Clinical Physiology and Functional Imaging最新文献_第5页

Diagnostic value of combined heart and lung ultrasound in emergency department patients with dyspnea 心肺联合超声对急诊科呼吸困难患者的诊断价值

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-04-17 DOI: 10.1111/cpf.70009

Anna Bjällmark, Gustaf Hummel, Kambiz Shahgaldi

Background

Acute dyspnea in emergency departments (ED) requires prompt and accurate diagnosis due to its high mortality and readmission rates. Conventional diagnostic methods are resource-intensive and time-consuming. This study aimed to evaluate the diagnostic accuracy and time to diagnosis of combined heart and lung ultrasound (HeaLus) compared to standard emergency department evaluation in patients presenting with dyspnea.

Methods

A prospective study was conducted in a cohort of 61 patients at the ED of Danderyd Hospital, Sweden. HeaLus examinations were performed alongside routine investigations. Diagnostic performance of HeaLus and ED evaluation was assessed for accuracy, sensitivity, specificity, positive predictive value, and negative predictive value, and agreement using Kappa index. Median time to diagnostics was compared between HeaLus and ED evaluation using Mann-Whitney U-test.

Results

Heart failure was the most common diagnosis (20%) among patients presenting with dyspnea. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 95% (95% CI: [87%, 98%]), 98% (95% CI: [88%, 100%]), 90% (95% CI: [69%, 97%]), 95% (95% CI: [85%, 99%]), and 94% (95% CI: [74%, 99%]), respectively. The agreement between HeaLus and ED diagnoses was 0.88. Time to diagnosis was significantly reduced with HeaLus (21 min vs. 3 h and 28 min).

Conclusions

HeaLus offers rapid and accurate assessment of dyspnea. These results suggest that HeaLus could be valuable in optimizing patient management, particularly in settings with limited resources and long ED wait times.

背景急诊急性呼吸困难由于其高死亡率和再入院率需要及时准确的诊断。传统的诊断方法需要大量的资源和时间。本研究旨在评价心肺联合超声（HeaLus）诊断呼吸困难患者的准确性和诊断时间，并与标准急诊科评估进行比较。方法对瑞典Danderyd医院急诊科的61例患者进行前瞻性研究。在常规检查的同时进行健康检查。采用Kappa指数评估HeaLus和ED诊断的准确性、敏感性、特异性、阳性预测值和阴性预测值以及一致性。采用Mann-Whitney u检验比较HeaLus和ED评估的中位诊断时间。结果在出现呼吸困难的患者中，心衰是最常见的诊断（20%）。诊断准确性、敏感性、特异性、阳性预测值和阴性预测值分别为95% （95% CI:[87%, 98%]）、98% （95% CI:[88%, 100%]）、90% （95% CI:[69%, 97%]）、95% （95% CI:[85%, 99%]）和94% （95% CI:[74%, 99%]）。HeaLus诊断与ED诊断的一致性为0.88。HeaLus显著缩短了诊断时间（21分钟vs. 3小时和28分钟）。结论HeaLus能快速准确地评估呼吸困难。这些结果表明HeaLus在优化患者管理方面很有价值，特别是在资源有限和急诊科等待时间长的情况下。

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引用次数: 0

Agreement of concomitant cardiac output measurement by thoracic bio-impedance and inert gas rebreathing in healthy subjects 健康受试者胸廓生物阻抗与惰性气体再呼吸同时测量心输出量的一致性

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-03-28 DOI: 10.1111/cpf.70005

Laura Filaire, Hélène Perrault, Claire Dauphin, Aurélie Chalard, Bruno Pereira, Frederic Costes, Ruddy Richard

Purpose

Inasmuch as they are deemed valid, noninvasive measurement of cardiac output techniques present advantages of ease and safety for use in humans. Few studies have compared the use of thoracic bioimpedance and inert gas rebreathing techniques for cardiac output (CO) assessment at rest and exercise. This manuscript reports on differences between Physioflow® and Innocor® CO measurements at rest and during cycling in a population of healthy subjects.

Methods

Fifty healthy subjects (52 ± 16 years) underwent an incremental cycle exercise testing (IET) during which standardized Physioflow® and Innocor® CO assessments were achieved. Measurements were completed in a subgroup of twelve subjects during two constant-load 10-min cycling bouts at moderate and high intensities.

