多巴酚丁胺负荷超声心动图及核素显像对慢性闭塞病变患者左心室功能的评价

对20例冠状动脉慢性闭塞病变（CTO）患者术前行多巴酚丁胺负荷超声心动图试验及99mTc-甲氧基异丙基丁腈（MIBI）灌注扫描、18F-葡萄糖代谢显像.根据MIBI左心室灌注缺损面积分为2组：高缺损组（缺损面积比例＞10％）,低缺损组（缺损面积比例≤10％）,比较两组患者的临床特点、灌注/代谢显像及多巴酚丁胺负荷超声心动图结果.显示高缺损组患者平均灌注缺损面积占左心室面积比例为25.0％,低缺损组平均灌注缺损面积占左心室面积比例为2.6％,高缺损组的平均左心室代谢缺损比例更高（P=0.02）.高缺损组患者心超检查左心室射血分数（LVEF）明显低于低缺损组（均P＜0.05）;但高缺损组患者负荷状态下LVEF上升百分比更高.提示,CTO患者心脏超声LVEF受左心室灌注缺损影响,多巴酚丁胺负荷时CTO患者具有良好的代偿性.

Evaluation of left ventricular function by DSE and MIBI/FDG perfusion/metabolic imaging in patients with chronic total coronary occlusion

Twenty patients with chronic total coronary occlusion （CTO） underwent dobutamine stress echocardiography （ DSE ） and 99mTc methoxyisobutylisonitrile （ MIBI ） SPECT and ^18F- fluorodeoxyglucose （FDG） PET/CT perhsion-metabolie imaging examination before pereutaneous coronary intervention （PCI）. Patients were classified as high deficit group （ n = 10） and low deficit group （ n = 10）, according to peffusion deficit percentage of left ventricle. Clinical eharaeteristies, MIBI/FDG peffusion/ metabolic imaging and DSE findings were compared between two groups. Mean perfusion defect percentage of left ventricular in high deft（it patients was 25.0% , while that in low deficit patients was 2.6% （P 〈0. 01 ）. Palients with high deficit had more metabolic defect （P = 0. 02） , and lower left ventricular ejeetion fi＇action （INEF） than those with low deficit （P 〈 0. 05）. However the increasing rate of LVEF in high deficit group was higher. The results indicate that INEF of CTO patients was affeeted by its left ventricular defect percentage, and it can be well compensated by dobutamine load.