陳旧性心筋梗塞症における残余心筋機能評価に対するニトログリセリン負荷左室造影の臨床的有用性
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概要
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The present study was undertaken to elucidate the clinical usefulness of contrast left ventriculography after sublingual administration of nitroglycerin (NTG) in old myocardial infarction (OMI). in this study. the findings of left ventriculography was compared with those of Tl-201 stress myocardial scintigraphy for assessing the residual left ventricular function in parallel with the local myocardial blood flow. Subjects in this study were 21 patients with OMI, who underwent left ventriculography, coronary angiography and Tl-201 stree myocardial scintigraphy. Results were as follows : (1) Left ventricular end-diastolic volume (EDV) and end-systolic volume (ESV) in patients with NTG-induced normalization of left ventricular ejection fraction (EF) was smaller th!ln that in patients without the normalization of EF, respectively. (2) Either percent-decrease of ESV (△ESV) or EDV (△EDV) in patients with single-vessel disease was significantly greater than that in patients with multi-vessel disease, respectively. (3) △ESV in the group with NTG-induced improvement of EF was higher than that in the group without the improvement of EF, but the difference of EDV in both groups was non-significant. (4) Anterior wall infarction group with the NTG-induced improvement of left ventricular wall motion (LVWM) revealed normal response on the corresponding myocardial segment in Tl-201 stress myocardial scintigraphy (SMS), while that without the improvement of LVWM revealed abnormal response in SMS. (5) Non-infarcted myocardial segments with normal response in SMS showed significant increase in percent shortening of left venticular axis after NTG administration. (6) A close correlation was demonstrated between percent shortening of left ventricular axis and the responsiveness of SMS on the corresponding myocardial segment. From these results, it was concluded that the contrast left ventriculography after the administration of NTG was of great use for assessing the residual left ventricular function in patients with old myocardial infarction.
- 神戸大学の論文