Results

Mean difference between Physioflow® and Innocor® was of 0.002 ± 0.98 l/min at rest and 0.38 ± 1.31 l/min during IET without statistical difference. Correlation coefficient values were higher for exercise (r = 0.83) than resting (r = 0.40) measurements. Good reproducibility of the two devices was observed on different graded exercises with intraindividual variability lower than 6%, except for rest Innocor® CO measurements (CV = 18%).

Conclusion

Physioflow® and Innocor® can be easily used concomitantly for noninvasive measurement of CO. Despite finding a strong agreement between techniques for exercise CO, results should not be interpreted as being interchangeable as values are derived from different flow measurements: systemic blood flow for Physioflow® and pulmonary blood flow for Innocor®. However, the concomitant use of both techniques could be of value in clinical setting for noninvasive intrathoracic shunt quantification.

目的：无创心输出量测量技术被认为是有效的，在人类中应用具有简单和安全的优点。很少有研究比较胸部生物阻抗和惰性气体再呼吸技术在休息和运动时心输出量（CO）评估中的应用。本文报道了在健康受试者人群中休息和循环期间Physioflow®和Innocor®CO测量的差异。方法50例健康受试者（52±16岁）进行增量周期运动试验（IET），并进行标准化的Physioflow®和Innocor®CO评估。测量在一个由12名受试者组成的亚组中完成，在两次中等和高强度的恒定负荷10分钟骑行中完成。结果Physioflow®与Innocor®在休息时的平均差异为0.002±0.98 l/min，在IET时的平均差异为0.38±1.31 l/min，差异无统计学意义。运动相关系数值（r = 0.83）高于静息相关系数值（r = 0.40）。除了Innocor®CO测量（CV = 18%）外，这两种装置在不同分级运动中的重复性良好，个体变异率低于6%。结论Physioflow®和Innocor®可以很容易地同时用于无创CO测量。尽管发现运动CO的技术之间有很强的一致性，但结果不应被解释为可互换，因为结果来自不同的流量测量：Physioflow®的全身血流和Innocor®的肺血流。然而，同时使用这两种技术在无创胸内分流量化的临床设置中可能是有价值的。

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引用次数: 0

Ventilation/perfusion scintigraphy in patients with pulmonary vascular anomaly 肺血管异常患者的通气/灌注显像。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-03-22 DOI: 10.1111/cpf.70008

Hamdi Afşin, Emine Afşin

Background

Although ventilation/perfusion (V/Q) scintigraphy is frequently used in the diagnosis of acute or chronic pulmonary embolism (PE), it also plays a significant role in diagnosing pulmonary vascular diseases. Additionally, in the presence of a mismatch defect on V/Q scintigraphy, pulmonary vascular anomalies should be considered as a possible alternative to PE. For this reason, we aimed to present three cases with Swyer–James–MacLeod syndrome (SJMS), one of which was also complicated by PE, and one case with pulmonary artery hypoplasia.

Case Presentation

Case 1: PE was diagnosed by V/Q scintigraphy in a patient with known SJMS. Case 2: SJMS was diagnosed by thoracic computed tomography (CT), flexible optical bronchoscopy (FOB) and V/Q scintigraphy. Case 3: V/Q scintigraphy revealed pulmonary artery hypoplasia in the differential diagnosis of PE when evaluated together with FOB and thoracic CT. Case 4: Diagnosed as SJMS by Thorax CT and V/Q scintigraphy in the presence of chronic lung disease.

Conclusions

V/Q scintigraphy is also used in the diagnosis of congenital/hereditary vascular and airway diseases. Thoracic CT should be performed together with evaluation to reach the diagnosis in this group of patients. In cases with mismatch defects, vascular anomalies should also be considered in the differential diagnosis.

