enlargement of ESV was an important factor resulting in TID.