SPECT/CT门控心肌显像相位分析对慢性心力衰竭患者心脏再同步治疗的疗效评价

Efficacy of phase analysis of SPECT/CT gated myocardial perfusion imaging in cardiac resynchronization therapy in patients with chronic heart failure

目的探讨单光束发射断层扫描(SPECT)/计算机断层显像(CT)门控心肌显像相位分析是否可指导心脏再同步治疗(CRT)植入,以及对CRT的远期效果进行评价。方法选取2009年6月-2014年6月该院因诊断慢性心力衰竭行CRT或心脏再同步除颤起搏器植入术(CRTD)的患者37例,分为治疗有反应组和无反应组。两组患者在术后6个月行SPECT/CT门控心肌显像相位分析,应用相位分析技术检测左心室瘢痕负荷,评价左室收缩协调性指标(峰相位、收缩期相位时间标准差和带宽),观察两组左心室瘢痕负荷和同步性指标有无差异。结果两组治疗后,左心室瘢痕负荷和同步性指标(瘢痕负荷、峰相位、收缩期相位时间标准差和带宽)比较,差异有统计学意义。结论 SPECT/CT门控心肌显像相位分析可以评价CRT术前适应证、预测术后效果、判断术中电极植入的位置,是术后随访的重要方法。

Objective To investigate the guidance of phase analysis of SPECT/CT gated myocardial imaging in cardiac resynchronization therapy（CRT） implantation and evaluate its long-term effect. Methods Thirtyseven cases who recieved CRT or CRT-defibrillator（CRTD） for chronic heart failure in our hospital from June2009 to June 2014 were divided into reactive group and non-response group. The two groups of patients had phase analysis of SPECT/CT gated myocardial perfusion imaging six months after operation. Using phase analysis technique, left ventricular scar load was detected, left ventricular systolic synchrony indexes（peak phase,standard deviation of systolic phase time and bandwidth） were assessed, the differences of left ventricular scar load and synchronous indexes between the two groups were observed. Results The left ventricular scar load and the synchronization indexes including scar load, peak phase, the standard deviation of the systolic phase time and bandwidth were significantly different between both groups. Conclusions The phase analysis of SPECT/CT gated myocardial imaging can be used to evaluate the indications of CRT, the effect of prediction and the location of electrode placement. It is an important method of postoperative follow-up.