疑似慢性冠状动脉综合征患者的定量心肌灌注应根据性别和合并症进行解释:心脏正电子发射断层扫描研究。

IF 1.3 4区 医学 Q4 PHYSIOLOGY Clinical Physiology and Functional Imaging Pub Date : 2023-08-29 DOI:10.1111/cpf.12854
Anna Székely, Katarina Steding-Ehrenborg, Daniel Ryd, Fredrik Hedeer, Kristian Valind, Shahnaz Akil, Cecilia Hindorf, Erik Hedström, David Erlinge, Håkan Arheden, Henrik Engblom
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引用次数: 0

摘要

目前对疑似慢性冠状动脉综合征(CCS)患者的诊断和治疗依赖于冠状动脉狭窄程度及其对心肌灌注的意义。然而,心肌灌注可受冠状动脉狭窄以外的因素影响。本研究旨在探讨性别、年龄、糖尿病、高血压和吸烟对疑似或确诊CCS患者冠状动脉狭窄程度以外的定量心肌灌注的影响程度。86例患者[中位年龄69岁(46-86岁),24例女性]因疑似或已确诊的CCS而计划进行选择性冠状动脉造影。所有患者均行心脏13n - nh3正电子发射断层扫描,定量静息和应激状态下心肌灌注。所有血管区域的最低心肌灌注(perfusionmin)和最低心肌灌注储备(MPRmin)作为线性混合模型的因变量。自变量为血管面积、冠状动脉狭窄程度(作为0%-100%狭窄的连续变量)、性别、年龄、糖尿病、高血压和吸烟习惯。冠状动脉狭窄程度(压力下p min)。冠状动脉狭窄程度(p min。性别、年龄增长、糖尿病、高血压和吸烟对疑似或确诊CCS患者心肌灌注的影响与冠状动脉狭窄无关。因此,在评估疑似或确诊CCS患者定量心肌灌注减少的意义时,需要考虑这些因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Quantitative myocardial perfusion should be interpreted in the light of sex and comorbidities in patients with suspected chronic coronary syndrome: A cardiac positron emission tomography study

Diagnosis and treatment of patients with suspected chronic coronary syndrome (CCS) currently relies on the degree of coronary artery stenosis and its significance for myocardial perfusion. However, myocardial perfusion can be affected by factors other than coronary stenosis. The aim of this study was to investigate to what extent sex, age, diabetes, hypertension and smoking affect quantitative myocardial perfusion, beyond the degree of coronary artery stenosis, in patients with suspected or established CCS. Eighty-six patients [median age 69 (range 46−86) years, 24 females] planned for elective coronary angiography due to suspected or established CCS were included. All patients underwent cardiac 13N-NH3 positron emission tomography to quantify myocardial perfusion at rest and stress. Lowest myocardial perfusion (perfusionmin) at stress and rest and lowest myocardial perfusion reserve (MPRmin) for all vessel territories was used as dependent variables in a linear mixed model. Independent variables were vessel territory, degree of coronary artery stenosis (as a continuous variable of 0%−100% stenosis), sex, age, diabetes, hypertension and smoking habits. Degree of coronary artery stenosis (p < 0.001), male sex (1.8 ± 0.6 vs. 2.3 ± 0.6 mL/min/g, p < 0.001), increasing age (p = 0.025), diabetes (1.6 ± 0.5 vs. 2.0 ± 0.6 mL/min/g, p = 0.023) and smoking (1.9 ± 0.6 vs. 2.1 ± 0.6 mL/min/g, p = 0.052) were independently associated with myocardial perfusionmin at stress. Degree of coronary artery stenosis (p < 0.001), age (p = 0.040), diabetes (1.8 ± 0.6 vs. 2.3 ± 0.7, p = 0.046) and hypertension (2.2 ± 0.7 vs. 2.5 ± 0.6, p = 0.033) were independently associated with MPRmin. Sex, increasing age, diabetes, hypertension and smoking affect myocardial perfusion independent of coronary artery stenosis in patients with suspected or established CCS. Thus, these factors need to be considered when assessing the significance of reduced quantitative myocardial perfusion of patients with suspected or established CCS.

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来源期刊
CiteScore
3.40
自引率
5.60%
发文量
62
审稿时长
6-12 weeks
期刊介绍: Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.
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