99Tcm-N-NOET负荷和延迟门控心肌灌注显像对高血压患者的临床价值

Objective To investigate clinical significance of the 99Tcm-bis (N-ethoxy-N-ethyl-dithiocarbamato) nitridotechnetium(99Tcm-N-NOET) exercise and delayed myocardial perfusion imaging (MPI) in hypertensive patients. Methods Sixty patients with hypertension and 19 normal subjects were carried out 99Tcm-N-NOET exercise and delayed MPI, and analyzed the results of MPI, exercise electrocardiography (ECG), cardiac function parameters end-diastolic volume(EDV), end-systolic volume(ESV), left ventricular ejection fraction(LVEF), △ LVEF (LV EF exercis-LVEF delay) and coronary angiography(CAG). Results ① Sixty patients with hypertension, 22 cases(36.7%)of exercise ECG were abnormal, 16 cases (26.7%)were the chest tightness in exercise, 13 cases (21.7%) were blood pressure excessive reaction in exercise; control group, 2 cases (10.5%) of exercise ECG were abnormal, 1 case (5.3%, 1/19) was chest tightness in exercise,no per-son was blood pressure response in excessive. ②The positive rate of myocardial perfusion in hyper tensive group was significantly higher than the control group (31.75％ vs.5.30％, P<0.05). ③Cardial function parameters in hypertension group [exercise EDV =(79.75 ±29.10)ml, ESV =(28.82 ± 15.73)ml, LVEF =(65.78 ±1.27)%; delay EDV=(81.42±3.47)ml, ESV=(30.62±2.05)ml, LVEF=(64.20±9.70)%] and control group[exercise EDV=(79.63 ±21.65)ml, ESV=(27.37±10.71)ml, LVEF=(66.42±1.55)%; delay EDV=(82.89±4.96)ml,ESV=(31.42±3.06)ml, LVEF=(63.16 ±7.54)%] were no statistical difference(exercise EDV: t=0.161, ESV: t=0.112, LVEF: t=0.261; delay EDV: t=0.276, ESV: t=0.197, LVEF: t=0.184, P>0.05), △ LVEF<0%, 28 cases (46.7%) in hypertension group, 4 cases (21.1%) in control group, χ2=3.929, P<0.05; 11 cases (57.9%) in MPI positive group, 12 cases (29.3％) in MPI negative group, χ2=4.501, P<0.05. ④Nineteen hypertension underwent CAG, 11 cases were abnormal, 8 cases were normal. MPI results: 9 cases were ischemia, 10 cases were normal, and they were no statistical difference (χ2=0.25, P>0.05). The sensitivity,specificity and accuracy of 99Tcm-N-NOET MPI were 72.7％, 87.5％ and 78.9％. Conclusions ①99Tcm-N-NOET exercise and delayed MPI can diagnose whether hypertension patients with myocardial ischemia or not. ② △ LVEF of hypertensive patients reduced, △ LVEF is lower in hypertensive patients of MPI-positive.

The clinical value of 99Tcm-N-NOET exercise and delayed myocardial perfusion imaging in patients with hypertension

Objective To investigate clinical significance of the 99Tcm-bis (N-ethoxy-N-ethyl-dithiocarbamato) nitridotechnetium(99Tcm-N-NOET) exercise and delayed myocardial perfusion imaging (MPI) in hypertensive patients. Methods Sixty patients with hypertension and 19 normal subjects were carried out 99Tcm-N-NOET exercise and delayed MPI, and analyzed the results of MPI, exercise electrocardiography (ECG), cardiac function parameters end-diastolic volume(EDV), end-systolic volume(ESV), left ventricular ejection fraction(LVEF), △ LVEF (LV EF exercis-LVEF delay) and coronary angiography(CAG). Results ① Sixty patients with hypertension, 22 cases(36.7%)of exercise ECG were abnormal, 16 cases (26.7%)were the chest tightness in exercise, 13 cases (21.7%) were blood pressure excessive reaction in exercise; control group, 2 cases (10.5%) of exercise ECG were abnormal, 1 case (5.3%, 1/19) was chest tightness in exercise,no per-son was blood pressure response in excessive. ②The positive rate of myocardial perfusion in hyper tensive group was significantly higher than the control group (31.75％ vs.5.30％, P<0.05). ③Cardial function parameters in hypertension group [exercise EDV =(79.75 ±29.10)ml, ESV =(28.82 ± 15.73)ml, LVEF =(65.78 ±1.27)%; delay EDV=(81.42±3.47)ml, ESV=(30.62±2.05)ml, LVEF=(64.20±9.70)%] and control group[exercise EDV=(79.63 ±21.65)ml, ESV=(27.37±10.71)ml, LVEF=(66.42±1.55)%; delay EDV=(82.89±4.96)ml,ESV=(31.42±3.06)ml, LVEF=(63.16 ±7.54)%] were no statistical difference(exercise EDV: t=0.161, ESV: t=0.112, LVEF: t=0.261; delay EDV: t=0.276, ESV: t=0.197, LVEF: t=0.184, P>0.05), △ LVEF<0%, 28 cases (46.7%) in hypertension group, 4 cases (21.1%) in control group, χ2=3.929, P<0.05; 11 cases (57.9%) in MPI positive group, 12 cases (29.3％) in MPI negative group, χ2=4.501, P<0.05. ④Nineteen hypertension underwent CAG, 11 cases were abnormal, 8 cases were normal. MPI results: 9 cases were ischemia, 10 cases were normal, and they were no statistical difference (χ2=0.25, P>0.05). The sensitivity,specificity and accuracy of 99Tcm-N-NOET MPI were 72.7％, 87.5％ and 78.9％. Conclusions ①99Tcm-N-NOET exercise and delayed MPI can diagnose whether hypertension patients with myocardial ischemia or not. ② △ LVEF of hypertensive patients reduced, △ LVEF is lower in hypertensive patients of MPI-positive.