Reverse Redistribution Phenomenon on Rest ^<99m>Tc-Tetrofosmin Myocardial Single Photon Emission Computed Tomography Involves Impaired Left Ventricular Contraction in Patients With Acute Myocardial Infarction
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概要
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The purpose of this study was to investigate the clinical significance of the reverse redistribution (RR) phenomenon on technetium-99m (^<99m>Tc)-tetrofosmin myocardial single photon emission computed tomography (SPECT) performed at rest. Twenty-five patients underwent myocardial SPECT 3 weeks after the onset of acute myocardial infarction. Myocardial images were acquired at 40min (early) and 4h (delayed) after the injection of 740MBq of ^<99m>Tc-tetrofosmin. The regional myocardial uptake of the tracer in 26 segments of the left ventricular (LV) wall was visually scored from 0 (no activity) to 3 (normal activity), and then the RR was defined as a decrease of more than 1 point in the activity score on the delayed image compared with that on the early image. Regions with an activity score of 3 on both the early and delayed images were defined as normal, and those with a score of 0 or 1 on the early image were considered to have a fixed defect. The regional myocardial ^<99m>Tc-tetrofosmin uptake and washout rate were also quantitatively assessed in each region. In addition, exercise stress electrocardiograph-gated SPECT with ^<99m>Tc-tetrofosmin was performed within 1 week of the rest study, and the percent count increase (%CI) during myocardial contraction in each corresponding region was studied. RR was observed in 18 of the 25 patients. The regional washout rate of ^<99m>Tc-tetrofosmin was significantly higher in the RR regions (45.0±3.8%) than in either the normal regions (36.4±4.1%, p<0.001) or in those with a fixed defect (39.7±3.9%, p<0.001). The %CI in the RR regions (10.4±10.4%) was significantly less than that in the normal regions (23.5±10.1%, p<0.001) ; however, no significant difference was found between the RR regions and those with a fixed defect (8.0±7.2%). In patients with acute myocardial infarction, the regions showing the RR phenomenon on ^<99m>Tc-tetrofosmin SPECT have severely impaired LV wall contraction after exercise.
- 社団法人日本循環器学会の論文
- 2003-09-20
著者
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Kimura Genjiro
名古屋市立大学 医学研究科心臓･腎高血圧内科学
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Kimura Genjiro
Department Of Cardio-renal Medicine And Hypertension Nagoya City University Graduate School Of Medic
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Ohte Nobuyuki
Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medi
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Ohte Nobuyuki
Department Of Cardio-renal Medicine And Hypertension Nagoya City University Graduate School Of Medic
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Yajima Kazuhiro
Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital
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Miyabe Hiromichi
Department of Internal Medicine and Pathophysiology, Nagoya City University Graduate School of Medic
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Akita Sachie
Department of Internal Medicine and Pathophysiology, Nagoya City University Graduate School of Medic
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Kurokawa Kazuyuki
Department of Internal Medicine and Pathophysiology, Nagoya City University Graduate School of Medic
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Matsuo Hitoshi
The Department Of Cardiology Gifu Prefectural Hospital
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Hayano Junichiro
Department Of Internal Medicine And Pathophysiology Nagoya City University Graduate School Of Medica
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Kurokawa Kazuyuki
Department Of Internal Medicine And Pathophysiology Nagoya City University Graduate School Of Medica
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Akita Sachie
Department Of Internal Medicine And Pathophysiology Nagoya City University Graduate School Of Medica
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Yajima Kazuhiro
Department Of Cardiovascular Medicine Gifu Prefectural Tajimi Hospital
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Ohte Nobuyuki
The Third Department Of Internal Medicine Nagoya City University
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Miyabe Hiromichi
National Center For Geriatrics And Gerontology
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Yajima Kazuhiro
Department Of Cardiology Gifu Prefectural Tajimi Hospital
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Ohte Nobuyuki
Department Of Internal Medicine And Pathophysiology Nagoya City University Graduate School Of Medica
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Yajima Kazuhiro
Department Of Internal Medicine And Pathophysiology Nagoya City University Graduate School Of Medica
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Miyabe Hiromichi
Department Of Cardiology Japanese Red Cross Nagoya First Hospital
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Akita Sachie
Department Of Internal Medicine And Pathophysiology Nagoya City University Graduate School Of Medical Sciences
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