背景：虽然通气/灌注（V/Q）显像常用于诊断急慢性肺栓塞（PE），但在肺血管疾病的诊断中也有重要作用。此外，在V/Q显像上存在错配缺陷时，应考虑肺血管异常作为PE的可能替代方案。因此，我们的目的是报告3例Swyer-James-MacLeod综合征（SJMS），其中1例合并PE， 1例合并肺动脉发育不全。病例介绍：病例1：在已知SJMS患者中，通过V/Q显像诊断PE。病例2：经胸部CT、柔性光学支气管镜及V/Q显像诊断为SJMS。病例3:V/Q显像显示肺动脉发育不全与FOB和胸部CT鉴别诊断PE。病例4：有慢性肺部疾病，经胸腔CT及V/Q显像诊断为SJMS。结论：V/Q显像可用于先天性/遗传性血管及气道疾病的诊断。本组患者需同时行胸部CT检查，以达到诊断目的。在有错配缺陷的病例中，在鉴别诊断中也应考虑血管异常。

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引用次数: 0

Blood flow restriction during high load bench press does not increase bar velocity or cause physiological changes in non-occluded agonist muscles 高负荷卧推时的血流限制不会增加杆速或引起非闭塞激动肌的生理变化

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-03-18 DOI: 10.1111/cpf.70006

Andrew LeMense, Abby Fleming, Samuel Gomez, John Lewis, Harrison Labanowski, Michael Fedewa, Lee Winchester

Purpose

Blood blow restriction (BFR) can increase peak velocity and power during high load resistance training. However, previous research primarily utilized high occlusion pressures (i.e., greater than 80% arterial occlusion pressure (AOP)), and rarely measured the physiological response during or after the bench press stimuli. The aim of this study was to investigate the application of 50%AOP during acute high load bench press exercise on barbell power, velocity, and the physiological responses to this stimulus.

Methods

Resistance trained males (n = 12, 26.2 ± 6.6 yrs., 84.0 ± 10.8 kg, 176.3 ± 10.4 cm) completed a maximum strength test followed by two experimental sessions which consisted of four sets of 4 reps of the barbell bench press at 75%1RM, with or without BFR applied to both arms at 50% AOP. Significance was set to p ≤ 0.05. A series of two-way repeated measures ANOVAs with Bonferroni post hoc corrections tested for potential changes in bar velocity, power, blood lactate, and muscle thickness and activation of the anterior deltoid and pectoralis major.

Results

There were no main effects for the interaction terms “Condition×Set” or “Condition×Time,” nor for “Condition” for any variables (all p > 0.05). There was a “Time” effect for blood lactate (p < 0.001) with lactate increasing from pre- to postexercise, and a main effects for “Set” for mean (p = 0.016) and peak velocity (p = 0.005).

Conclusion

There was no difference in the change in velocity, or physiological responses during high load bench press with or without BFR at 50%AOP. While promising, use of BFR for upper body power may require pressures >50%AOP.

目的：血击限制（BFR）可以在高负荷阻力训练中提高峰值速度和功率。然而，以往的研究主要是利用高闭塞压（即大于80%动脉闭塞压（AOP）），很少测量卧推刺激期间或之后的生理反应。本研究的目的是探讨50%AOP在急性高负荷卧推运动中对杠铃力量、速度和生理反应的影响。方法接受阻力训练的男性12例，年龄26.2±6.6岁。（84.0±10.8 kg, 176.3±10.4 cm）完成了最大力量测试，随后进行了两次实验，包括四组杠铃卧推，每组4次，75%1RM，双臂在50% AOP上施加或不施加BFR。显著性设为p≤0.05。采用Bonferroni事后校正的一系列双向重复测量方差分析（anova）测试了杆速、功率、血乳酸、肌肉厚度以及前三角肌和胸大肌激活的潜在变化。结果交互项“Condition×Set”或“Condition×Time”和“Condition”对任何变量均无主效应（p > 0.05）。血乳酸从运动前到运动后增加，存在“时间”效应（p < 0.001），平均（p = 0.016）和峰值速度（p = 0.005）的“集”效应主要存在。结论在50%AOP的情况下，高负荷卧推时，加BFR和不加BFR的速度变化和生理反应无显著差异。虽然很有希望，但使用BFR为上肢提供力量可能需要50%AOP的压力。

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引用次数: 0

Effects of consciously controlled slow breathing on cardiac parasympathetic nervous activity postexercise in young healthy males 有意识控制缓慢呼吸对年轻健康男性运动后心脏副交感神经活动的影响

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-03-13 DOI: 10.1111/cpf.70007

