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1.
Chinese Journal of Ultrasonography ; (12): 3-9, 2023.
Artigo em Chinês | WPRIM | ID: wpr-992800

RESUMO

Objective:To detect the abnormal changes of myocardial blood perfusion in patients with hypertrophic cardiomyopathy(HCM) by myocardial contrast echocardiography (MCE) combined with adenosine stress test.Methods:Fifteen adult patients with HCM who were treated in Fuwai Central China Cardiovascular Hospital from May 2021 to March 2022 were prospectively selected as the HCM group, and eighteen healthy volunteers matched by gender, age and body surface area during the same period were chosen as the control group. All subjects underwent routine echocardiography, rest and adenosine stress MCE. The MCE images were analyzed by QLab software to obtain the myocardial perfusion parameters: peak signal intensity (A value), rising slope of the curve (β value) and A×β value, and the differences of above parameters between the two groups were compared.According to whether the end-diastolic wall thickness ≥12 mm, the myocardial segments in the HCM group were divided into hypertrophic segments and non-hypertrophic segments. The differences in myocardial perfusion parameters were compared among control group segments, hypertrophic segments and non-hypertrophic segments of the HCM group. The correlations of stress myocardial blood flow with maximal left ventricular wall thickness (MLVWT), left ventricular mass index (LVMI) and left atrial volume index (LAVI) in the HCM group were analyzed.Results:Compared with the control group, the A value, β value and A×β value of whole myocardium, hypertrophic segments and non-hypertrophic segments in the HCM group were significantly decreased in the rest and adenosine stress state, and the differences were statistically significant (all P<0.05). In the stress state, the A value, β value and A×β value of the hypertrophic segments were significantly lower than those in the non-hypertrophic segments in the HCM group, and the detection rate of abnormal perfusion segments in the HCM group was significantly higher than that in the rest state(all P<0.05). Compared with the control group, the myocardial blood flow reserve of whole myocardium, hypertrophic segments and non-hypertrophic segments in the HCM group were significantly decreased, and the differences were statistically significant(all P<0.05). The stress myocardial blood flow in the HCM group was negatively correlated with MLVWT, LVMI and LAVI ( r=-0.815, -0.805, -0.742; all P<0.05). Conclusions:Myocardial blood perfusion abnormalities can occur in both hypertrophic and non-hypertrophic myocardial segments in patients with HCM, and adenosine stress MCE can significantly improve the sensitivity of detecting myocardial perfusion abnormalities. The stress myocardial blood flow in patients with HCM is negatively correlated with MLVWT, LVMI and LAVI.

2.
Korean Journal of Radiology ; : 476-486, 2017.
Artigo em Inglês | WPRIM | ID: wpr-114057

RESUMO

OBJECTIVE: To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dual-energy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard. MATERIALS AND METHODS: We retrospectively reviewed the records of 25 patients with suspected coronary artery disease, who underwent CCTA, DE-CTP, SPECT, SP-CMR, and ICA. The reference standard was defined as ≥ 50% stenosis by ICA, with a corresponding myocardial hypoperfusion on SP-CMR. RESULTS: For per-vascular territory analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 96, 96, 68, 93, and 68%, respectively, and specificities were 72, 75, 89, 85, and 94%, respectively. The areas under the receiver operating characteristic curve (AUCs) were 0.84 ± 0.05, 0.85 ± 0.05, 0.79 ± 0.06, 0.89 ± 0.04, and 0.81 ± 0.06, respectively. For per-patient analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 100, 100, 89, 100, and 83%, respectively; the specificities were 14, 43, 57, 43, and 57%, respectively; and the AUCs were 0.57 ± 0.13, 0.71 ± 0.11, 0.73 ± 0.11, 0.71 ± 0.11, and 0.70 ± 0.11, respectively. CONCLUSION: The combination of CCTA and DE-CTP enhances specificity without a loss of sensitivity for detecting hemodynamically significant coronary artery stenosis, as defined by combined ICA and SP-CMR.


Assuntos
Humanos , Angiografia , Área Sob a Curva , Constrição Patológica , Angiografia Coronária , Doença da Artéria Coronariana , Estenose Coronária , Vasos Coronários , Imageamento por Ressonância Magnética , Imagem de Perfusão do Miocárdio , Miocárdio , Perfusão , Estudos Retrospectivos , Curva ROC , Sensibilidade e Especificidade , Tomografia Computadorizada de Emissão , Tomografia Computadorizada de Emissão de Fóton Único
3.
Chinese Journal of Medical Imaging Technology ; (12): 82-85, 2010.
Artigo em Chinês | WPRIM | ID: wpr-472742

RESUMO

Objective To evaluate Meta-analysis in assessing the overall diagnostic value of adenosine stress echocardiography (ASE) in patients with coronary heart disease (CHD). Methods Relevant English and Chinese articles about ASE for assessing diagnostic accuracy of CHD were collected from the literatures published from 1994 to 2007 in China and abroad. Meta-analysis was conducted with the method recommended by the Cochrane Collaboration. Results Twelve papers were included. The reported sensitivity of ASE for the diagnosis of CHD ranged from 0.69 to 0.94, and the specificity ranged from 0.71 to 1.00. The pooled weighted sensitivity and specificity was 0.81 (95%CI 0.77-0.85) and 0.83 (95%CI 0.78-0.87), respectively;and the pooled positive and negative likelihood ratio was 4.81 (95%CI 3.65-6.33) and 0.22 (95%CI 0.18-0.28), respectively. The area under the curve of the summary receiver operating characteristic was 0.8968±0.0151. Conclusion ASE is medium to highly accurate in the diagnosis of CHD.

4.
Korean Circulation Journal ; : 189-196, 1997.
Artigo em Coreano | WPRIM | ID: wpr-19136

RESUMO

BACKGROUND: Myocardial perfusion scintigraphy with intravenous adenosine has proved efficacy for the diagonosis and risk stratification of coronary artery disease. To determine the safety of adenosine infusion in conjunction with radionuclide imaging, we evaluated prospectively 1,093 patients who underwent myocardial perfusion study. METHODS: Informations on safety and adverse events during and immediately after adenosine infusion were collected and statistical analysis was performed. RESULTS: The adverse events were reported in 730 patients (66.8%), but no death or myocardial infarction. There asverse events were well tolerated and no prolonged effect was noted. Chest pain occured in 223 patients(20.4%) and facial flushing and dyspnea were reported by 246 patients(22.5%) and 253 patients(23.1%), respectively. ECG changes, such as mild arrhythmia, ST depression and AV block were checked in 230 patients(21.0%). The infusion was prematurely terminated in 32 patients(2.9%), due to serve chest pain, serve brochospasm, or third degree AV block. Higher frequency of chest pain was reported in women compare to men(p<0.05), and ST segment depression was more frequent in patients with abnormal myocardial perfusion scitigraphic findings(p<0.05). CONCLUSION: These results demonstrate that intravenous infusion of adenosine is relatively safe, and myocardial perfusion scintigraphy with intravenous ademosine is feasible technique in the evaluation of the coronary artery disease patients unable to exercise.


Assuntos
Feminino , Humanos , Adenosina , Arritmias Cardíacas , Bloqueio Atrioventricular , Dor no Peito , Doença da Artéria Coronariana , Depressão , Dispneia , Eletrocardiografia , Rubor , Infusões Intravenosas , Infarto do Miocárdio , Imagem de Perfusão do Miocárdio , Perfusão , Imagem de Perfusão , Estudos Prospectivos , Cintilografia
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