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Non ECG gated supine to prone left ventricular volume ratio: a novel marker for myocardial ischemia.

非心电图门控仰卧至俯卧左心室容积比: 心肌缺血的新型标志物。

  • 影响因子:1.76
  • DOI:10.1007/s10554-020-01836-2
  • 作者列表:"Yew MS","Ong WSJ","Ong SJJ
  • 发表时间:2020-07-01
Abstract

:Transient ischemic dilation (TID), a marker of severe coronary artery disease (CAD), is the post-stress to rest left ventricular (LV) volume ratio quantified using non ECG gated single photon emission computerized tomography (SPECT). Although prone positioning causes physiological reduction of LV volume in normal subjects, we hypothesize this may not occur in TID with underlying severe CAD as cardiac hemodynamics worsen when prone. We aim to evaluate the utility of the non ECG gated supine to prone LV volume ratio (SPLVr) for identifying severe CAD. Retrospective data analysis from 130 patients with TID ratio ≥ 1.21 and both post-stress supine and prone images. SPLVr had a significant negative correlation with summed stress (r =  - 0.221, p = 0.011) and rest (r =  - 0.292, p = 0.001) scores. Of the 129 cases with follow-up invasive or computed tomography coronary angiography, 52 (40.3%) had severe CAD (left main ≥ 50% stenosis, 3-vessel with ≥ 70% stenosis or 2-vessel with proximal left anterior descending ≥ 70% stenosis). Mean SPLVr was significantly lower in severe CAD cases (1.05 ± 0.14 vs 1.12 ± 0.17, p = 0.012). SPLVr predicted severe CAD on univariate [OR 0.12 (95% CI 0.00-0.35) p = 0.01] but not in multivariate analysis. SPLVr is a novel marker that negatively correlates with extent of perfusion abnormalities and is lower amongst TID patients with severe CAD. Larger studies are needed to assess if SPLVr can reliably identify underlying severe CAD amongst TID cases.

摘要

: 短暂性缺血性扩张 (TID) 是严重冠状动脉疾病 (CAD) 的标志物,是使用非ECG门控单光子发射计算机断层扫描 (SPECT) 定量的应力后与静息左心室 (LV) 体积比。尽管在正常受试者中俯卧位导致LV体积的生理性减少,我们假设这可能不会发生在具有潜在的严重CAD的TID中,因为当俯卧时心脏血流动力学恶化。我们的目的是评估非ECG门控仰卧至俯卧LV容积比 (SPLVr) 用于识别严重CAD的效用。回顾性分析130例TID比率 ≥ 1.21的患者的资料,并同时进行应激后仰卧位和俯卧位图像。SPLVr与压力 (r   =   -  0.221,p   =   0.011) 和休息 (r   =   -  0.292,p   =   0.001) 总分呈显著负相关。在随访的129例有创或计算机断层扫描冠状动脉造影中,52例 (40.3%) 患有重度CAD (左主干 ≥ 50% 狭窄,3支血管 ≥ 70% 狭窄或2支血管近端左前降支 ≥ 70% 狭窄)。严重CAD病例的平均SPLVr显著较低 (1.05 ± 0.14 vs 1.12 ± 0.17,p = 0.012)。单变量 [OR 0.12 (95% CI 0.00-0.35) p   =   0.01] 预测严重CAD,但在多变量分析中没有。SPLVr是一种新的标志物,其与灌注异常的程度负相关,并且在患有严重CAD的TID患者中较低。需要更大规模的研究来评估SPLVr是否能够在TID病例中可靠地识别潜在的严重CAD。

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作者列表:["Dev M","Sharma M","Rana N"]

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心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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