Myocardial Blood Flow and Metabolism in Patients With Hypertrophic Cardiomyopathy : A Study With Carbon-11 Acetate and Positron Emission Tomography

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概要

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• The underlying pathophysiology of hypertrophic cardiomyopathy (HCM) is still unclear. Positron emission tomography is a suitable and promising technique for the detection of possible metabolic consequences of the disease. To assess regional myocardial blood flow and metabolism, 19 asymptomatic or only mildly symptomatic patients with HCM and 10 normal control subjects were studied using carbon-11 acetate and fluorine-18-1abelled deoxyglucose (FDG) as tracers of myocardial blood flow (Ao), oxygen consumption (k), and exogenous glucose utilization. In the patients, regional Ao in the hypertrophied septum and apex (H) was similar to that in the nonhypertrophied free Wall (N) (91.3±3.9% vs 92.9±3.1%; p=NS). However, the k values were significantly lower in H than in N (0.044±0.012 vs 0.060±0.016/min, p<0.0001). The k value in N and normal control subjects (0.062±0.013) was similar. Postprandial FDG uptake was lower in H than in N (70±16 vs 91±7%; p<0.0001) in 16 patients and slightly higher in 3 patients. Fasting FDG study showed increased FDG uptake in H in 3 out of 13 patients, suggesting a disorder of the myocardial microvascular circulation. A relative decrease in hypertrophied septal and apical oxidative metabolism and glucose utilization without any corresponding perfusion defect could reflect abnormal regional aerobic metabolism in the disproportionately thickened myocardium in patients with HCM. This suggests that a primary myocardial metabolic defect might be present in patients with HCM.

• 社団法人日本循環器学会の論文
• 1997-02-20

著者

• SENDA Michio

  Positron Medical Center, Tokyo Metropolitan Institute of Gerontology

• TOYAMA Hinako

  Positron Medical Center, Tokyo Metropolitan Institute of Gerontology

• Nishiyama Shinichiro

  Division Of Cardiology Saitama Medical University International Medical Center

• Nishiyama Shinichiro

  Cardiovascular Center Toranomon Hospital

• Seki Akira

  Department Of Cardiovascular Medicine Toranomon Hospital

• Nishimura Shigeyuki

  Department Of Cardiology Saitatama International Medical Center Saitama Medical Univeristy

• Nishimura Shigeyuki

  Yokohama Rosai Hospital

• Ishiwata Sugao

  Division of Cardiology Cardiovascular Center Toranomon Hospital

• Seki Akira

  Division of Cardiology, Cardiovascular Center, Toranomon Hospital

• Senda Michio

  Positron Medical Center Tokyo Metropolitan Institute Of Gerontology

• Maruno Hirotaka

  Division of Nuclear Medicine, Toranomon Hospital

• Nishiyama Shinichiro

  Division Of Cardiology And Interned Medicine Toranomon Hospital Tokyo

• Maruno Hirotaka

  Division Of Nuclear Medicine

• Maruno Hirotaka

  Division Of Nuclear Medicine Toranomon Hospital

• Seki Akira

  Division Of Cardiology Toranomon Hospital

• Seki Akira

  Division Of Cardiology Cardiovascular Center Department Of Internal Medicine Toranomon Hospital

• Ishiwata Sugao

  Department Of Cardiovascular Center Medicine Toranomon Hospital

• Nishiyama Shiniciro

  Saitama International Medical Center

• Nishiyama Shinichiro

  Division Of Cardiology Cardiovascular Center Toranomon Hospital

• Toyama Hinako

  Positron Medical Center Tokyo Metropolitan Institute Of Gerontology

• Nishimura Shigeyuki

  Department Of 2^<nd> Internal Medicine Saitama Medical School

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