Tatsuya Sugimoto, Kazuya Sugiyama, Kumi Matsumura, Kana Michiue, Kumiko Ono, Akira Ishikawa

The purpose of the present study was to clarify the effects of consciously controlled slow breathing on cardiac parasympathetic nervous activity Postexercise. Fifteen young healthy adult men participated in this study. They exercised on the bicycle ergometer at 50% of peak oxygen uptake for 10 min and then rested on the chair for 10 min. Two conditions were performed, namely slow breathing at 6 breaths per minute (SLOW) and spontaneous breathing (CON) at recovery phase in randomized order. We measured the oxygen uptake (V̇_O2), respiratory rate (RR), minute ventilation (V̇_E), tidal volume (V_T), ventilatory equivalents for carbon dioxide excretion (V̇_E/V̇_CO2), heart rate (HR), and R-R intervals. From the R-R intervals, we calculated the coefficient of variation of the R-R intervals (CVRR), the natural logarithms of the high-frequency (lnHF), and the natural logarithms of the sum of the components from very low- to high-frequency (total power: lnTP). There were no significant differences between conditions in V̇_O2 at exercise phase. At recovery phase in SLOW compared with CON, RR and V̇_E/V̇_CO2 were significantly decreased (both p < 0.001) with a slight decrease in V̇_E, and V_T was increased (p < 0.001). At recovery phase, while HR and lnHF had no differences between conditions, lnTP and CVRR were significantly higher in SLOW compared with CON (p < 0.05) and baseline phase (p < 0.05). In conclusion, slow breathing at six breaths per minute accelerated the reactivation of cardiac parasympathetic nervous activity Postexercise, accompanied by improved efficiency of pulmonary gas exchange due to a slight decrease in V̇_E.

本研究的目的是阐明有意识控制的缓慢呼吸对运动后心脏副交感神经活动的影响。15名年轻健康的成年男性参加了这项研究。他们在自行车测力仪上以峰值摄氧量的50%运动10分钟，然后在椅子上休息10分钟。在恢复阶段随机进行6次/分钟缓慢呼吸（slow）和自发呼吸（CON）两种情况。我们测量了摄氧量（V * O2）、呼吸速率（RR）、分钟通气量（V * E）、潮气量（VT）、二氧化碳排出的通气当量（V * E/V * CO2）、心率（HR）和R-R间期。从R-R区间，我们计算了R-R区间的变异系数（CVRR），高频的自然对数（lnHF），以及从极低到高频的分量之和的自然对数（总功率：lnTP）。两组运动阶段的V （O2）无显著性差异。在恢复阶段，与CON相比，慢速组的RR和V (E) /V （CO2）显著降低（p < 0.001）， V (E)略有降低，VT升高（p < 0.001）。在恢复期，不同条件间HR和lnHF无差异，而SLOW组的lnTP和CVRR显著高于CON （p < 0.05）和基线期（p < 0.05）。综上所述，每分钟6次的缓慢呼吸加速了运动后心脏副交感神经活动的再激活，同时由于V (E)的轻微降低，肺部气体交换效率也有所提高。

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引用次数: 0

Diaphragm thickness and physical performance in regular smokers and non-smokers: A pilot study 常规吸烟者和非吸烟者的隔膜厚度和身体表现：一项初步研究

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-03-04 DOI: 10.1111/cpf.70003

Bahar Özgül, Zübeyir Sarı, İlkşan Demirbüken, Hilal Başak Can, Zana Gezer, Halil Yıldırım, Mine Gülden Polat

Background

Despite the understanding of the role of diaphragm role as a crucial element in trunk stabilizer performance, limited research has been carried out on the diaphragmatic features particularly in smoking population.

Objectives

It was aimed to compare the diaphragm structure beside trunk stabilizer performance & body balance of young regular smokers and non-smokers and investigate the relationship between diaphragmatic features and physical performance in regular smokers.

Methods

Asymptomatic regular smoker (n = 22) and nonsmoker (n = 22) young male subjects (21.63 ± 2.37 years) were participated to the study. The diaphragmatic ultrasonic scanning and physical performance tests of core muscle strength and endurance & Y balance test were performed.

