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Circulation：定量心肌灌注的预后意义

2020-05-23 QQY MedSci原创

心肌灌注心血管磁共振（CMR）心肌灌注储备
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心肌灌注反映冠状动脉的大血管和微血管循环。近期，使用心血管磁共振进行灌注定量的发展使临床自动测量心肌灌注成为可能。本研究探索了应激心肌血流量(MBF)和心肌灌注储备（MPR）对患者预后的影响。

心肌灌注反映冠状动脉的大血管和微血管循环。近期，使用心血管磁共振进行灌注定量的发展使临床自动测量心肌灌注成为可能。本研究探索了应激心肌血流量(MBF)和心肌灌注储备（MPR）对患者预后的影响。

本研究在两个中心开展，对疑诊和确诊冠脉疾病患者进行临床灌注评估。采用了一种新的人工智能方法进行自动化图像分析，该方法可获得整体和局部的应激和静息状态下的MBF和MPR。Cox比例危险模型调整合并症和心血管磁共振参数，明确应激时MBF和MPR与死亡及主要不良心血管事件(MACE)的关系，包括心肌梗死、中风、心力衰竭住院和晚期(>90天)血运重建术。

共1049位患者参与本研究，中位随访605天（四分位范围：464-814天）。研究期间，共发生了42例（4%）死亡，并有174位（16.6%）患者发生了188例MACE。应激MBF和MPR与死亡和MACE均独立相关。应激MBF每降低1 mL/g·min，死亡和MACE的校正风险比分别为1.93和2.14，即使根据年龄和合并症进行校正后。MPR每降低1U，死亡和MACE的校正风险比分别为2.45和1.74。在临床评估无局部灌注障碍且无已知大血管冠心病的患者（783位）中，MPR仍与死亡和MACE独立相关，而应激MBF仅与MACE相关。

在疑诊或确诊的冠状动脉疾病患者中，使用人工智能自动定量发现的心血管磁共振灌注图MBF和MPR降低，是一个强有力的、独立的心血管预后不良的预测指标。

原始出处：

Kristopher D. Knot,et al. The Prognostic Significance of Quantitative Myocardial Perfusion. Circulation. 2020;141:1282–1291

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    2021-02-08 鹏儿

    不知核医学spect心肌血流灌注敏感性怎么样

    0

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    2020-08-27 14818eb4m67暂无昵称

    嗯

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=923614, encodeId=052b923614c5, content=不知核医学spect心肌血流灌注敏感性怎么样, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ZBAFYNOLbJf2mpwWDiciaJZxm06o0jHmQNOQ4ImNu3z1sAVNlrEc4KiacxicZTOjoZ2GwHRyZAZEyj26XKicODKYf7A/132, createdBy=ba375247513, createdName=鹏儿, createdTime=Mon Feb 08 10:29:03 CST 2021, time=2021-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813636, encodeId=692481363604, content=嗯, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 07:06:48 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1642510, encodeId=872e1642510a8, content=<a href='/topic/show?id=8210512940e' target=_blank style='color:#2F92EE;'>#心肌灌注#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51294, encryptionId=8210512940e, topicName=心肌灌注)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=754b22951372, createdName=12498e5fm19(暂无昵称), createdTime=Fri Aug 21 16:53:04 CST 2020, time=2020-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1546256, encodeId=5c1f154625652, content=<a href='/topic/show?id=a6fa100185d7' target=_blank style='color:#2F92EE;'>#预后意义#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100185, encryptionId=a6fa100185d7, topicName=预后意义)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba9d13903217, createdName=haouestc, createdTime=Mon May 25 12:53:04 CST 2020, time=2020-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=383084, encodeId=8b88383084fc, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76cf5325122, createdName=148b8aeam20(暂无昵称), createdTime=Sun May 24 01:18:12 CST 2020, time=2020-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=383080, encodeId=e2863830801a, content=学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat May 23 22:00:28 CST 2020, time=2020-05-23, status=1, ipAttribution=)]
    2020-08-21 12498e5fm19(暂无昵称)

    #心肌灌注#

    0

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    2020-05-25 haouestc

    #预后意义#

    0

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    2020-05-24 148b8aeam20(暂无昵称)

    学习了

    0

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    2020-05-23 天地飞扬

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