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首页> 外文期刊>JACC. Cardiovascular imaging. >Troponin T levels and infarct size by SPECT myocardial perfusion imaging.
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Troponin T levels and infarct size by SPECT myocardial perfusion imaging.

机译：通过SPECT心肌灌注显像检测肌钙蛋白T水平和梗死面积。

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OBJECTIVES: To evaluate the relationship between serial cardiac troponin T (cTnT) levels with infarct size and left ventricular ejection fraction by gated single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in patients with acute myocardial infarction (AMI). BACKGROUND: Current guidelines recommend the use of cTnT as the biomarker of choice for the diagnosis of AMI. Data relating cTnT to SPECT-MPI in patients with AMI are limited. METHODS: A subset of patients with their first AMI participating in a community-based cohort of AMI in Olmsted County, Minnesota, were prospectively studied. Serial cTnT levels were evaluated at presentation, <12 h and 1, 2, and 3 days after onset of pain. Peak cTnT was defined as the maximum cTnT value. RESULTS: A total of 121 patients (age, 61 +/- 13 years; 31% women) with AMI underwent gated SPECT-MPI at a median (25th percentile, 75th percentile) of 10 (5, 15) days post-AMI. The type of infarct was non-ST-segment elevation myocardial infarction in 61%, and 13% were anterior in location. The median infarct size was 1% (0%, 11%) and the median gated left ventricular ejection fraction was 54% (47%, 60%). Fifty-nine patients (49% of the population) had no measurable infarction by SPECT-MPI. Independent predictors of measurable SPECT-MPI infarct size included cTnT at days 1, 2, and 3 and peak cTnT, but not at presentation or <12 h. In receiver-operator characteristic analysis, the area under the curve was highest at day 3. Receiver-operator characteristic analysis demonstrated a cutoff of 1.5 ng/ml for peak cTnT for the detection of measurable infarct size. CONCLUSIONS: In a community-based cohort of patients with their first AMI, independent predictors of measurable SPECT-MPI infarct size included cTnT at days 1, 2, and 3 and peak cTnT. In contrast, cTnT level at presentation and <12 h was not an independent predictor of myocardial infarction size as assessed by SPECT-MPI. Receiver-operator characteristic analysis demonstrated a cutoff value peak cTnT of 1.5 ng/ml for the detection of measurable infarct.
机译：目的：通过门控单光子发射计算机断层扫描心肌灌注显像（SPECT-MPI）评估急性心肌梗死（AMI）患者的系列心肌肌钙蛋白T（cTnT）水平与梗死面积和左室射血分数之间的关系。背景：当前指南建议使用cTnT作为AMI诊断的首选生物标志物。 AMI患者中cTnT与SPECT-MPI相关的数据有限。方法：前瞻性研究了在明尼苏达州奥姆斯特德县以社区为基础的AMI队列中首次参加AMI的患者子集。在出现时，疼痛发作后<12 h和1、2和3天评估连续cTnT水平。峰值cTnT定义为最大cTnT值。结果：总共121例AMI患者（年龄为61 +/- 13岁;女性占31％）在AMI后10（5、15）天的中位（25％，75％）接受了门控SPECT-MPI。梗塞类型为非ST段抬高型心肌梗塞，占61％，位于前位的占13％。中位梗死面积为1％（0％，11％），中位门控左心室射血分数为54％（47％，60％）。 59名患者（占人口的49％）没有通过SPECT-MPI可测量的梗塞。可测量的SPECT-MPI梗死面积的独立预测因子包括第1、2、3天的cTnT和峰值cTnT，但在就诊时或<12 h时不包括。在接受者-操作者特征分析中，曲线下面积在第3天最高。接受者-操作者特征分析表明，峰值cTnT的截止值为1.5 ng / ml，用于检测可测量的梗塞面积。结论：在以社区为基础的首次AMI患者队列中，可测量SPECT-MPI梗死面积的独立预测因素包括第1、2和3天的cTnT和峰值cTnT。相比之下，通过SPECT-MPI评估，出现时和<12 h时cTnT水平不是心肌梗死面积的独立预测因子。接收者-操作者特征分析表明，用于检测可测量梗塞的临界值峰cTnT为1.5 ng / ml。

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