| PART1.1 Evaluation of Myocardial Blood Supply and Cardiac Function ofMetabolic Syndrome Using Myocardial Perfusion ImagingObjective: To evalue the change of myocardial blood supply and Cardiac function of MetabolicSyndrome using myocardial perfusion imaging.Methods:There were 342 patients underwent 99mTc methoxyisobutylisonitrile (MIBI) gatedmyocardial perfusion SPECT with stress+rest using the standard 2 day protocol,182 patientsonly underwent rest myocardial perfusion SPECT.103 patients(79men,24women) who met thediagnostic criteria of metabolic syndrome of CDS , underwent 99mTc MIBI stress and restmyocardial perfusion SPECT,and coronary angiography was carried out within onemonth.Imaging were interpreted by two experienced nuclear medicine physicians. Statisticalanalysis was performed using SPSS 13.0 software. Kappa test was used to analyze thecorrelation between the two imaging studies.Results:①By coronary angiography, there were 41 patients diagnosed of CAD (one , two ,three vessel disease: 19,12,10, respectively) and 62 normal. By stress and rest myocardialperfusion imaging , 42 patients were diagnosed of myocardial ischemia (sensitivity:80.5%,33/41 )and 53 patients had negative finding (spcificity: 85.1%, 53/62). The positive andnegative predictive values were 78.6%(33/42) and 86.9%(53/61), respectiveiy; the correlationcoeffient between the two imaging studues was 0.657(P<0.001).Conclusion :①MPI is reliable for myocardial blood supply in MS,and the The MPI(+)elevated accompanied by the increasing number of abnormal metabolic indices. PART1.2 Assessment of the Correlation Between Each MetabolicComponent and Cardiovascular Disease by MPIObjective: Survey the epidemic state of MS and abnormal metabolic indices in the group ofcardiovascular disease(CAD) using MPI.Evaluate the correlation between MS and CVD.Methods: 342 patients who were suspected or known for coronary artery disease(CAD)underwent 99mTc MIBI gated myocardial perfusion SPECT with stress and rest using thestandard 2 day protocol, Imaging were interpreted by two experienced nuclear medicinephysicians. (1) All subjects were divided into two groups with or without MPI(+),Metabolicindices between Two groups were compared and prevalences of abnormal metabolic indices inMPI(+) group were surveyed. t test was used to evaluate the difference between 2 group. (2) Allpatients were divided into four groups according the number of abnormal metabolic indexes :Group 1: no abnormal metabolic indexes; Group 2: with 1 abnormal metabolic indexes; Group 3:with 2 abnormal metabolic indexes; Group 4: With 3 or more than 3 abnormal metabolism (MSgroup). Analysis the impact between the number of metabolic abnormalities and myocardialperfusion. (3) Logistic regression was used to estimate the cross sectional association of MS andeach of its components separately with MPI(+).Results:①FBG,HDL C of MPI(+) group were higher than those without MPI( )group(P<0.05).②Prevalence of MPI(+) elevated accompanied by the increasing number ofabnormal metabolic indices.③Logistic regression analysis of MPI(+) for each component of MSprior to correction showed that male, ageing, high FG high and Dyslipidemia FG werestatistically significant (OR: male 1.445, ageing 3.615, high FG 1.993, dyslipidemia:1.582,P<0.01). After adjustment for age and gender, high FG and dyslipidemia showedsignificance (OR : high FG 1.855, dyslipidemia 1.825 ).Conclusion :MS and its components were the risk factors of MPI(+). The Incidence of theAbnormal Myocardial perfusion elevated accompanied by the inereasing number of abnormalmetabolic indices. Hyperglycemia and dyslipidemia on cardiovascular disease is more important. PART1.3 Evaluation of Cardiac Function of Metabolic Syndrome UsingMyocardial Perfusion ImagingObjective: To evalue the change of Cardiac function of Metabolic Syndrome using myocardialperfusion imaging.Methods: A total of 524 patients who were suspected or known for coronary arterydisease(CAD) were selected ,182 women, age range from 25 to 89 years old(the average54.47±12.92).There were 342 patients underwent 99mTc methoxyisobutylisonitrile(MIBI)gated myocardial perfusion SPECT with stress+rest using the standard 2 day protocol,182patients only underwent rest myocardial perfusion SPECT. Imaging were interpreted by twoexperienced nuclear medicine physicians. Quantitative indexes (including LVEF, EDV, ESV,WM, WT)were handled automatically by the QGS software. All patients were divided into fourgroups according the number of abnormal metabolic indexes : Group 1: no abnormal metabolicindexes; Group 2: with 1 abnormal metabolic indexes; Group 3: with 2 abnormal metabolicindexes; Group 4: With 3 or more than 3 abnormal metabolism (MS group). Analysis the impactbetween the number of metabolic abnormalities and myocardial function using One WayANOVAor Chi Square test.Results:①The relation between the number of metabolic components and myocardialperfusion imaging: the prevalence of MPI (+) were significantly increased with the increasingin the number of metabolic components (without metabolic components: 23.7%, with onemetabolic component: 23.7%, with two metabolic components: 53.8% , MS group: 57.7%).