THE SIGNIFICANCE OF RESTING THALLIUM-201 DELAYED SPECT FOR ASSESSING VIABILITY OF INFARCTED REGIONS : Comparison with Exercise Thallium-201 SPECT

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概要

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• To clarify the clinical significance of resting thallium-201 (Tl) delayed SPECT for assessing the viability of infarcted regions, we studied resting Tl initial and delayed Tl SPECT one week after exercise (Ex) Tl SPECT in 38 patients (40 regions) with old myocardial infarction (OMI) and 35 patients (37 regions) with effort angina pectoris (EAP). Analysis of resting Tl and Ex Tl SPECT divided the patients with OMI into 3 groups. Twenty-three patients whose perfusion defect (PD) on resting delayed image was same as that of Ex delayed image were divided into 12 patients with Ex Tl redistribution (RD) (G1) and 11 patients without Ex Tl RD (G3). Fifteen patients showed a decrease of PD on resting delayed image compared with Ex delayed image (G2):, Thirty-five patients with EAP were divided into 18 patients who had no PD oh Ex delayed image (G1) and 17 patients whose PD did not disappear on Ex delayed image but disappeared on resting delayed image (G2). The increase of pulmonary artery wedge pressure on Ex was higher in G2 than in G1 of both OMI and EAP (OMI; G1 15±16mmHg vs G2 27±7mmHg; p<0.01, EAP; G1 12±7 mmHg vs G2 22±6 mmHg; p<0.05). The percent Tl uptake of the PD on Ex Tl initial images was lower in G2 than in G1 of both OMI and EAP (OMI: G1 63±7% vs G2 55±9%; p<0.05, EAP: G1 72±7% vs G2 65±9%; p<0.05). That of the PD on resting Tl delayed images was higher in G1, and G2 than in G3 of OMI (G1 78±7%. G2 74±8%. G3 41±10%; G1 vs G3, G2 vs G3 p<0.001). The prevalence of akinetic or dyskinetic wall motion on left ventriculography was higher in G2 than G1, and in :G3 than G2 (G1 ,24.3%. G2 52.2%. G3 85.7%; p<0.001). Thus, in patients with OMI the decrease of Tl PD on resting Tl delayed images compared with Ex delayed images may indicate severe ischemia induced by stress as well as in patients with EAP, and furthermore the presence of viable muscle. On the other hand, the infarcted region without decrease of Tl PD on resting delayed images may lack viable muscle.

• 社団法人日本循環器学会の論文
• 1991-02-20

著者

• Fukuzaki H

  Miki City Hospital Department Of Cardiology

• Mori Takao

  Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University

• Yamabe Hiroshi

  First Department of Internal medicine, Kobe University School of Medicine

• Mori T

  Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University

• Mori Takao

  Miki City Hospital Department Of Cardiology

• Yamabe Hiroshi

  First Department Of Internal Medicine Kobe University School Of Medicine

• Fukuzaki Hisashi

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Yamabe Hiroshi

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Maeda Kazumi

  The First Department of Internal Medicine, Kobe University

• Miki Takashi

  The Department Of Cardiology Himeji Cardiovascular Center

• Yamabe H

  Kobe Univ. School Of Medicine

• Maeda Kazumi

  School Of Allied Medical Sciences Kobe University

• Maeda Kazumi

  Faculty Of Health Science Kobe University School Of Medicine

• FUKUZAKI Hisashi

  三木市民院循環器内科

• MORI TAKAO

  The First Department of Internal Medicine, Kobe University School of Medicine

• YOSHIDA HIROYUKI

  The First Department of Internal Medicine, Kobe University School of Medicine

• Fukuzaki Hisashi

  Department Of Thoracie Srugery Osaka Medical College

• Fukuzaki Hisashi

  Dept Of Intern Med. Div. I Kobe Univ. School Of Med.

• Maeda Kazumi

  The First Department Of Internal Medicine Kobe University

• Fukuzaki Hisasi

  Dept. of Intern. Med. Kobe Univ. school of Med.

• Fukuzaki Hisashi

  The First Department Of Internal Medicine Kobe University

• Yamamoto Hiroshi

  First Depatment Of Internal Medicine Kobe University School Of Medicine

• Fukuzaki Hisashi

  Dept. Of Int. Med. Div1 Kobe Univ.

• Yoshida Hiroaki

  Department Of Cardiology Himeji Cardiovascular Center

• Fukuzakl Hisashi

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Fukuzaki Hisashi

  1st Dep. Of Internal Med. Kobe Univ.

• Fukuzaki Hisashi

  Department Of Thoracic Surgery Osaka Medical College

• Fukuzaki Hisashi

  Internal Medicine Division I Kobe University

• Fukuzaki Hisashi

  The 1st.dept.of Inter. Med Kobe Univ. School Of Med.

• Yoshida Hiroyuki

  The First Department Of Internal Medicine Okayama University Medical School

• Mori Takao

  Cardiology Division Miki City Hospital

• Yoshida Hiroaki

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Mori Takao

  The 1st Department Of Internal Medicine Kobe University School Of Medicine

• Fukumoto Hitoshi

  Department Of Thoracie Srugery Osaka Medical College

• Yamamoto Hiroshi

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Mori Takao

  神戸大学 第1内科

• Yoshida Hiroyuki

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Fukuzaki Hisashi

  First Department Of Internal Medicine. Kobe University School Of Medicine

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