運動負荷 thallium-201 心筋シンチグラフィーによる陳旧性心筋梗塞症の病態評価における thallium 再分布 (redistribution) の臨床的意義について
スポンサーリンク
概要
- 論文の詳細を見る
The purpose of this study is to determine the clinical usefulness of thallium-201 stress myocardial scintigraphy (T1 SMS) in the evaluation of peri-infarct ischemia. T1 SMS and right heart sided hemodynaroic measurement during exercise (EX) were performed in 68 pts with old myocardial infarction. The myocardium was devided into 10 segments and regional T1 defect score was visual By determined as 0=normal to 3=background. Redistribution (Rd) was defined by a decrease in regional defect score>1 from immediately to 2.5 hours after EX. Of 68 pts. 66(97%) showed perfusion defect on images immediately after EX in the infact regions suspected from ECG. Rd in the infarct region occurred in 26(38%) of 68 pts with infarction, 18(44%) of 41 pts with anterior and 8 (30%) of 27 pts with inferior infarction. ST -depression in the lead without abnormal Q-wave was demonstrated in 22 (85%) of 26 pts with Rd, while in 21 (50%) of 42 pts without Rd (p>0.005). Chest pain on EX was noticed in 14 (54%) with Rd, but only in 6 (14%) without Rd (p>0.005). Mean pulmonary artery wedge pressure during EX was higher in pts with Rd than in pts without Rd(33.6±12.3 vs 22.4±12.2 mmHg, p<0.01). There was no relation between Rd and coronary stenosis perfusing infarct area, but pts with Rd were accompanied with jeopardized collateral vessels more frequently compared with pts without Rd (63 vs 28%, <0.05). In conclusion, T1 Rd in the infarct region may be a sign of peri-infarct ischemia and T1 SMS is a useful tool for evaluating the pathologic aspects of old myocardial infarction.
- 神戸大学の論文