CAJ | 학술논문

目的探讨特发性扩张型心肌病(IDCM)患者右室心肌葡萄糖代谢水平与左、右心室功能之间的关系.方法前瞻性研究2010年10月至2013年5月间确诊的IDCM连续病例64例,其中男45例,女19例,平均年龄(53±12)岁.所有入选者均行18F-FDG心肌代谢PET显像、心脏MRI延迟增强成像(cMRI-LGE)和UCG检查.应用PET-TrueD软件测定右室游离壁SUVmean(SUV-R)和左室游离壁SUVmean(SUV-L),以及两者的比值(SUV-R/L);应用cMRI-LGE测定左、右室功能及左心延迟强化的情况;应用UCG测定肺动脉收缩压(PASP).利用两样本t检验和Pearson相关分析分析数据.结果 SUV-R、SUV-R/L与LVEF均呈负相关(r=-0.48和-0.33,均P＜0.01),与RVEF也呈负相关(r=-0.45和-0.44,均P＜0.01);SUV-R/L与PASP呈正相关(r=0.58,P＜0.01).延迟强化组和无延迟强化组的SUV-R/L分别为0.45±0.18和0.36±0.12,差异有统计学意义(t=2.50,P＜0.05);延迟强化组的SUV-R和SUV-L分别为2.0±0.9和4.7±1.6,无延迟强化组的SUV-R和SUV-L分别为1.7±0.9和5.0±2.8,2组间的SUV-R和SUV-L差异均无统计学意义(t=0.54和0.63,均P＞0.05).结论右室心肌葡萄糖代谢水平与左、右室功能密切相关,通过PET显像测定右室18F-FDG的摄取,对IDCM患者的病情评估和预后判断具有一定的临床价值.
목적 탐토특발성확장형심기병(IDCM)환자우실심기포도당대사수평여좌、우심실공능지간적관계.방법 전첨성연구2010년10월지2013년5월간학진적IDCM련속병례64례,기중남45례,녀19례,평균년령(53±12)세.소유입선자균행18F-FDG심기대사PET현상、심장MRI연지증강성상(cMRI-LGE)화UCG검사.응용PET-TrueD연건측정우실유리벽SUVmean(SUV-R)화좌실유리벽SUVmean(SUV-L),이급량자적비치(SUV-R/L);응용cMRI-LGE측정좌、우실공능급좌심연지강화적정황;응용UCG측정폐동맥수축압(PASP).이용량양본t검험화Pearson상관분석분석수거.결과 SUV-R、SUV-R/L여LVEF균정부상관(r=-0.48화-0.33,균P＜0.01),여RVEF야정부상관(r=-0.45화-0.44,균P＜0.01);SUV-R/L여PASP정정상관(r=0.58,P＜0.01).연지강화조화무연지강화조적SUV-R/L분별위0.45±0.18화0.36±0.12,차이유통계학의의(t=2.50,P＜0.05);연지강화조적SUV-R화SUV-L분별위2.0±0.9화4.7±1.6,무연지강화조적SUV-R화SUV-L분별위1.7±0.9화5.0±2.8,2조간적SUV-R화SUV-L차이균무통계학의의(t=0.54화0.63,균P＞0.05).결론 우실심기포도당대사수평여좌、우실공능밀절상관,통과PET현상측정우실18F-FDG적섭취,대IDCM환자적병정평고화예후판단구유일정적림상개치.
Objective To explore the relationship between myocardial glucose metabolism in the right heart and cardiac function in patients with idiopathic dilated cardiomyopathy (IDCM).Methods From October 2010 to May 2013,64 consecutive patients (45 males,19 females; mean age:(53 ± 12) years) with IDCM were enrolled in this study.All patients underwent 18F-FDG myocardial PET imaging,late-gadolinium enhancement cardiac MRI (cMRI-LGE) and UCG.TrueD software was used to determine the SUVmax in right (SUV-R) and left (SUV-L) ventricular free wall,and the ratio of SUV-R to SUV-L (SUV-R/L) was calculated.The cMRI-LGE was used to evaluate LVEF,RVEF and LGE in left heart.Pulmonary artery systolic pressure (PASP) was measured by UCG.Two-sample t test and Pearson correlation analysis were used to analyze the data.Results Both SUV-R and SUV-R/L had negative correlation with LVEF (r=-0.48,-0.33; both P＜0.01) and also with RVEF (r=-0.45,-0.44; both P＜0.01).SUV-R/L positively correlated with PASP (r =0.58,P＜0.01).SUV-R/L of patients with and without LGE were statistically different (0.45±0.18 vs 0.36±0.12; t=2.50,P＜0.05).SUV-R and SUV-L of patients with LGE were 2.0±0.9 and 4.7±1.6,and those of patients without LGE were 1.7±0.9 and 5.0±2.8.Both differences of SUV-R and SUV-L between the two groups were not statistically significant (t=0.54 and 0.63,both P＞0.05).Conclusions Myocardial glucose metabolism in right heart is closely correlated with left and right ventricular function.The assessment of 18F-FDG uptake in right heart by PET imaging is potentially useful for evaluation of the severity and prognosis in IDCM patients.