Results

The duration of prone and lateral side bridge (t = −3.347, t = 3.477, p < 0.001), and modify push-up test repetition (Z = −2.213, p = 0.027) were detected lower in regular smokers. A positive moderate correlation was observed between the duration of the prone bridge test and the maximum inspiration thickness & the thickness difference at inspiration and expiration (r = 0.545, p = 0.009 & r = 0.468, p = 0.028) and between the number of repetitions of the modify push-up and the maximum expiration thickness (r = 0.530, p = 0.011).

Conclusion

While no difference was detected in terms of the diaphragm structure between groups, trunk stabilizer performance was lower and greater diaphragm thickness was associated with better trunk stability in some performance tasks in smokers. While the diaphragm muscle structure, which is the main respiratory muscle, does not differ in young smokers, the effects of the diaphragm muscle on general body biomechanics have been preliminary demonstrated.

尽管人们已经认识到横隔膜在躯干稳定器性能中的关键作用，但对横隔膜特征的研究有限，特别是在吸烟人群中。目的比较尾翼侧横隔膜结构的性能；年轻吸烟者和非吸烟者的身体平衡，研究吸烟者膈肌特征与身体表现之间的关系。方法选取年龄（21.63±2.37）岁的无症状经常吸烟者（n = 22）和不吸烟者（n = 22）为研究对象。横膈膜超声扫描与核心肌力量耐力体能测试进行Y平衡试验。结果常规吸烟者俯卧桥和侧卧桥持续时间（t = - 3.347, t = 3.477, p < 0.001）和改良俯卧撑重复次数（Z = - 2.213, p = 0.027）明显低于常规吸烟者。俯卧桥试验持续时间与最大吸气厚度呈中等正相关；吸气和呼气时的厚度差(r = 0.545, p = 0.009；R = 0.468, p = 0.028)，修改俯卧撑重复次数与最大呼气厚度之间的关系（R = 0.530, p = 0.011）。结论抽烟者在某些表演任务中躯干稳定器的性能较低，而在膈膜厚度较大的情况下躯干稳定性较好。虽然作为主要呼吸肌的横膈肌结构在年轻吸烟者中没有差异，但横膈肌对全身生物力学的影响已经初步得到证实。

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引用次数: 0

Minimum detectable change estimates of heart-to-finger arterial pulse wave conduction time in cardiovascular-healthy young adults 心血管健康年轻人心脏到手指脉搏波传导时间的最小可检测变化估计

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-03-04 DOI: 10.1111/cpf.70002

Harvey N. Mayrovitz

Background

Pulse wave velocity (PWV) measurements are the gold standard for assessing arterial stiffness and estimating time or treatment-related changes in cardiovascular status. What constitutes a statistically significant change is an important clinical consideration. This study aimed to describe the variability of heart-to-finger pulse wave conduction time (PWCT) to provide estimates of the minimum detectable change (MDC) dependent on the number of PWCT samples used.

Materials and methods

Heart-to-finger PWCT was measured based on the time delay between the peak of the EKG R-wave and arterial pulse arrival at the left hand index finger as measured by a photoplethysmographic sensor. Measurements were done in 10 young adults (25.7 ± 1.2 years) while supine for 45 min. Depending on the subject's heart rate, these measurements yielded 2430 to 3750 contiguous PWCT for analysis. The variability in these PWCTs was used to determine the minimal detectable percentage change for specified p-values of 0.05, 0.01, and 0.001.

Results

Sample sizes of 10, 30, 50, or 300 contiguous PWCTs yield similar MDC estimates for a given targeted p-value. The MDC% depended on the chosen p-value, with values of MDC% for p-values of 0.05, 0.01, and 0.001 being 7.8%, 10.5%, and 13.6%.

Conclusions

The estimates may help plan experiments when changes or differences in PWCT or PWV are of interest. Also, these MDC estimates may help assess the validity of clinical study outcomes if PWV changes are outcome measures. The main limitation of the estimates is that they are based on 10 healthy subjects.

