Predictive value for adverse cardiac events of left ventricular diastolic function measured by gated myocardial perfusion imaging / 中华核医学与分子影像杂志

ABSTRACT

Objective To study the predictive value for adverse cardiac events (ACE) of left ventricular diastolic function measured by G-MPI. Methods Patients assessed by 2 days rest-stressed G-MPI during March 2012 to May 2013 in Beijing Hospital were collected and observed for the cumulative survival rate without ACE after G-MPI. ACE included cardiac death, non-fatal MI and late revascularization (60 d after the examination). Using quantitative gated SPECT (QGS) to get the LVEF and left ventricular peak filling rate (PFR). Using 17 segments, 5-point scoring system to get the summed stress score (SSS). Cox regression analysis was used to identify the independent predictors for ACE, and Kaplan-Meier method was used to investigate the cumulative survival rate without ACE.χ2 test was also used. Results A total of 11 patients who underwent early revascularization (within 60 d after G-MPI) were excluded and 139 patients (76 males, 63 females; average age 68.73 years) were assigned to different groups for outcome analysis, and 9 (6.5%, 9/139) patients had ACE in the whole group. Cox regression analysis showed that SSS, LVEF, PFR were the independent predictors for ACE (all P<0.05). Patients with PFR<2.1 EDV/s had a higher incidence of ACE than those with PFR≥2.1 EDV/s (14.3%(7/49) vs 2.2%(2/90), χ2=7.63, P<0.05). Kaplan-Meier survival analysis showed that the cumulative survival rate without ACE was lower in patients with PFR<2.1 EDV/s than that in patients with PFR≥2.1 EDV/s (67.7% vs 95.0%), and lower in patients with LVEF<50% than that in patients with LVEF≥50%(32.0% vs 90.8%), and also lower in patients with SSS≥8 than those with SSS<8(62.0% vs 94.7%; χ2 values: 11.92,11.27, 10.40, all P<0.01).Combining PFR with SSS and LVEF respectively, Kaplan-Meier survival analysis showed that the cumulative survival rate without ACE in patients with LVEF≥50% was higher than that in patients with LVEF<50% when PFR<2.1 EDV/s (76.7% vs 30.8%), and also higher in patients with SSS<8 than that in patients with SSS≥8 when PFR≥2.1 EDV/s (100% vs 72.2%; χ2 values: 7.14, 13.09, both P<0.01). Conclusion PFR of left ventricular diastolic function measured by G-MPI is one of the independent predictors for ACE, and it could effectively improve the predictive value for ACE if combined with LVEF and SSS.