张飞飞; 王建锋; 邵晓梁; 杨晓宇; 徐敏; 万鹏; 范圣登; 史云梅; 俞雯吉; 刘保; 李小霞; 徐梅; 陈佳恬; 王跃涛

doi:10.3760/cma.j.cn321828-20200820-00319

点赞 0
分享 0
收藏 0
纠错

• 基础研究 •

门控心肌灌注显像评价急性心肌梗死早期左心室舒张不同步及其影响因素的实验研究

中华核医学与分子影像杂志, 2022,42(3) : 154-159. DOI: 10.3760/cma.j.cn321828-20200820-00319

摘要

目的

应用SPECT门控心肌灌注显像(GMPI)相位分析评价急性心肌梗死(AMI)早期左心室舒张不同步(LVDD)及其影响因素。

方法

取16头巴马小型猪建立AMI模型，分别于建模前及AMI后1 d行GMPI，经定量分析获得心肌灌注缺损范围占左心室的百分比(Extent，%)、左心室收缩不同步(LVSD)及LVDD参数[相位直方图带宽(PBW)和相位标准差(PSD)]；同期行超声心动图，获得左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)及二尖瓣口舒张早期/晚期血流峰值速度比值(E/A)。采用两独立样本t检验、配对t检验及Pearson相关分析处理数据。

结果

16头小型猪均建模成功。AMI后Extent、LVEDV、LVESV均较建模前明显增大(t值：-11.14、-4.55、-6.12，均P<0.001)，LVEF、E/A明显减小(t值：10.16、2.18，P<0.001，P＝0.046)。AMI后LVDD参数PBW、PSD[(142.25±72.06)°、(56.15±26.71)°]均较建模前增大[(33.06±8.98)°、(12.51±5.13)°；t值：-6.11、-6.60，均P<0.001]，且与AMI后LVSD参数PBW、PSD[(109.06±62.40)°、(44.40±25.61)°]间存在明显差异(t值：-2.73、-2.20，P值：0.016、0.044)。AMI后LVDD参数PBW、PSD与E/A呈中度负相关(r值：-0.569、-0.566，P值：0.021、0.022)，与Extent呈正相关(r值：0.717、0.634，P值：0.002、0.008)。GMPI相位分析评价LVDD具有很好的观察者内及观察者间重复性[组内相关系数(ICC): 0.953~0.984，均P<0.001]。

结论

AMI后1 d即发生LVDD，LVDD可反映舒张功能障碍，左心室灌注缺损范围与LVDD相关。GMPI相位分析是评价LVDD及舒张功能的有效方法。

引用本文: 张飞飞, 王建锋, 邵晓梁, 等. 门控心肌灌注显像评价急性心肌梗死早期左心室舒张不同步及其影响因素的实验研究 [J] . 中华核医学与分子影像杂志, 2022, 42(3) : 154-159. DOI: 10.3760/cma.j.cn321828-20200820-00319.

参考文献导出: Endnote NoteExpress RefWorks NoteFirst 医学文献王

扫描看全文

正文

作者信息

基金 0 关键词 0

English Abstract

阅读 0 评论 0

相关资源

引用 | 论文 | 视频

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

急性心肌梗死(acute myocardial infarction, AMI)可导致左心室机械不同步(left ventricular mechanical dyssynchrony, LVMD)^[1]。LVMD包括左心室收缩不同步(left ventricular systolic dyssynchrony, LVSD)和舒张不同步(left ventricular diastolic dyssynchrony, LVDD)。既往研究已证实LVSD在心血管疾病的危险分层、预后评价及预测心脏再同步化治疗(cardiac resynchronization therapy, CRT)疗效等方面具有重要价值^[2,3]。近年来研究发现，冠状动脉粥样硬化性心脏病(简称冠心病)患者可存在LVDD^[4,5]。

贡献者信息

张飞飞

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

王建锋

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

邵晓梁

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

杨晓宇

苏州大学附属第三医院、常州市第一人民医院心血管内科，常州　213003

徐敏

苏州大学附属第三医院、常州市第一人民医院心超室，常州　213003

万鹏

苏州大学附属第三医院、常州市第一人民医院心血管内科，常州　213003

范圣登

苏州大学附属第三医院、常州市第一人民医院麻醉科，常州　213003

史云梅

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

俞雯吉

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

刘保

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

李小霞

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

徐梅

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

陈佳恬

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

王跃涛

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

通信作者

王跃涛

苏州大学附属第三医院、常州市第一人民医院核医学科、常州市分子影像重点实验室，常州　213003

Email：yuetao-w@163.com

关键词

心肌梗死; 心肌灌注显像; 体层摄影术，发射型计算机，单光子; 99m锝甲氧基异丁基异腈; 猪;

