扩张型心肌病合并左束支传导阻滞患者室间隔心肌代谢与左心室收缩同步性的相关性分析  

Relationship Between Septal Myocardial Metabolism and Left Ventricular Mechanical Synchronization in Patients With Dilated Cardiomyopathy and Left Bundle Branch Block

作　　者：马兴鸿 汪蕾[1] 杨勇[1] 郭风[1] 王道宇[1] 张海龙[1] 耿庆海[1] 郭琳[1] 方纬[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院核医学科,北京市100037

出　　处：《中国循环杂志》2016年第1期69-72,共4页Chinese Circulation Journal

基　　金：国家自然科学基金(81071176;81070194)

摘　　要：目的:采用门电路(简称"门控")控制18氟-脱氧葡萄糖(^(18)F-FDG)心肌代谢显像,探讨扩张型心肌病合并左束支传导阻滞(LBBB)患者室间隔心肌代谢与左心室收缩同步性的相关性。方法:2010-10至2013-05,诊断为扩张型心肌病合并LBBB的连续病例20例(其中男性11例,女性9例),平均年龄(54±11)岁。所有入选患者均进行门控^(18)F-FDG心肌代谢正电子发射计算机断层(PET)显像。应用True D软件测定室间隔^(18)F-FDG最大标准摄取值(S-SUVmax)、平均标准摄取值(S-SUVavg)。应用QGS软件进行左心室相位分析、心功能的测定,获得左心室相位带宽、相位标准差、左心室舒张末期容积、左心室收缩末期容积和左心室射血分数等参数。分析室间隔^(18)F-FDG摄取值与相位分析参数和心功能参数之间的相关性。结果:S-SUVmax和S-SUVavg分别与左心室相位带宽呈显著的负相关关系(r=-0.44,P=0.05和r=-0.48,P<0.05);也分别与左心室相位标准差呈显著负相关关系(r=-0.57,P<0.01和r=-0.51,P<0.05);但与左心室功能参数左心室舒张末期容积、左心室收缩末期容积和左心室射血分数之间均无显著的相关性(P均>0.05)。结论:对于扩张型心肌病合并LBBB的患者,室间隔心肌代谢降低与左心室收缩不同步之间具有明显的关联,应用门控^(18)F-FDG心肌代谢PET显像可同时评价心肌代谢及左心室收缩同步性,对于预后评价和疗效监测都具有重要的临床意义。Objective： To explore the relationship between septal myocardial metabolism and left ventricular mechanical synchronization in patients with dilated cardiomyopathy （DCM） and left bundle branch block （LBBB） by gated ^18F-FDG myocardial metabolic imaging. Methods： A total of 20 consecutive patients diagnosed for DCM with LBBB from 2010-10 to 2013-05 were enrolled, there were 11 male and 9 female at the mean age of （54 ± 11） years. All patients received gated ^18F-FDG myocardial metabolic PET imaging. TrueD software was used to determine the maximal standardized ^18F-FDG uptake value （S-SUVmax） and the average standardized uptake value （S-SUVavg）. QGS software was applied to conduct left ventricular phase analysis and to detect the cardiac function, left ventricular bandwidth （BW）, standard deviation of bandwidth （SD）, left ventricular end- diastolic volume （LVEDV）, LVESV and LVEF. The relationship between ^18F-FDG uptake in septal myocardium with the indexes of phase analysis and the indexes of cardiac fimction was analyzed. Results： S-SUVmax and S-SUVavg were respectively negatively related to BW （r=-0.44, P〈0.05 and r=-0.48, P〈0.05）; they were also respectively negatively related to SD （r=-0.57, P〈0.01 and r=-0.51, P〈0.05）. While S-SUVmax and S-SUVavg were not really related to LVEDV, LVESV and LVEF, all P〉0.05. Conclusion： In patients of DCM with LBBB, reduced septal myocardial metabolism was closely related to left ventricular mechanical synchronization, gated ^18F-FDG myocardial metabolic PET imaging may simultaneously detect both functions, which was important for prognostic evaluation and therapeutic monitoring in clinical practice; phase analysis.

关 键 词：心肌病 扩张型 左束支传导阻滞 代谢显像 相位分析 

分 类 号：R541[医药卫生—心血管疾病]