Radiology Cardiothorax Imaging:这种影像学检查可预测心脏死亡,尤其对于糖尿病患者

2019-07-06 国际糖尿病编辑部 国际糖尿病

有研究者报告,在接受应力性心肌灌注PET扫描检查的患者中,其结果异常程度增加与心脏死亡风险增加有关。而且,这种相关性在糖尿病患者中最为明显。

有研究者报告,在接受应力性心肌灌注PET扫描检查的患者中,其结果异常程度增加与心脏死亡风险增加有关。而且,这种相关性在糖尿病患者中最为明显。

哈佛医学院布莱根妇女医院Hicham Skali博士指出,来自糖尿病患者压力测试的数据让我们能够更好地对39%以上的患者进行风险分层。与非糖尿病患者相比,糖尿病患者的心脏死亡风险明显更高,压力测试数据能够帮助我们进一步对那些风险最高的患者进行分层。

Skali及其同事对7061例接受应力性心肌灌注PET扫描检查的患者数据进行了分析,其中1966例为糖尿病患者,平均年龄63岁,47%为女性,32.5%有明确冠状动脉疾病,26.8%既往曾接受血运重建治疗。主要终点是心脏死亡。平均随访时间为2.5年。

当研究者采用已知临床风险预测因素构建多元模型时,他们发现,应力性心肌灌注异常程度的增加会使心脏死亡风险增加(严重异常vs.正常:HR=7.2;95%CI:3.1~16.8)。

将心肌灌注PET结果加入临床预测因素可改善糖尿病患者的风险重分类(基于分类的净重分类指数=0.39;95%CI:0.15~0.6)。

在糖尿病亚组中,应力性心肌灌注PET结果异常与心脏死亡风险增加相关(HR=4.4;95%CI:2~9.7),且这种相关性与性别、肥胖、年龄、既往血运重建或无症状不存在交互作用。

在糖尿病患者中,心脏死亡的独立预测因素是年龄和异常心肌百分比。在非糖尿病患者中,心脏死亡的独立预测因素为年龄、女性、高胆固醇水平、静息心率和异常心肌百分比。

Skali指出,对于非糖尿病患者来说,无论压力有多大,身为女性都有一定优势,因为她们的死亡风险要低得多。然而,当观察糖尿病患者时,男性和女性心脏死亡风险相似,而且这种风险随着PET压力测试结果的恶化而增加。

原始出处:
Hicham Skali , Marcelo F. Di Carli,  et al. Stress Myocardial Perfusion PET Provides Incremental Risk Prediction in Patients with and Patients without Diabetes. Radiology: Cardiothorac Imaging. Jun 27 2019

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    2019-08-17 jyzxjiangqin

    影像学检查可预测心脏病。

    0

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    2019-08-07 jyzxjiangqin

    心肌灌注医学。

    0

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    2019-07-10 zhangqingzui

    好好学习,感谢

    0

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    2019-07-06 misszhang

    谢谢MedSci提供最新的资讯

    0

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