CONGESTIVE HEART FAILURE--NUCLEAR STUDIES

心肌存活和左室功能（LVEF）恢复 通过正电子的存在来预测血运重建后 放射断层扫描定义的F-18脱氧葡萄糖（FDG）：血流不匹配 缺血性心肌病（ICM）患者的模式。 不过小 了解患者的局部血流和代谢模式 非缺血性心肌病（NICM） 我们研究了10 症状性患者（NYHA II级和III级），左心室 功能障碍; 5例ICM和5例NICM。 所有患者均接受放射性核素检查 血管造影术、负荷铊造影术、冠状动脉造影术和 正电子发射研究与N-13氨和FDG在休息。 的 负荷铊研究中计数最多的心肌区域 作为相对氨和FDG的正常参考区 摄取。 从匹配的氨和FDG短轴图像，共156 在ICM患者中分析了144个区域，在NICM患者中分析了144个区域。 在铊和氨研究中，局部血流量低于85% 被认为是不正常的 FDG：氨的比例约等于1.2 被认为代表代谢-血流不匹配。 异常流动 失配 匹配 LVEF（%） ICM 89人（57%） 37人（47%） 52人（53%） 16 +/- 8 NICM 37人（26%） 4人（11%） 33人（89%） 12 +/- 5 *p <0.001 **p <0.005 在ICM患者中，57%的所有区域表现出异常血流， 几乎一半的这样的区域表现出保留的葡萄糖提取 表明缺血和存活心肌。 相比之下， 大约四分之一的NICM区域出现局部血流 大多数（89%）这些区域的葡萄糖水平也相应降低， 提取（非缺血性）。 因此，尽管缺乏重要的 心外膜冠状动脉狭窄，局部血流减少 发生在NICM患者中，可能反映了混合有 存活的肌细胞和纤维化。

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.