Objective To evaluate the predictive value of stress+rest gated myocardial perfusion imaging(G-MPI)in assessing all-cause mortality risk in patients with familial hypercholesterolemia(FH).Methods From June 2010 to March 2022,72 patients(39 males,33 females;age(21.1±12.3)years)who diagnosed with FH clinically and genetically and underwent stress+rest G-MPI in Beijing Anzhen Hospi-tal,Capital Medical University were retrospectively followed up.Image analysis was performed using the 17-segment 5-point method to obtain left ventricular myocardial perfusion and functional parameters.Patients were followed for all-cause mortality events,and predictors associated with the risk of all-cause mortality were analyzed using Cox regression.The efficiencies of predictors were evaluated by ROC curve analysis,and the Kaplan-Meier method and log-rank test were used to compare the differences in the incidence of all-cause mortality in different groups of patients with FH.Independent-sample t test or Mann-Whitney U test was used to analyze the data.Results The follow-up time of 72 patients was 7(4,10)years,and all-cause death occurred in 16(22.2％)patients during the follow-up period.There were statistically significant differ-ences in total cholesterol(TC),low density lipoprotein cholesterol(LDLC),summed stress score(SSS),summed rest score(SRS),summed difference score(SDS),stress end-systolic volume(SESV),stress ejection fraction(SEF),rest end-diastolic volume(REDV),rest end-systolic volume(RESV)and rest ejection fraction(REF)between the death group and the survival group(t values:from-2.65 to 4.47,z values:from-3.43 to-1.98,all P＜0.05).Cox regression analysis showed that SDS(hazard ratio(HR)=1.337,95％CI:1.114-1.604,P=0.002),SESV(HR=1.019,95％CI:1.008-1.030,P＜0.001)and LDLC(HR=1.355,95％CI:1.049-1.749,P=0.020)were independent predictors associated with the risk of all-cause mortality in patients with FH.The optimal cut-off value of SESV for predicting mortality in patients with FH determined by ROC curve analysis was 35.5 ml,with the AUC of 0.701(95％CI:0.517-0.885).The inci-dence of all-cause mortality in the group with SESV ≥35.5 ml was significantly higher than that in the group with SESV＜35.5 ml(28.6％vs 6.9％;x2=5.15,P=0.023).Conclusion Stress+rest G-MPI is an impor-tant imaging method for all-cause mortality risk assessment in patients with FH,and SDS,SESV and LDLC are important factors in predicting mortality in patients with FH.
Hyperlipoproteinemia type ⅡMyocardial perfusion imagingTomography,emission-computed,single-photonTomography,X-ray computedTechnetium Tc 99m sestamibiForecasting
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