DOI QR코드

DOI QR Code

64 절편 MDCT를 이용한 심장CT에서 측정된 좌심실 구혈률에 영향을 미치는 요인

Affecting Factors on Left Ventricle Ejection Fraction Measured using 64-slice MDCT

  • 강영한 (대구가톨릭대학교병원 영상의학과) ;
  • 김경욱 (대구가톨릭대학교병원 영상의학과) ;
  • 조광호 (대구가톨릭대학교 방사선학과)
  • 발행 : 2010.02.28

초록

64 절편 MDCT를 이용하여 측정된 좌심실 구혈률에 성별과 연령, 체질량지수, 혈압, 심박동수 등의 요인이 영향을 미치는지 비교 분석하였다. 164명(남자 84명, 여자 80명)을 대상으로 혈압, 체질량지수, 심박동수를 측정하였고, 심장 CT 검사를 실시하여 좌심실 구혈률을 구하였다. 체질량지수 25kg/$m^2$ 미만 군에서 좌심실 구혈률은 52.00${\pm}$118.95%, 25 kg/$m^2$이상 군에서 59.50${\pm}$16.05%였다(p<0.05). 정상 혈압군에서 좌심실 구혈률이 57.26${\pm}$17.84%, 고혈압군에서는 49.95${\pm}$17.63%로 고혈압군에서 유의하게 낮았다(p<0.05). 분당 심박동수 60회 미만 군에서는 60.76${\pm}$17.26%, 60-70회군에서 54.14${\pm}$16.56%, 70회 이상 군에서 50.83${\pm}$20.56%였다(p<0.05). 좌심실 구혈률과 연령(r=-0.283), 심박동수(r=-0.231)는 각각 음의 상관관계가 있었고, 체질량지수(r=0.228)와는 양의 상관관계가 있었다. 좌심실 구혈률에 영향을 미치는 요인으로는 연령, 체질량지수, 수축기혈압, 심박동수 등이었다. 결론적으로 연령, 체질량지수와 혈압, 심박동수에 따라서 구혈률이 차이가 나므로 이를 확인하여 평가하여야 한다.

This study was to analysis what factors could affect left ventricle ejection fraction(LVEF) using 64-slice multidetector CT. 164 patients(84 men, 80 women) had a cardiac CT in this study, and their blood pressure, body mass index(BMI), heart rate(HR) measured. LVEF was 52.00${\pm}$18.95% in below 25kg/$m^2$, 59.50${\pm}$16.05% in above 25kg/$m^2$ of BMI. LVEF was 57.26${\pm}$17.84% in normal blood pressure group(NBPG), 49.95${\pm}$17.63 in hypertension group(HG). LVEF was 60.76${\pm}$17.26 in below 60 beats/min, 54.14${\pm}$16.56 in 60-70 beats/min, 50.83${\pm}$20.56 in above 70 beats/min of HR. LVEF was negatively correlated with age, HR(r=-0.283 p<0.05, r=-0.231 p<0.05. respectively). And LVEF was positively correlated with BMI(r=0.228 p<0.05). A measurement of LVEF at cardiac CT by using MDCT may be considered to age, blood pressure, heart rate and BMI.

