CONGESTIVE HEART FAILURE--NUCLEAR STUDIES

心肌存活与左心功能恢复(LVEF) 通过正电子的存在来预测血运重建后 发射断层扫描确定的F-18脱氧葡萄糖(FDG)：血流不匹配 缺血性心肌病(ICM)患者的临床表现。然而，几乎没有 了解患者的局部血流和代谢模式 患有非缺血性心肌病(NICM)。因此，我们研究了10个 有症状的左心室患者(NYHA II级和III级) 功能障碍：ICM 5例，NICM 5例。所有患者都接受了放射性核素检查。 血管造影术，应力铊闪烁造影术，冠状动脉造影术和 N-13氨和FDG静止状态下的正电子发射研究。这个 心肌组织对应激铊的最大计数研究 被用作相对氨和FDG的正常参考区 领悟。从匹配的氨气和FDG短轴图像中，共有156个 分析了ICM患者的区域和NICM患者的144个区域。 铊和氨研究中区域血流均低于85% 被认为是不正常的。FDG：氨水比约等于1.2 被认为代表新陈代谢和血流不匹配。 异常流量不匹配LVEF(%) ICM 89(57%)37(47%)52(53%)16+/-8 NICM 37(26%)4(11%)33(89%)12+/-5 *P&lt；0.001**P&lt；0.005 在ICM患者中，57%的区域显示异常血流和 几乎一半的这样的区域显示了保存的葡萄糖提取 表明有心肌缺血和存活。相比之下，减少了 局部血流出现在大约四分之一的NICM区域 这些区域中的大多数(89%)都有相应的血糖下降 拔牙(非缺血)。因此，尽管没有重大的 心外膜冠状动脉狭窄，局部血流量减少 发生在NICM患者中，可能反映出混合了 存活的心肌细胞和纤维化。

Myocardial viability and recovery of left ventricular function (LVEF) after revascularization is predicted by the presence of positron emission tomography defined F-18 deoxyglucose (FDG):blood flow mismatch pattern in patients with ischemic cardiomyopathy (ICM). However, little is known about regional blood flow and metabolism patterns in patients with non-ischemic cardiomyopathy (NICM). Therefore, we studied 10 symptomatic patients (NYHA class II and III) with left ventricular dysfunction; 5 had ICM and 5 NICM. All patients underwent radionuclide angiography, stress thallium scintigraphy, coronary angiography and positron emission studies with N-13 ammonia and FDG at rest. The myocardial region with the maximum counts on the stress thallium study was used as the normal reference region for relative ammonia and FDG uptake. From matched ammonia and FDG short-axis images, a total of 156 regions were analyzed in ICM patients and 144 regions in NICM patients. Regional blood flow less than 85% in both thallium and ammonia studies was considered abnormal. FDG:ammonia ratio of equals approximately 1.2 was considered to represent metabolism-blood flow mismatch. abnormal flow mismatch match LVEF (%) ICM 89 (57%) 37 (47%) 52 (53%) 16 +/- 8 NICM 37 (26%) 4 (11%) 33 (89%) 12 +/- 5 *p <0.001 **p <0.005 In ICM patients, 57% of all regions demonstrated abnormal blood flow and almost half of such regions exhibited preserved glucose extraction indicative of ischemic and viable myocardium. In contrast, decreased regional blood flow occurred in approximately one-fourth of NICM regions and the majority (89%) of such regions had matched decrease in glucose extraction (nonischemic). Thus, despite the absence of significant epicardial coronary artery stenosis, decreased regional blood flow occurs in patients with NICM and may reflect regions with admixture of viable myocytes and fibrosis.