| Objective: To analysis the clinical value of 99TcmN-NOET SPECT exercise-delay gated myocardial perfusion imaging (99TcmN-NOET Ex-Del GMPI) in evaluation the cardiac function in patients (pts) with suspected coronary artery disease (CAD). On the base of our previous works, we further studied the differences of left ventricular ejection fraction (LVEF) and the LVEFsress-LVEFdelay (△LVEF), heart-lung ratio (HLR) and the change of HLR between stress and delay imaging; HLR under the influence of smoking history.Methods: Selecting 83 subjects who had been examined by 99TcmN-NOET Ex-Del GMPI in the first hospital of Shan xi medical university between May and December 2004. There are 21 subjects (8 females/13 males; mean age, 43.8±7.74y) in normal control group. All of them had normal perfusion. No cardiac events (angina, ischemia, infraction, enlargement of infarcted areas and coronary revascularization) happened during the 2-9 months follow-up periods. Among them, 3 subjects undergoing coronary angiography (CAG) two months before and after 99TcmN-NOET Ex-Del GMPI and the results were normal. Meanwhile, there are 62 pts with suspected or known CAD which are convicted by clinical information and relation tests (22 females/40 males; mean age, 54.15±10.67y) (ECG, treadmill exercise testing, HOLTER, color ultrasound, CAG). During the period of follow-up, 17 pts suffered cardiac events and 14 pts underwent CAG. According to the history of smoking, G1 and G2 were further divided into two groups respectively (Gla, G1b; G2a, G2b), the smoking groups (Gla, G2a) consecutive smoking no less than 5 years and 10 pieces of every day, and non-smoking groups (G1b, G2b) consecutive smoking no more than 1 month, 1pts withdraw smoking for 4 years. All subjects exercised following the standard Bruce protocol. 99TcmN-NOET 925-1110MBq (2530mCi) wasinfused through the antecubital vein when the endpoints achieved. Image acquisition was performed with a double-head Y -camera system (VERTEX , made in the company of America) after injection 30 min and 180 min. Quantitative Gated SPECT (QGS) software was used for calculating the end diastolic volume (EDV), end systolic volume (ESV) and left ventricular ejection fraction (LVEF). HLR ( myocardium ROI mean quantity / the left lung ROI mean quantity) on behalf of pulmonary uptaken NOET.Results:? There was significant difference in GlHLRsreSs (2.323±0.188) and HLRdeiay (2.994±0.104) ^ G2HLRsress (1.941±0.069) and HLRdeiay (2.293±0.061) respectively (PO.001,P<0.05). Both of groups' HLRsress lower than HLRdeiay and this phenomenon significantly in CAD. (2) There were significant difference in Gl and G2 of HLRsress and HLRdeiay respectively (P<0.05,/><0.001). (D GlaHLRsress and G2aHLRsreSs had significance relations with the history of smoking respectively (PO.05,P<0.001). Not only GlaHLRSress but also G2aHLRsreSs had no difference with the total time (year) of smoking (P>0.05). We didn't come to the conclusion of the total quantity of smoking with HLR for the number of subjects limited. ? GlLVEFsress higher than G2' and close to the statistic difference (P=0.069). GlLVEFdeiay lighter higher than G2\ but no significant difference were found between them (P>0.05). Gl'ALVEF higher than G2' and there was significance difference (P<0.001).Conclusion: 1 nHLR of CAD decreased and the range of elevation less than normal groups' with the time prolong after injection. This indicated that CAD' pulmonary uptake NOET elevate and exclusion time prolong.2^ Although HLR of normal group and CAD were influenced by smoking history, the change of CAD was more evident. That is to say, everyone's pulmonary uptake NOET will elevate. Moreover, the patients with CAD uptaken NOET elevate especially.3^ ALVEF provided incremental information over LVEF about evaluation the cardiac function of CAD.
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