Reverse Redistribution of Thallium-201 Myocardial Single Photon Emission Tomography and Contractile Reserve

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概要

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• The present study investigated the contractile reserve of myocardium exhibiting reverse redistribution (RRD) of thallium-201 (^<201>Tl) after acute myocardial infarction. Forty patients experiencing their first acute myocardial infarction underwent resting ^<201>Tl single-photon emission conputed tomography (SPECT) and low-dose (5-10μg・kg^<-1>・min^<-1>) dobutamine stress echocardiography (DSE) within 4 weeks after the onset of infarction. The left ventricle was divided into 13 segments for analysis. The severity of defects in ^<201>Tl SPECT and the extent of wall motion abnormality in DSE were visually assessed and scored. The sum of each defect score and wall motion score of infarct-related segments were defined as total defect score (TDS) and total wall motion score (TWM), respectively. Quantitative analysis of ^<201>Tl uptake was also performed. Resting ^<201>Tl SPECT revealed RRD in 16 patients (group RRD), fixed defect (FIX) in 23 patients (group FIX), and redistribution in one. There was a significant difference in improvement of TWM between rest and stress in TWM in both the RRD and FIX groups (p<0.0001, each case). The improvement of TWM with dobutamine was significantly greater in RRD than in FIX (1.6±1.0 vs 0.6±0.7, p=0.001). There was a positive correlation between the magnitude of RRD and improvement of TWM with dobutamine (r=0.48, p=0.002). Myocardium exhibiting RRD on ^<201>Tl SPECT in patients with acute myocardial infarction has greater contractile reserve than that exhibiting a fixed defect.

• 社団法人日本循環器学会の論文
• 2000-04-20

著者

• Yamaguchi Junichi

  Division Of Cardiology Saitama Prefecture Cardiovascular And Respiratory Center

• Sakanoue Yuji

  Department Of Cardiology Osaka City General Hospital

• Hirata Kumiko

  Department Of Cardiology Osaka City General Hospital

• Yamagishi Hiroyuki

  First Department of Internal Medicine Osaka City University Medical School

• Akioka Kaname

  First Department of Internal Medicine Osaka City University Medical School

• Hirata Kumiko

  First Department of Internal Medicine Osaka City University Medical School

• Sakanoue Yuji

  First Department of Internal Medicine Osaka City University Medical School

• Takeuchi Kazuhide

  First Department of Internal Medicine Osaka City University Medical School

• Yoshikawa Junichi

  First Department of Internal Medicine Osaka City University Medical School

• Ochi Hironobu

  Division of Nuclear Medicine, Osaka City University Medical School

• Takeuchi Kazuhide

  大阪市立大学 医学研究科循環器病態内科学

• Takeuchi Kazuhide

  The First Department Of Internal Medicine Osaka City University Medical School

• Tani Tomoko

  First Department of Internal Medicine, Osaka City University Medical School

• Ochi Hironobu

  Radiology Osaka City University Medical School

• Ochi Hironobu

  Division Of Nuclear Medicine Osaka City University Medical School

• Yamashita Hajime

  Department Of Internal Medicine And Cardiology Osaka City University Graduate School Of Medicine

• Hirata Kumiko

  Higashisumiyoshimorimoto Hospital

• Ochi Hironobu

  Dept. Of Radiology Osaka City Univ. Med. School

• Tani Tomoko

  First Department Of Internal Medicine Osaka City University Medical School

• Hirota Kazuyoshi

  1st Department Of Internal Medicine Osaka City University Medical School

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