COMPARISON OF SESTAMIBI DEFECTS WITH KNOWN INDICES OF ADVERSE PROGNOSIS

静息和运动异常的左心室射血分数和 运动中肺对铊的摄取增加可识别冠状动脉 动脉疾病患者是未来心脏事件的高危人群。至 测定~(99m)Tc-Sestamibi肺/心比值 运动与运动性Sestamibi血流灌注缺陷的程度 也与已知的不良预后指标相关，12名患者 慢性冠状动脉疾病患者在同一天休息-锻炼 运动和静息核素血管造影术 平均在8天内学习。在赛斯塔米比运动研究之前， 所有患者均放置Swan-Ganz导尿管。肺毛细血管 基线测得的楔形压力范围为7至43 mm Hg(平均为19 最大运动量为7~47 mm Hg(平均27 mm Hg)。 图像是在平均25分钟内获得的 赛司他米在跑步机运动中的注射。定量Sestamibi 根据前投影计算肺/心比率，并基于 根据之前公布的数据，肺/心脏比率超过0.42是 被认为不正常的。静息状态下平均左心室射血分数为 29%(10%至50%)，运动期间降至25%(6%至50% 44%)。每个患者因运动导致的Sestamibi缺陷的数量(平均 2.33/患者)与他们各自的运动显著相关 肺毛细血管楔压测定(r=0.59，P<0.04)。 而肺毛细血管楔压与 静息状态下的左心室射血分数(r=-0.73，P<0.01) 而在运动过程中(r=-0.87，P<0.01)，二者无相关性 肺毛细血管楔压与肺/心比值的关系 (r=0.42，p=NS)。这些数据表明，与肺/心脏增加不同 运动中的铊比率、Sestamibi肺/心比率可能不 有助于识别高危冠心病患者 为将来的心脏事件做准备。

Abnormal rest and exercise left ventricular ejection fraction and increased lung uptake of thallium during exercise identify coronary artery disease patients at high risk for future cardiac events. To determine whether technetium-99m sestamibi lung/heart ratio during exercise and the extent of exercise-induced sestamibi perfusion defects also correlate with known indices of adverse prognosis, 12 patients with chronic coronary artery disease underwent both same-day rest-exercise sestamibi tomography and rest and exercise radionuclide angiography studies within a mean of 8 days. Prior to sestamibi exercise studies, Swan-Ganz catheters were placed in all patients. Pulmonary capillary wedge pressure measured at baseline ranged from 7 to 43 mm Hg (mean 19 mm Hg) and at peak exercise ranged from 7 to 47 mm Hg (mean 27mm Hg). Images were acquired within a mean of 25 minutes from the time of sestamibi injection during treadmill exercise. Quantitative sestamibi lung/heart ratios were calculated from the anterior projections and based on previously published data, lung/heart ratio more than0.42 was considered abnormal. Mean left ventricular ejection fraction at rest was 29% (range 10% to 50%) and decreased to 25% during exercise (range 6% to 44%). The number of exercise-induced sestamibi defects per patient (mean 2.33/patient) correlated significantly with their respective exercise pulmonary capillary wedge pressure measurements (r=0.59, pless than0.04). While pulmonary capillary wedge pressure was inversely correlated with left ventricular ejection fraction both at rest (r=-0.73, pless than0.01) and during exercise (r=-0.87, pless than0.01), there was no correlation between pulmonary capillary wedge pressure and sestamibi lung/heart ratio (r=0.42, p=NS). These data suggest that unlike increased lung/heart ratio of thallium, sestamibi lung/heart ratios during exercise may not be useful in identifying coronary artery disease patients at high risk for future cardiac events.