EARLY DETECTION OF ABNORMAL CORONARY FLOW RESERVE IN ASYMPTOMATIC MEN AT HIGH-RISK FOR CORONARY-ARTERY DISEASE USING POSITRON EMISSION TOMOGRAPHY
EARLY DETECTION OF ABNORMAL CORONARY FLOW RESERVE IN ASYMPTOMATIC MEN AT HIGH-RISK FOR CORONARY-ARTERY DISEASE USING POSITRON EMISSION TOMOGRAPHY
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DOI：
10.1161/01.cir.90.2.808
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发表时间：
1994-08-01
期刊：
影响因子：
37.8
通讯作者：
SCHWAIGER, M
中科院分区：
文献类型：
--
作者：
DAYANIKLI, F;GRAMBOW, D;SCHWAIGER, M
背景：本研究的目的是利用正电子发射断层扫描(PET)比较有冠状动脉疾病家族史(CAD)和高危血脂谱的无症状中年男性与无冠心病危险因素的男性的冠状动脉血流储备(CFR)作为血管完整性的指标。以往的研究表明，CFR的评估是在冠状动脉造影前发现血管异常的敏感手段，N-13氨水PET扫描可以无创性地评估局部和整体心肌血流，从而定量CFR。方法和结果我们使用动态N-13氨水PET显像结合静脉注射腺苷来评估无症状的中年男性冠心病高危人群(第1组，n=16)和无任何已知危险因素的男性(第2组，n=11)的局部和整体CFR。第一组患者是根据阳性的冠心病家族史、一个或多个血脂异常和正常的负荷试验选择的。没有患者有糖尿病或高血压病史。本研究所开发并验证的三室示踪剂动力学模型用于计算心肌血流量。计算每个患者在五个地区的绝对心肌血流量(毫升/100g/分钟)。CFR被定义为最大药物血管扩张期间的血液与静息状态下的血流量的比率。比较两组患者的CFR。两组的平均年龄相似(组1，49.3+/-0.5岁；组2，48.1+/-8.7岁；P=NS)。第1组总胆固醇(mg/dL)高于对照组(241+/-43比173+/-34，P
Background The objective of this study was to compare coronary flow reserve (CFR) as a measure of vascular integrity in asymptomatic middle-aged men with family history of coronary artery disease (CAD) and a high-risk lipid profile with men without risk factors for CAD using positron emission tomography (PET). Previous studies suggested that the assessment of CFR is a sensitive means to detect vascular abnormalities before angiographic appearance of CAD, N-13 ammonia PET scanning allows noninvasive evaluation of regional and global myocardial blood flow and thereby quantification of CFR.Methods and Results We used dynamic N-13 ammonia PET imaging in conjunction with intravenous adenosine to assess regional and global CFR in asymptomatic middle-aged men with high risk (group 1, n=16) and men without any known risk factors (group 2, n=11) for CAD. Group 1 patients were selected based on positive family history of CAD, one or more lipid abnormalities, and a normal stress test. No patient had history of diabetes or hypertension. A three-compartment tracer kinetic model developed and validated in our institution was used to calculate myocardial blood flow. Absolute myocardial blood flow (mL/100 g per minute) was calculated in five territories for each patient. CFR was defined as the ratio of blood how during maximum pharmacological vasodilatation to blood flow at rest. Comparisons of CFR between the two groups of patients were performed. The mean age was similar between groups (group 1, 49.3+/-0.5 years; group 2, 48.1+/-8.7 years; P=NS). Group 1 had higher total cholesterol (mg/dL) (241+/-43 versus 173+/-34, P