키워드

참고문헌

  1. L. Pilote, J. Silberberg, R. Lisbona, and A. Sniderman, "Prognosis in patients with low left ventricular ejection fraction after myocardial infarction. Importance of exercise capacity," Circulation, Vol.80, No.6, pp.1636-1641, 1989. https://doi.org/10.1161/01.CIR.80.6.1636
  2. K. Hina, S. Kusachi, and K. Iwasaki, "Progression of left ventricular enlargement in patients with hypertrophic cardiomyopathy: incidence and prognostic value," Clin Cardiol, Vol.16, No.5, pp.403-407, 1993. https://doi.org/10.1002/clc.4960160507
  3. P. Garot, O. Pascal, and M. Simon, "Impact of microvascular integrity and local viability on left ventricular remodelling after reperfused acute myocardial infarction," Heart, Vol.89, No.4, pp.393-397, 2003. https://doi.org/10.1136/heart.89.4.393
  4. T. Sharir, G. Germano, and P. B. Kavanagh, "Incremental prognostic value of post-stress left ventricular ejection fraction and volume by gated myocardial perfusion single photon emission computed tomography," Circulation, Vol.100, No.10, pp.1035-1042, 1999. https://doi.org/10.1161/01.CIR.100.10.1035
  5. Y. W. Wu, M. Tadamuro, and M. Yamamuro, "Estimation of global and regional cardiac function using 64-slice computed tomography: a comparison study with echocardiography, gated- SPECT and cardiovascular magnetic resonance," Int J Cardiol, Vol.128, No.1, pp.69-76, 2008. https://doi.org/10.1016/j.ijcard.2007.06.017
  6. A. K. Chung, S. R. Das, and D. Leonard, "Women have higher left ventricular ejection fractions than men independent of differences in left ventricular volume: the Dallas Heart Study," Circulation, Vol.113, No.12, pp.1597-1604, 2006. https://doi.org/10.1161/CIRCULATIONAHA.105.574400
  7. A. T. Yamada, Campos Neto Gde C., and Soares J. Jr, "Gender difference in ventricular volumes and left ventricle ejection fraction estimated by myocardial perfusion imaging: comparison of Quantitative Gated SPECT(QGS) and Segami software programs," Arg Bras Cardiol, Vol.88, No.3, pp.285-290, 2007. https://doi.org/10.1590/S0066-782X2007000300006
  8. S. Dobala, S. Crugnale, D. Yang, and M. F. Di Cali, "Effect of body mass index on left ventricular cavity size and ejection fraction," Am J Cardiol. Vol.97, No.5, pp.725-729, 2006. https://doi.org/10.1016/j.amjcard.2005.09.122
  9. B. D. Powell, M. M. Redfield, K. A. Bvbee, W. K. Freeman, and C. S. Rihal, "Association of obesity with left ventricular remodelling and diastolic dysfunction in patients without coronary artery disease," Am J Cardiol, Vol.98, No.1, pp.116-120, 2006. https://doi.org/10.1016/j.amjcard.2006.01.063
  10. World Health Organization western pacific region, "The asia-pacific perspectives; redefining obesity and its treatment," 2000.
  11. D. Mele, M. Campana, and M. Sclavo, "Impact of tissue harmonic imaging in patients with distorted left ventricles: improvement in accuracy and reproducibility of visual, manual and automated echocardiographic assessment of left ventricular ejection fraction," Eur J Echocardiogr, Vol.4, No.1, pp.59-67, 2003. https://doi.org/10.1053/euje.2002.0619
  12. 강재황, 박은숙, 강병선, 임현옥, 최동주, 이근우 등, “정상 한국인에서 게이트혈액풀스캔을 이용한 좌심실 심기능지표들의 분석”, 대한핵의학회지, 제28권, 제1호, pp.52-61, 1994.
  13. B. Berkalp, V. Cesur, D. Corapcioglu, C. Erol, and N. Baskal, "Obesity and left ventricular diastolic dysfunction," Int J Cardiol, Vol.52, No.1, pp.23-26, 1995. https://doi.org/10.1016/0167-5273(95)02431-U
  14. F. H. Messerli, K. Sundugaard-Riise, E. Reisiu, G. Dreslinski, F. G. Dunn, and E. Frohlich, "Disparate cardiovascular effects of obesity and arterial hypertension," Am J Med, Vol.74, No.5, pp.808-812, 1983. https://doi.org/10.1016/0002-9343(83)91071-9
  15. J. P. Coffev and J. C. Hill, "Gated single photon emission tomography MIBI stress perfusion imaging for assessing cardiac output and index in obese and non-obese patients," Ir J Med Sci, Vol.176, No.4, pp.297-303, 2007. https://doi.org/10.1007/s11845-007-0100-4
  16. 강덕희, "고혈압환자에서 도플러 심초음파를 이용한 좌우심실 이완기능에 관한 연구", 이화여자대학교 대학원 석사학위논문, 1991.
  17. R. O. Bonow, E. Lakatos, B. J. Maron, and S. E. Epstein, "Serial long-term assessment of the natural history of asymptomatic patients with chronic aortic regurgitation and normal left ventricular systolic function," Circulation, Vol.84, No.4, pp.1625-1635, 1991. https://doi.org/10.1161/01.CIR.84.4.1625
  18. R. J. Rodeheffer, G. Gerstenblith, L. C. Becker, J. L. Fleg, M. L. Weisfeldt, and E. G. Lakatta, "Exercise cardiac output is maintained with advancing age in healthy human subjects: Cardiac dilatation and increased stroke volume compensate for a diminished heart rate," Circulation, Vol.69, No.2, pp.203-213, 1984. https://doi.org/10.1161/01.CIR.69.2.203
  19. T. Mochizuki, K. Murase, and H. Higashino, "Two-and three dimensional CT ventriculography: a new application of helical CT", AJR, Vol.174, No.1, pp.203-208, 2000. https://doi.org/10.2214/ajr.174.1.1740203
  20. M. L. Weisfieldt, "Left ventricular function, The aging heart," New York Raven Press, pp.297-316, 1980.