fa بررسی تعداد ضربان قلب و جذب ریوی در اسکن پرفیوژن میوکارد با دی پیریدامول در بیماران مشکوک به بیماری کرونر قلب و ارتباط آن‌ها با عوامل خطر بالینی پزشکی هسته ای nuclear medicine پژوهشي Original <div style="text-align: justify;"><span style="font-size:12pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#1f4e79">زمینه:</span></span></span></span></b> <span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">یافته‌های غیرتصویربرداری در اسکن پرفیوژن میوکارد (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">MPI</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">) ممکن است در بیماران مشکوک به بیماری کرونر قلب (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">CAD</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">) کمک کننده باشند. هدف از این مطالعه بررسی تعداد ضربان قلب و جذب ریوی و ارتباط آن‌ها با عوامل خطر بالینی در این بیماران بود.</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#1f4e79">مواد و روش‌ها:</span></span></span></span></b><b> </b><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">354 بیمار (98 مرد و 256 زن) غیرسیگاری بدون سابقه بیماری ریوی و مشکوک به </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">CAD</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"> که برای انجام </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">MPI</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"> با دی پیریدامول در سال 1401 به پزشکی هسته‌ای کوثر سنندج مراجعه کرده بودند مورد بررسی قرار گرفتند. ضربان قلب استراحت (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">RHR</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">)، حداکثر ضربان قلب بعد از تزریق دی پیریدامول (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">PHR</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">) و نسبت جذب ریه به قلب (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">LHR</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">) در فاز استرس اندازه‌گیری شده و ارتباط آن‌ها با سن، جنس، شاخص توده بدن، دیابت، پرفشاری خون و چربی خون بالا در دو گروه با اسکن طبیعی و غیرطبیعی بررسی شدند.</span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#1f4e79">یافته‌ها:</span></span></span></span></b> <span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">در بیماران مبتلا به دیابت یا پرفشاری خون، </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">RHR</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"> بطور معنی‌داری بالاتر از بیماران غیردیابتی و غیر فشار خونی بود. ارتباط معنی‌دار </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">PHR</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"> تنها با سن و جنس مشاهده شد (0/0001</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">P<</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">). در آنالیز رگرسیون چند متغیری، همبستگی معنی‌دار بین </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">LHR</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"> با اسکن غیرطبیعی (0/03=</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">P</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">) و جنس مذکر (0/01=</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">P</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">) دیده شد.</span></span></span></span> &nbsp;<span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#1f4e79">نتیجه‌گیری:</span></span></span></span></b> <span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">گرچه دیابت و پرفشاری خون باعث افزایش </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">RHR</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"> می‌شدند ولی تنها عوامل مؤثر بر </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">PHR</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">، سن و جنس بودند به‌طوری که کمترین پاسخ ضربان قلب به دی پیریدامول در افراد مسن و مردان مشاهده شد. علاوه بر اسکن غیرطبیعی، جنسیت مذکر نیز احتمال </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d">LHR</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"> غیرطبیعی را افزایش می‌داد.</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#0d0d0d"></span></span></span></span></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:9.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#002060">Background:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#404040">Non-imaging findings in myocardial perfusion imaging (MPI) may be helpful in patients with suspected coronary artery disease (CAD). The aim of this study was to investigate heart rate and pulmonary uptake and their relationship with clinical risk factors in these patients.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:9.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#002060">Materials and Methods:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#404040">A total of 354 non-smokers (98 men and 256 women) with suspected CAD and no history of lung disease who were referred to Kowsar Nuclear Medicine Center in Sanandaj in 2022 for MPI with dipyridamole were examined. Resting heart rate (RHR), peak heart rate after dipyridamole injection (PHR) and lung-to-heart ratio (LHR) in the stress phase were measured and their relationship with age, gender, BMI, diabetes, hypertension and hyperlipidemia was evaluated in two groups &ndash;those with normal and those with abnormal scans.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:9.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#002060">Results:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#404040">Patients with diabetes or hypertension had a significantly higher RHR compared to the non-diabetes non-hypertension cases. PHR had a significant relationship only with age and gender (P<0.0001). In the multivariate regression analysis, a significant correlation was observed between LHR and abnormal scan (P=0.03) and male gender (P=0.01).</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:9.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#002060">Conclusion:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="line-height:115%"><span iransans="" style="font-family:"><span style="color:#404040">Although diabetes and hypertension increased RHR, the only factors affecting PHR were age and gender, so that the lowest heart rate response to dipyridamole was observed in older adults and men. In addition to an abnormal scan, male gender also increased the likelihood of an abnormal LHR.</span></span></span></span></span></span></span></div> ضربان قلب, نسبت ریه به قلب, اسکن پرفیوژن میوکارد, دی پیریدامول Heart rate, lung-to-heart ratio, myocardial perfusion imaging, dipyridamole 205 214 http://ismj.bpums.ac.ir/browse.php?a_code=A-10-1115-26&slc_lang=fa&sid=1 Siamak Derakhshan سیامک درخشان siamakderakhshan@yahoo.com 5700319475328460018680 5700319475328460018680 Yes Department of Radiotherapy, School of Paramedical Medicine, Kurdistan University of Medical Scienc-es, Sanandaj, Iran گروه رادیوتراپی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران Bahar Moassesghafari بهار مؤسس‌غفاری 5700319475328460018681 5700319475328460018681 No Department of Radiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran گروه رادیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران Khaled Rhmani خالد رحمانی 5700319475328460018682 5700319475328460018682 No Department of community medicine, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj گروه پزشکی اجتماعی و خانواده، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران