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過去の講演会
第327回 川崎医学会講演会
:: 日 時 | 平成27年3月17日(火) 15:30・16:30 | |
:: 場 所 | 図書館小講堂 | |
:: 座 長 | 曽根 照喜 |
「The prognostic value of end-systolic volume measured by gated PET in patients with left ventricular aneurysm: comparison with remodeling parameters from gated SPECT and CMR」
Xiaoli Zhang,M.D., Ph.D.
Professor, Vice-Director
Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital Chinese
Academy of Medical Sciences and Peking Union of Medical College, Beijing, China
Purpose: The aim of our current study in patients with left ventricular (LV) aneurysm was to compare the prognostic value of LV remodeling parameters by different imaging modalities, including gated SPECT myocardial perfusion imaging (GSPECT), gated metabolic PET imaging (GPET), cardiac magnetic resonance imaging (CMR) and echocardiography.
Materials & Methods: Ninety-three consecutive patients with LV aneurysm determined by CMR underwent 99mTc-MIBI GSPECT, 18F-FDG GPET, CMR and echocardiography were followed up for a mean of 2.3 years .Cardiac death during follow-up was served as the endpoint. LV ejection fraction (LVEF, %), end-diastolic volume (EDV, ml) and end-systolic volume (ESV, ml) were measured by GSPECT, GPET and CMR. LVEDD (cm) was measured by echocardiography.
Results: Univariate Cox hazard regression analysis showed that LVEF (P <0.05) measured by GPET, both EDV and ESV measured by GSPECT, GPET and CMR were independent predictors for cardiac death (all P value < 0.05). Multivariate Cox analysis showed that ESV measured by GPET(HR 1.013, 95% CI:1.003・1.022, P = 0.007) was the only independent predictor for cardiac death. Mortality in patients with an ESV ≥ 140mL measured by GPET was significant higher than that in patients with an ESV <140mL (24.1% vs 7.8%, χ2 = 5.16, P = 0.023).The 1-year, 3-year, 5-year survival of patients with ESV≥ 140ml were ( 86.2 ± 6.4)%,(75.7 ± 0.8)% and (75.7 ± 0.8)%, while those were (98.4 ± 1.6)%, (98.4 ± 1.6)% and (92.2 ± 3.4)% in patients with ESV< 140ml.
Conclusions: ESV measured by GPET was the only independent predictor for cardiac death in patients with LV aneurysm among all the LV remodeling parameters. LV aneurysm patients with severe LV remodeling were at high risk for cardiac death.