扩张型心肌病与缺血性心肌病致心力衰竭患者门控心肌灌注显像对比分析

Gated myocardial perfusion imaging in the treatment of dilated cardiomyopathy and ischemic cardiomyopathy induced heart failure

目的比较扩张型心肌病与缺血性心肌病致心力衰竭患者门控心肌灌注显像特点,为临床合理治疗提供依据。方法扩张型心肌病致心力衰竭患者23例(扩张型心肌病组),缺血性心肌病致心力衰竭患者28例(缺血性心肌病组),均行门控心肌灌注显像,比较2组缺血面积、缺血严重程度、负荷和静息舒张末期容积、负荷和静息收缩末期容积、左室射血分数(left ventricular ejecyion fraction,LVEF)值。结果门控心肌灌注显像提示扩张型心肌病组轻度缺血5例,中度缺血12例,严重缺血6例;缺血性心肌病组轻度缺血2例,中度缺血10例,严重缺血16例。扩张型心肌病组缺血面积[(22.13±9.10)%]大于缺血性心肌病组[(15.25±9.80)%],而局部缺血的严重程度(-2.7±1.2)、LVEF[(33.3±8.5)%]小于缺血性心肌病组[-3.1±1.8、(41.3±6.5)%],2组比较差异有统计学意义(P<0.05);扩张型心肌病组负荷舒张末期容积[(59.97±19.68)mL]、静息舒张末期容积[(55.95±24.36)mL]、负荷收缩末期容积[(38.29±16.90)mL]、静息收缩末期容积[(36.68±17.74)mL]高于缺血性心肌病组[(51.08±17.56)、(49.90±20.31)、(25.95±14.67)、(25.35±15.84)mL],2组比较差异均有统计学意义(P<0.05)。结论扩张型心肌病与缺血性心肌病致心力衰竭具有不同的心肌灌注显像特点,其可用于指导临床治疗。

Objective To study the different characteristics of gated myocardial perfusion imaging of dilated cardiomyopathy and ischemic cardiomyopathy induced heart failure to provide important evidence for clinical therapy. Methods Gated myocardial perfusion imaging was performed in 23 patients with dilated cardiomyopathy （dilated group） and 28 patients with ischemic cardiomyopathy induced heart failure （ischemic group）. The ischemic area, severity, loading and resting end-diastolic volume, loading and resting end-systolic volume, and left ventricular ejection fraction （LVEF） were detected and compared between two groups. Results Gated myocardial perfusion imaging showed mild ischemia in 5 patients, moderate ischemia in 12 and severe ischemia in 6 in dilated group, and 2, 10 and 16 patients respectively in ischernic group. The ischemic area was significantly larger in dilated group （（22.13 ±9.1）%） than that in ischemic group （（15.25±9.8）%） （P〈0.05）. The severity of local ischemia （-2.7±1.2） and LVEF （（33.3±8.5） %） were lower in dilated group than those in ischemic group （- 3. 1 ± 1. 8, （41. 3±6. 5）%） （P〈0.05）. Loading enddiastolic volume （ （59.97± 19.68） mL）, resting end-diastolic volume （ （55.95± 24.36） mL）, loading end-systolic volume （（38. 29±16.90） mL）, resting end-systolic volume （（36.68±17.74） mL） were higher in dilated group than those in ischemic group （（51. 08±17.56）, （49. 90±20.31）, （25.95±14.67）, （25.35±15.84） mL） （P〈0.05）. Conclusion Gated myocardial perfusion imaging has different characteristics in patients with dilated cardiomyopathy and ischemic cardiomyopathy induced heart failure, and can be used to guide the therapy.