ECToolbox软件四种公式计算左心室射血分数的比较

Comparison of ECToolbox Formulae for the Assessment of Left Ventricular Ejection Fraction

目的 比较ECToolbox软件四种公式（R0、R1、R2、R3）计算心电图门控心肌灌注显像（GMPS）左心室射血分数（LVEF）与平衡法心血池显像（ERNA）所得结果的相关性和一致性,并判断四种公式所得结果的诊断阈值。资料与方法选择38例心肌梗死患者和65例可疑冠心病患者,同一患者1周内完成99Tcm-甲氧异腈（MIBI）静息态GMPS和99Tcm-红细胞（RBC）ERNA,用ECToolbox软件中的R0、R1、R2、R3公式分别计算LVEF,并与ERNA结果进行对比,通过ROC曲线判断R0~R3公式的最佳诊断阈值。结果 ERNA计算的平均LVEF为（54.6±17.5）%,R0~R3公式计算的平均LVEF分别为（64.1±15.7）%、（56.3±15.1）%、（69.9±17.9）%、（56.7±13.6）%。四种公式所得LVEF与ERNA所得LVEF呈显著正相关（r=0.899、0.898、0.890、0.895,P〈0.01）;四种公式计算的平均LVEF均高于ERNA计算的平均LVEF,差异有统计学意义（P〈0.05）。以ERNA计算的LVEF≥50%为正常诊断值,R0~R3公式的LVEF最佳诊断阈值分别为56.5%、51.5%、64.5%、52.5%。结论 用于GMPS的ECToolbox四种公式与ERNA计算的LVEF具有显著相关性,但LVEF有显著差异,同一患者随诊过程中应采用同一种公式进行计算,用于诊断心功能时,每种公式应选用不同的阈值。

Purpose To evaluate the correlation and consistency of left ventricular ejection fraction （LVEF） obtained by ECG-gated myocardial perfusion SPECT （GMPS） using four formulae （R0-R3） of ECToolbox software and findings on equilibrium radionuclide angiography （ERNA）, and to determine the optimal diagnostic thresholds by using the four formulae. Materials and Methods A total of 38 patients with myocardial infarction and 65 patients with suspected coronary heart disease underwent both ^99Tc^m- M1BI rest GMPS and ^99Tc^m-RBC ERNA within a week. The LVEF values calculated by ECToolbox R0, RI, R2 and R3 were compared with those obtained by ERNA, and compared with ERNA results, the optimal diagnostic thresholds of the [bur formulae （R0- R3） were assessed by receiver operating characteristic （ROC） curves. Results The results calculated by the formulae （R0-R3） presented a significant positive correlation with that obtained by ERNA [mean LVEF value by ERNA （54.6±17.5）%, mean LVEF value by formulae R0-R3 （64.1 ± 15.7）%, （56.3± 15.1）%, （69.9± 17.9）% and （56.7± 13.6）%, respectively, r-0.899, 0.898, 0,890, 0,895% P〈0.01]. All mean LVEF values calculated by the four lbrmulae were higher than that by ERNA, and the difference was significant （P〈0.05）. LVEF ≥ 50% obtained by ERNA was considered as normal diagnostic value, the optimal diagnostic thresholds of R0-R3 were 56.5%, 51.5%, 64.5% and 52.5%. respectively. Conclusion The results calculated by R0, RI, R2 and R3 in the ECToolbox software and that by ERNA show significant correlation and difference for the assessment of LVEF. Thus it is advisable to stick to one formula in the follow-up of each patient and select correspondent threshold in the clinical diagnosis.