CLINICAL SIGNIFICANCE OF THE RIGHT VENTRICULAR FREE WALL APPEARANCE ON STRESS Tl-201 MYOCARDIAL IMAGES IN ISCHEMIC HEART DESEASE
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概要
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In order to evaluate the clinical significance of thallium (Tl)-201 myocardial imaging for diagnosing the right ventricular (RV) ischemia, we studied the relationship of right ventricular free wall (RVFW) appearance on myocardial images to coronary arteriographic findings. Patients were divided into 3 groups as follows : 1) normal control (NC) group (19 cases) without angiographically documented coronary artery disease ; 2) non-RCA group (18 cases) with significant coronary artery lesion restricted to the left coronary artery (LCA) ; and 3) RCA group (36 cases) with significant right coronary artery (RCA) stenosis regardless of underlying LCA disease. After the patients had exercised up to 80 - 85 % of the predicted maximal heart rate, immediate and 2-4 hour delayed myocardial images were obtained. As for presence of absence of the RV ischemia on images, the RVFW appearance in 30°and 60° left anterior oblique (LAO) views were assessed carefully. On the immediate images, all patients except one in the NC group an all except 3 in the non-RCA group demonstrated 'continuous visualization' of the RVFW in both views. In the RCA group, 6 showed 'non-visualization' and 11 'defective visualization' of the RVFW in 30° LAO view. In 60° LAO view, 6 presented ' non-visualization' and other 6 'defective visualization' of the RVFW. On the delayed images, although none of the patients in the groups NC and non-RCA demonstrated redistribution phenomenone of the RVFW, 4 patients in the RCA group showed redistribution of Tl-201 into the RVFW. Non-and defective visualization of the RVFW on the immediate images were related to the proximally located RCA lesion, previous history of inferior myocardial infarction and high grade RCA stenosis. Collateral vessels seemed to protect the RVFW against the development of exercise induced ischemia and affect the occurrence of redistribution of Tl-201 into the RVFW. In conclusion, stress Tl-201 myocardial imaging enables us to estimate the myocardial blood flow of the RV and is a useful non-invasive method in the evaluation of RV ischemia.
- 社団法人日本循環器学会の論文
- 1983-12-20
著者
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Hashimoto Shuji
The 2nd Dep. Of Intern. Med. Kagoshima Univ.
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Nakamura Kazuhiko
Second Department Of Cardiology Kagoshima Medical Center National Hospital Organization
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Takaoka Shigeru
The Second Department of Internal Medicine, Kagoshima University
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Nakamura Kazuhiko
The Second Department of Internal Medicine, Kagoshima University
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Hashimoto Shuji
The Second Department of Internal Medicine, Kagoshima University
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Kataoka Hajime
The 2nd Dept. of Int. Med. Kagoshima University School of Medicine
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KATAOKA HAJIME
The Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University
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OHKUBO TOSHITAKA
The Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University
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OHSHIGE TAMAO
The Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University
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Nakamura Kazuhiko
The 2nd Dep. Of Intern. Med. Kagoshima Univ.
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Nakamura Kazuhiko
The Second Department Of Cardiology Kyushu Cardiovascular Center
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Ohshige Tamao
The Second Department Of Internal Medicine Faculty Of Medicine Kagoshima University
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Hashimoto Shuji
The 2nd Dept.of Intern.ned. Kagoshima Univ.school Of Med
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Takaoka Shigeru
The Second Department Of Internal Medicine Kagoshima University
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Kataoka Hajime
Div. Of Cardiology And Dept. Of Nuclear Med. Tokyo Metropolitan Geriatric Hospital
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Ohkubo Toshitaka
The Second Department Of Internal Medicine Kagoshima University
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Hashimoto Shuji
The Second Department Of Internal Medicine Faculty Of Medicine Kagoshima University
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Nakamura Kazuhiko
The Second Cardiovascular Division The National Southern Kyu-syu Central Hospital
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Nakamura Kazuhiko
2nd Division Of Cardiovascular Medicine National Hospital Organization Kagoshima Medical Center
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Nakamura Kazuhiko
Division Of 2nd Cardiology National Hospital Organization Kagoshima Medical Center
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Takaoka Shigeru
Div. Of Cardiology And Dept. Of Nuclear Med. Tokyo Metropolitan Geriatric Hospital
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Hashimoto Shuji
The Second Dep. of Intern. Med., Faculty of Med., Kagoshima Univ.
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