②The relation between the number of abnormal metabolic components and Cardiac function:LVEF,total WM,total WT and△EF were reduced , EDV,ESV were increased with theincreasing in the number of metabolism components.there were significant difference among thegroup(sP<0.05).③The relation between Hypertension, diabetes and Cardiac function:LVEF,T WM,T WT of the patients who had Hypertension or Diabetes were lower than the patientswho had not Hypertension or Diabetes, EDV,ESV was increased; But each cardiac functionparameters between the two groups were not statistically difference(P>0.05).④The relationbetween the number of abnormal metabolic components and Cardiac function in patients withoutcoronary heart disease : LVEF,EDV,ESVwere reduced with the increasing in the number ofmetabolic components, but LVEF has statistically difference in 2 abnormal metaboliccomponents and MS group (P<0.05,P<0.01, respectively). It was confirmed the wall contractionintensity reduced with the increasing in the number of abnormal metabolism in the patients without coronary heart disease。Conclusion :.①MPI can be used to assess cardiac function in patients with metabolicsyndrome, cardiac function and cardiac reserve were decreased with the increasing in the numberof abnormal metabolic components.②Hyperglycemia and Hypertension on cardiac function ismore important.③It was confirmed the wall contraction intensity reduced with the increasingin the number of abnormal metabolism in the patients without coronary heart disease。Thedecline of LVEF was significantly in MS. PART 2 Analysis and Comparison of Myocardial Perfusion Imagingamong the Different Diagnostic Criteria of MSObjective: Analysis of prevalence of MS in patients with the different work definitions ofMS and comparison myocardial perfusion imaging among MS。Methods:342 patients who were suspected or known for coronary artery disease(CAD)underwent 99mTc MIBI gated myocardial perfusion SPECT with stress and rest using thestandard 2 day protocol, Imaging were interpreted by two experienced nuclear medicinephysicians.342 patients with MS work definitions of WHO,IDF and CDS. Prevalences ofmyocardial perfusion imaging in patients of MS were evaluated. Distinetion among three workdefinitions were analyzed.Results:Prevalences of MS were: 35.44%%(WHO),31.56% (IDF), and 34.21 (CDS). Theconsistency of three MS work definitions was better.The consistency between CDS and WHO definitions was the best andKappa value was 0.78.According the results of myocardial perfusion imaging,theprevalences of CVD were 54.96%,52.08%,57.70% with definitions of WHO,IDF and CDSrespectively. The prevalence of cardiovascular disease is the highest in MS patient of CDSdefined diagnosis,there was not significant difference compared with the WHO (P> 0.05),butthere was significant difference compared with the IDF (P> 0.05)。Conclusions: The consistency of WHO,IDF and CDS work definitions was good。theprevalences of CVD were high in patients with MS. There were more closely relation betweenthe patients in MS of WHO,CDS work definitions and cardiovascular disease PART 3 Quantitative Analysis of the Correlation of Regional Motion andCardiac Function by Gated Myocardial Perfusion SPECTObjective:To retrospectively estimate the correlation of each regional wall motion of leftventricular and cardiac function by using quantitative gated 99mTc MIBI myocardial perfusionSPECT.Methods:768 consecutive patients with different left ventricular function were included. Leftventricular ejection fractions (LVEF) and regional wall motion(WM) were evaluated withautomatic gated myocardial perfusion imaging processing software (QGSPECT), regional wallmotion were quantified automatically and expressed in millimeters for 20 segments based on thefunctional polar map. Firstly, because each regional WM is not independent variables of 20regional wall motion, we extract the four common factors (factor cumulative%=90.76%) usingfactor analysis method to overcome the multi collinearity.Results:The factor 1 (F1)reflects the information of Apex, Mid and Distal of lateral wall, Distalof anterior,inferior and infero septum wall; The factor 2 (F2) reflects the information of Mid ofanterior , infero septum and anterior septum wall; The factor 3 (F3) reflects the information ofDistal of anterior and lateral wall; The factor 4 (F4) reflects the information of Midinferior,Distal inferior and Distal infero septum wall respectively. Then, the correlation betweenLVEF and four factors was analyzed by using multivariable linear regression methods. Theinfluence of each segment on left ventricular function was different according to theStandardized Partial Regression coefficient. The results are F1>F3>F2>F4 (StandardizedCoefficientβis 0.633, 0.471, 0.415, 0.169, respectively; P<0.001).Conclusions:The correlation between LVEF and wall motion was better, especially in Apex,Middle and Distal of lateral wall, Distal of anterior wall, inferior and infero septum wall. |
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