脉波速度（PWV）测量是评估动脉硬度和估计时间或治疗相关心血管状态变化的金标准。什么是统计上的显著变化是一个重要的临床考虑因素。本研究旨在描述心脏到手指脉冲波传导时间（PWCT）的可变性，以提供依赖于PWCT样本数量的最小可检测变化（MDC）的估计。材料与方法采用光电体积描记传感器测量心电图r波峰值与动脉脉冲到达左手食指的时间差，测量心-指PWCT。10名年轻成人（25.7±1.2岁）在仰卧45分钟时进行测量。根据受试者的心率，这些测量产生2430至3750个连续PWCT进行分析。这些pwct的变异性用于确定指定p值为0.05、0.01和0.001时的最小可检测百分比变化。结果对于给定的目标p值，10、30、50或300个连续pwct的样本量产生相似的MDC估计。MDC%取决于所选的p值，p值为0.05、0.01和0.001时，MDC%的值分别为7.8%、10.5%和13.6%。结论当对PWCT或PWV的变化或差异感兴趣时，这些估计可能有助于计划实验。此外，如果PWV变化是结果测量，这些MDC估计可能有助于评估临床研究结果的有效性。这些估计的主要局限性在于，它们是基于10名健康受试者。

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引用次数: 0

SVAT–sonographic thickness ratio of visceral adipose tissue to anterior thigh muscle: a novel approach for body composition analysis 内脏脂肪组织与大腿前肌的svat超声厚度比：一种新的身体成分分析方法

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-03-02 DOI: 10.1111/cpf.70004

Murat Kara, Ahmad J. Abdulsalam, Vincenzo Ricci, Levent Özçakar

Body composition analysis is essential for assessing health and fitness, providing insights into fat and muscle distribution in the body and serving as a vital indicator for various conditions. Traditional methods often lack precision, but ultrasound (US) has emerged as a noninvasive alternative. The intra-abdominal visceral adipose tissue to quadriceps muscle thickness ratio emerges as a significant indicator of metabolic health, offering clinicians a valuable tool for personalized interventions. With US, it represents a significant advancement in body composition analysis, promising detailed insights with its noninvasive and real-time imaging capabilities, likely expanding its role in improving human health assessment and interventions.

身体成分分析对于评估健康和健身是必不可少的，它提供了对体内脂肪和肌肉分布的洞察，并作为各种状况的重要指标。传统的方法往往缺乏精度，但超声（US）已成为一种无创的替代方法。腹内内脏脂肪组织与股四头肌厚度之比成为代谢健康的重要指标，为临床医生提供了个性化干预的宝贵工具。与US一起，它代表了身体成分分析的重大进步，有望通过其无创和实时成像功能提供详细的见解，可能扩大其在改善人类健康评估和干预方面的作用。

引用次数: 0

Pulmonary blood volume as a marker of adenosine-induced cardiac hyperemia: A Rubidium-82 study 肺血容量是腺苷诱发心脏充血的标志：铷-82研究

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-02-26 DOI: 10.1111/cpf.70001

Martin Lyngby Lassen, Jacob Peter Hartmann, Christina Byrne, Ronan M. G. Berg, Andreas Kjær, Philip Hasbak

Purpose

To investigate the efficacy of pulmonary blood volume (PBV) as a marker of the cardiac hyperemic response to adenosine during myocardial perfusion imaging (MPI).

Methods

Forty healthy subjects underwent four consecutive Rubidium-82 rest/adenosine-stress MPI: two sessions were conducted without any caffeine consumption (baseline), while the remaining two sessions involved controlled caffeine consumption (arm 1: 100 and 300 mg; arm 2: 200 and 400 mg). We evaluate the ability of the stress-to-rest ratio of PBV (PBV ratio) to identify an adequate cardiac hyperemic response. The adequate hyperemic response was defined as a stress myocardial blood flow >2 mL/g/min and a corresponding myocardial flow reserve >68% of the maximum myocardial flow reserve obtained during the baseline scans.

Results

Based on 126 MPI sessions conducted in 40 subjects, the PBV ratio demonstrated a sensitivity of 78% and a specificity of 74% in detecting adequate cardiac hyperemia. The positive predictive value was 95%, while the negative predictive value was 36%.

Conclusion

The PBV ratio permits the identification of adequate hyperemic response with sensitivities and specificities comparable to existing markers.