基金项目

国家自然科学基金（81871381，81901777，81701737）

常州高技术研究重点实验室（CM20193010）

常州市卫生健康委青年人才科技项目（QN201920）

常州市卫生健康青苗人才培养工程（CZQM2020002）

作者声明

作者贡献声明

张飞飞：研究实施、数据分析、统计分析、论文撰写；王建锋、邵晓梁、杨晓宇、徐敏、史云梅、徐梅、陈佳恬：研究实施、数据采集；万鹏、范圣登、俞雯吉、刘保、李小霞：研究实施；王跃涛：研究设计及指导、论文修改、经费支持

利益冲突

所有作者声明无利益冲突

历史

出版日期：2022-03-25

收稿日期：2020-08-20

Basic Science Investigation

Assessment of left ventricular diastolic dyssynchrony and its influencing factors early after acute myocardial infarction by SPECT gated myocardial perfusion imaging: an experimental study

Zhang Feifei, Wang Jianfeng, Shao Xiaoliang, Yang Xiaoyu, Xu Min, Wan Peng, Fan Shengdeng, Shi Yunmei, Yu Wenji, Liu Bao, Li Xiaoxia, Xu Mei, Chen Jiatian, Wang Yuetao

Published 2022-03-25

Cite as Chin J Nucl Med Mol Imaging, 2022, 42(3): 154-159. DOI: 10.3760/cma.j.cn321828-20200820-00319

Abstract

Objective

To evaluate the left ventricular diastolic dyssynchrony (LVDD) and its influencing factors early after acute myocardial infarction (AMI) using phase analysis of SPECT gated myocardial perfusion imaging (GMPI).

Methods

Bama miniature swines (n=16) were subjected to establish AMI models. GMPI was performed before and 1 d after AMI to obtain the extent of myocardial perfusion defect (Extent, %) and left ventricular systolic dyssynchrony (LVSD)/LVDD parameters, namely the phase histogram bandwidth (PBW) and phase standard deviation (PSD). Meanwhile, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), and the ratio of early to late peak mitral diastolic flow (E/A) were obtained by echocardiography. Independent-sample t test, paired t test and Pearson correlation analysis were used to analyze the data.

Results

Sixteen AMI swines were successfully created. Compared to baseline, Extent, LVEDV and LVESV significantly increased on 1 d after AMI (t values: -11.14, -4.55, -6.12, all P<0.001), while LVEF and E/A significantly decreased (t values: 10.16, 2.18, P<0.001, P=0.046). GMPI showed that the LVDD parameters PBW and PSD increased significantly on 1 d after AMI when compared to those at baseline((142.25±72.06)° vs (33.06±8.98)°, (56.15±26.71)° vs (12.51±5.13)°; t values: -6.11, -6.60, both P<0.001). There were significant differences between LVSD parameters and LVDD parameters (PBW: (109.06±62.40)° vs (142.25±72.06)°, PSD: (44.40±25.61)° vs (56.15±26.71)°; t values: -2.73, -2.20, P values: 0.016, 0.044). LVDD parameters PBW, PSD were negatively correlated with E/A after AMI (r values: -0.569, -0.566, P values: 0.021, 0.022), and positively correlated with the Extent (r values: 0.717, 0.634, P values: 0.002, 0.008). The phase analysis of SPECT GMPI to evaluate LVDD showed good intra-observer and inter-observe reproducibility (intraclass correlation coefficient (ICC): 0.953-0.984, all P<0.001).

Conclusions

LVDD occurs early on 1 d after AMI, and can reflect left ventricular diastolic dysfunction. The Extent is correlated with LVDD significantly. Phase analysis of SPECT GMPI is an accurate method to evaluate LVDD and left ventricular diastolic function.

Key words:

Myocardial infarction; Myocardial perfusion imaging; Tomography, emission-computed, single-photon; Technetium Tc 99m sestamibi; Swine

Contributor Information

Zhang Feifei

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

Wang Jianfeng

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

Shao Xiaoliang

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

Yang Xiaoyu

Department of Cardiology, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou 213003, China

Xu Min

Department of Echocardiography, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou 213003, China

Wan Peng

Department of Cardiology, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou 213003, China

Fan Shengdeng

Department of Anesthesiology, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou 213003, China

Shi Yunmei

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

Yu Wenji

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

Liu Bao

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

Li Xiaoxia

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

Xu Mei

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

Chen Jiatian

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

Wang Yuetao

Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou Key Laboratory of Molecular Imaging, Changzhou 213003, China

共有条评论

验证码

本文被引情况 CSCD: 0次万方数据： 0次 Scopus: 0次

施引文献(最多仅列5条文献，进入CSCD官网发现更多)

未获取施引文献信息...

暂无相关资源