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首页> 外文期刊>Circulation journal >Prognostic Value of Normal Stress-Only Technetium-99 m Myocardial Perfusion Imaging Protocol - Comparison With Standard Stress-Rest Protocol -
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Prognostic Value of Normal Stress-Only Technetium-99 m Myocardial Perfusion Imaging Protocol - Comparison With Standard Stress-Rest Protocol -

机译：正常仅Tech 99 m心肌灌注显像方案的预后价值-与标准静息协议的比较-

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Background: Patients with a normal stress image on technetium-99 m (Tc-99 m) single-photon emission computed tomography (SPECT) have a good prognosis for diagnosing coronary artery disease. However, current guidelines recommend stress and rest imaging to confirm that a stress image is normal. Methods and Results: We determined all-cause of cardiac events (acute coronary syndrome and sudden death) in 1,939 patients undergoing stress myocardial perfusion SPECT with Tc-99 m radiotracers. Patients with an abnormal stress image were excluded, so we focused on 1,125 patients in whom the stress SPECT study was interpreted as normal. A stress-only protocol was used in 726 patients (adenosine=339; exercise=387), whereas 399 had both stress and rest imaging (adenosine=294; exercise=105). Mean follow-up was 1,252 days. At the end of follow-up, there were 39 cardiac events in the stress-only cohort and 19 in the stress-rest cohort. Kaplan-Meier analysis revealed that there were no differences for the entire cohort of cardiac events not only between the stress-only and stress-rest protocols but also for stressor modality, despite the fact that the stress-rest cohort showed higher coronary risk factors. Conclusions: Patients determined as having a normal SPECT on the basis of stress imaging alone have a similar cardiac event rate as those who have a normal SPECT on the basis of evaluation of both stress and rest images. This imaging strategy will significantly reduce radiation exposure in a substantial number of patients.
机译：背景：在tech 99 m（Tc-99 m）单光子发射计算机断层扫描（SPECT）上具有正常应力图像的患者对于诊断冠状动脉疾病具有良好的预后。但是，当前的指南建议进行压力和静止成像以确认压力图像正常。方法和结果：我们确定了1939例接受应激性心肌灌注SPECT和Tc-99 m放射性示踪剂治疗的心脏病事件的全因（急性冠状动脉综合征和猝死）。排除了具有异常压力图像的患者，因此我们重点研究了1,125例压力SPECT研究被认为是正常的患者。 726例患者使用了仅接受压力的方案（腺苷= 339;运动= 387），而399例同时进行了压力和静息成像（腺苷= 294;运动= 105）。平均随访时间为1,252天。在随访结束时，仅应激人群中有39例心脏事件，而应激休息人群中有19例心脏事件。 Kaplan-Meier分析显示，尽管仅应激组显示出较高的冠心病危险因素，但仅在应激组和应激组之间，在整个心脏事件队列中，以及应激源形态上都没有差异。结论：仅根据压力显像确定为SPECT正常的患者，其心脏事件发生率与根据对压力和静止图像进行评估而确定为SPECT正常的患者的心脏事件发生率相似。这种成像策略将显着减少大量患者的放射线暴露。

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