心肌灌注-代谢显像定量分析评价心肌梗死后左室重构

Assessment of left ventricular remodeling after myocardial infarction by quantitative analysis of myocardial perfusion/metabolism imaging

目的应用心肌灌注-代谢显像对左室重构进行定量分析,并探讨左室重构与心肌活力的关系。方法分别测定心肌梗死患者45例(前壁组16例,下后壁组18例,复合组11例)和正常对照组21例前壁、下后壁的局部膨出指标EG/EF、GF/EF值,以及左心室梗死后球形化指标EF/AB值,并对照血流灌注与代谢图像,分析心肌活力与左心室功能、球化的关系。结果前壁组、下后壁组、复合壁组舒张末容积(EDV)、收缩末容积(ESV)、左心室射血分数(LVEF)及EF/AB值与对照组比较有显著改变(P值均<0.05);前壁组、复合组与对照组EG/EF值比较的差异有统计学意义(P<0.001)。存活组、部分存活组的LVEF高于无存活组(P<0.05);而EF/AB值依次增高,3组比较的差异有统计学意义(P<0.05)。结论心肌灌注-代谢显像定量分析指标可用于评估心肌梗死后左心室重构;心肌梗死后病灶有存活心肌的患者心脏整体功能及左室重构显著优于无存活心肌的患者。

Objective To quantitatively evaluate left ventricular remodeling （LVRM） by quantitative analysis of myocardial perfusion/metabolism imaging and to investigate the relationship between LVRM and myocardial viability. Methods A total of 45 patients were divided into three groups according to the location of infarction： 16 eases of anterior infarction, 18 cases of inferoposterior infarction and 11 cases of anterior-inferoposterior infarction. The value of EG/EF, GF/EF and EF/AB were measured by Xeleris 2.0. The myocardial viability were detected by myocardial perfusion /metabolism imaging. Results The global left ventricular ejection fraction （LVEF）, end-diastolic volume （EDV）, end-systolic volume （ESV） and the value of EF/ AB in all of the three infarction groups were significantly higher than those in the normal group （P〈0.05）. Compared with the the normal group, the value of EG/EF were higher in both the anterior infarction group and anterior-inferoposterior infarction group （P〈0. 001）. Global LVEF and the value of EF/AB in two viable groups were less than those in the nonviable group （P 〈0.05）. Conclusion The quantitative analysis of myocardial perfusion/metabolism imaging is useful for evaluating LVRM after myocardial infarction. The global cardiac function and LVRM of the patients with viable myocardium in infarction area are better preserved than those of the patients with nonviable myocardium in infarction area.