腺苷导致ST段压低而体层成像显示灌注正常的患者的临床结局  

Outcome of Patients With Adenosine-Induced ST-Segment Depression But With Normal Perfusion on Tomographic Imaging

作　　者：Hage F.G. Dubovsky E.V. Heo J. Iskandrian A.E. 杜媛 

机构地区：[1]Dr.The Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2007年第3期31-31,共1页

摘　　要：在输注腺苷的过程中出现ST段压低的大多数患者均有可逆性灌注缺损,这可被单光子发射计算机体层成像(SPECT)灌注显影所检测到。但是在灌注显影正常的患者中也可偶见ST段压低。Most patients with ST depression during adenosine infusion have reversible perfusion defects by single-photon emission computed tomographic (SPECT) perfusion images. Occasionally ST depression is observed in the setting of normal perfusion images. The outcome of such patients is controversial. We identified 65 patients who underwent gated SPECT perfusion imaging with adenosine as the stress agent. These patients were selected based on the following criteria: none had previous myocardial infarction or coronary revascularization, all were in sinus rhythm, and none had left bundle branch block. The 65 patients had normal SPECT images but ischemic ST response (≥1 mm ST depression). There were 52 women and 13 men who were 66 ±13 years of age. History of diabetes mellitus was present in 16 patients (25%) and hypertension in 48 patients (74%). At a mean follow-up of 24 months, there were no cardiac deaths or myocardial infarctions, and there were 6 coronary revascularization procedures (2 coronary artery bypass graftings and 4 coronary stentings of 1-vessel coronary disease). One patient died of cancer. In conclusion, patients with no previous myocardial infarction or coronary revascularization who have normal SPECT images have a benign outcome despite the presence of ST depression (0%for death or myocardial infarction and 4.6%/year for coronary revascularization). Balanced ischemia could not be a common cause for discordant perfusion and ST response.

关 键 词：临床结局 成像显示 ST段压低 灌注缺损 单光子发射 血运重建术 左束支传导阻滞 窦性节律 计算机体 

分 类 号：R540.4[医药卫生—心血管疾病]