目的探讨肺血容量（PBV）在心肌灌注显像（MPI）中作为心脏对腺苷充血反应指标的作用。方法40名健康受试者连续接受4次铷-82休息/腺苷应激MPI，其中2次不摄入咖啡因（基线），其余2次控制咖啡因摄入(第1组：100和300 mg；组2:200和400毫克)。我们评估PBV的应激-休息比（PBV比）识别充分的心脏充血反应的能力。充分充血反应定义为应激心肌血流量为2ml /g/min，相应的心肌血流储备为基线扫描时获得的最大心肌血流储备的68%。结果基于40名受试者的126次MPI， PBV比值在检测足够的心脏充血方面的敏感性为78%，特异性为74%。阳性预测值为95%，阴性预测值为36%。结论PBV比值可识别充血反应，其敏感性和特异性与现有标志物相当。

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引用次数: 0

Renal clearance estimated by rubidium-82 positron emission tomography/computed tomography and technetium-99m-mercaptoacetyltriglycine clearance infusion technique 通过铷-82正电子发射断层扫描/计算机断层扫描和锝-99m-巯基乙酰甘油三酯清除输注技术估计肾脏清除率

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-02-23 DOI: 10.1111/cpf.70000

Stine Sundgaard Langaa, Camilla Lundgreen Duus, Marie Houmaa Vrist, Frank Holden Mose, Claire Anne Fynbo, Jørn Theil, June Anita Ejlersen, Jesper Nørgaard Bech

Background

Although numerous techniques exist for renal blood flow (RBF) estimation, none of the methods have been implemented in routine clinical practice due to their inadequacies and burdensomeness. Previously, we evaluated rubidium-82 (⁸²Rb) positron emission tomography/computed tomography (PET/CT) for renal perfusion determination and found strong indications of method precision and reliability. The aim of this study was to compare renal ⁸²Rb clearance with renal technetium-99m-mercaptoacetyltriglycine ([^99mTc]Tc-MAG3) clearance as a first attempt to validate ⁸²Rb PET/CT for renal perfusion estimation using a reference method.

Methods

Ten subjects with essential hypertension underwent two treatment periods, receiving spironolactone and placebo in random order. At the end of each period, each subject completed a ⁸²Rb PET/CT scan and a [^99mTc]Tc-MAG3 clearance study.

Results

⁸²Rb clearance correlated positively with [^99mTc]Tc-MAG3 clearance in both treatment periods. The [^99mTc]Tc-MAG3-to-⁸²Rb clearance ratio was 0.83 and 0.86 in the placebo and spironolactone treatment periods, respectively.

Conclusion

The correlation between ⁸²Rb clearance and [^99mTc]Tc-MAG3 clearance may indicate that PET/CT determined ⁸²Rb clearance can act as an estimator of renal perfusion. The [^99mTc]Tc-MAG3-to-⁸²Rb clearance ratios suggest that the extraction fraction of ⁸²Rb is higher than that of [^99mTc]Tc-MAG3, further suggesting ⁸²Rb clearance as an estimator of flow. However, further studies are warranted to validate use of ⁸²Rb PET/CT for flow estimation.

背景肾血流量（RBF）的估算方法有很多，但由于其不足和繁琐，没有一种方法在常规临床实践中得到应用。先前，我们评估了铷-82 （82Rb）正电子发射断层扫描/计算机断层扫描（PET/CT）用于肾脏灌注测定，并发现该方法具有很强的精确度和可靠性。本研究的目的是比较肾脏82Rb清除率与肾脏锝-99m-巯基乙酰三甘氨酸（[99mTc]Tc-MAG3）清除率，作为验证82Rb PET/CT使用参考方法评估肾脏灌注的第一次尝试。方法10例原发性高血压患者分2期治疗，随机给予螺内酯和安慰剂。在每个时间段结束时，每位受试者完成82Rb PET/CT扫描和[99mTc]Tc-MAG3清除研究。结果两个治疗期82Rb清除率与[99mTc]Tc-MAG3清除率呈正相关。安慰剂组和螺内酯组[99mTc] tc - mag3对82rb的清除率分别为0.83和0.86。结论82Rb清除率与[99mTc]Tc-MAG3清除率的相关性提示PET/CT测定的82Rb清除率可作为肾灌注的一个指标。[99mTc]Tc-MAG3与82Rb的间隙比表明，82Rb的萃取分数高于[99mTc]Tc-MAG3，进一步表明82Rb间隙是流量的一个估计指标。然而，需要进一步的研究来验证使用82Rb PET/CT进行流量估计。

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