共 50 条
Long-term survival of patients with viable and nonviable aneurysms assessed by 99mTc-MIBI SPECT and 18F-FDG PET:: A comparative study of medical and surgical treatment
被引:19
|作者:
Zhang, Xiaoli
[1
,2
,3
,4
]
Liu, Xiu-jie
[1
,2
,3
]
Hu, Shengshou
[2
,3
,5
]
Schindler, Thomas H.
[4
]
Tian, Yueqing
[1
,2
,3
]
He, Zuo-xiang
[1
,2
,3
]
Gao, Runlin
[2
,3
,6
]
Wu, Qingyu
[2
,3
,5
]
Wei, Hongxing
[1
,2
,3
]
Sayre, James W.
[4
]
Schelbert, Heinrich R.
[4
]
机构:
[1] Cardiovasc Inst, Dept Nucl Med, Beijing 100037, Peoples R China
[2] Fu Wai Hosp, Chinese Acad Med Sci, Beijing, Peoples R China
[3] Peking Union Med Coll, Beijing 100021, Peoples R China
[4] Univ Calif Los Angeles, David Geffen Sch Med, Dept Mol & Med Pharmacol, Los Angeles, CA 90095 USA
[5] Cardiovasc Inst, Dept Cardiovasc Surg, Beijing, Peoples R China
[6] Cardiovasc Inst, Dept Cardiol, Beijing, Peoples R China
关键词:
coronary disease;
aneurysm;
myocardial viability;
survival;
D O I:
10.2967/jnumed.107.046730
中图分类号:
R8 [特种医学];
R445 [影像诊断学];
学科分类号:
1002 ;
100207 ;
1009 ;
摘要:
The prognostic value of myocardial viability assessment on left ventricular (LV) aneurysms remains undetermined. We aimed, first, to evaluate the long-term survival benefit of assessing the viability of the aneurysmal myocardium in patients with ischemic cardiomyopathy and, second, in the revascularization subgroup, to compare the short-term effects on LV function and clinical symptoms in patients treated by revascularization alone or by revascularization plus aneurysmectomy. Methods: Seventy consecutive patients with an LV aneurysm who underwent Tc-99m-sestamibi SPECT and F-18-FDG PET were followed up fora median of 6.8 y (range, 0.1-8.8 y). Only cardiac death during follow-up served as the endpoint. Patients were classified into 4 groups by aneurysmal viability and by treatment strategy (medical or surgical). Further, the effects of aneurysmectomy on LV function at 3 mo were evaluated by an analysis of revascularized patients grouped by aneurysmal viability and by aneurysmectomy. Results: Twenty-four patients were assigned to medical therapy, and 46 patients were assigned to surgery (18 revascularization alone and 28 revascularization plus aneurysmectomy). The annual cardiac mortality rate in patients with a viable aneurysm treated medically (n = 10) was significantly higher than that in patients with a viable aneurysm treated surgically (n 23) (11.6% vs. 1.5%, chi(2) = 12.87, P < 0.0001) and was also significant higher than that in patients with a nonviable aneurysm treated medically (n = 14) (chi(2) = 4.13, P < 0.05) or surgically (n = 23) (chi(2) = 10.46, P = 0.001). Multivariate analysis showed that the aneurysmal mismatch score (P = 0.003) and surgical therapy (P = 0.001) were independent predictors of cardiac death. Improvement of LV function and symptoms after revascularization (P < 0.05) was observed in patients with revascularization plus aneurysmectomy and in patients with a viable aneurysm
引用
收藏
页码:1288 / 1298
页数:11
相关论文