Nghiên cứu giá trị tiên lượng của xạ hình SPECT tưới máu cơ tim ở bệnh nhân sau nhồi máu cơ tim

Evaluation the prognostic of SPECT in post myocardial infarct

SUMMARY:

Aims: The purpose of our study was to evaluate the prognostic value of characteristics of defects in Tc99m-sestamibi gated SPECT myocardial perfusion imaging (MPI) in post-MI patients.

Subjects and methods: 116 post-myocardial infarction (MI) patients were underwent gated SPECT in Nuclear Medicine Department, 108 Central Military Hospital from March 2007 to May 2010. Mean follow-up time was 23.27 ± 9,9 months.

Results: The reversible perfusion defects had higher rate of patients with unstable angina (92.1% vs 76.9%, p<0.05) and revascularization (95.8% vs 72.1%, p<0.01), respectively. The fixed defect had higher rate of patients with congestive heart failure compared to patient group without congestive heart failure (47.2% vs 6.1%, p<0.001). In patients with unstable angina (UA) and/or recurrent MI, severe and large defects were significant highger than that of patients without UA and/or recurrent MI (p<0.05). In congestive heart failure (CHF) patients, severe and large defects were 97.1% and 76.8% in comparison with 88.2% and 70.7% respectively (p < 0.05). In fatal patient group, 100% had large defects compared to 72% in non-fatal MI patients. SSS and SRS were higher in post-MI patient with coronary events compared to those without coronary events (18.17 ± 5.3 vs 13.5 ± 3.65, p<0.001 and 14.77 ± 5.46 vs 11.04 ± 3.58, p < 0.01).

Conclusions: the characteristics of myocardial perfusion defect on MPI have prognostic value in post-MI patients.