Impaired Exercise-Related Myocardial Uptake of Technetium-99m-Tetrofosmin in Relation to Coronary Narrowing and Diabetic State : Assessment with Quantitative Single Photon Emission Computed Tomography

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概要

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• Despite the diagnostic efficacy of stress myocardial perfusion imaging, the correlation between the actual perfusion tracer activity and diseased state of a coronary artery has not been studied in detail. We estimated exercise-related perfusion augmentation in relation to disease states of a coronary artery in diabetic and non-diabetic patients by a newly developed quantitative technetium (Tc)-99m-tetrofosmin myocardial imaging technique. Tc-99m-tetrofosmin tomographic imaging with an exercise-rest protocol was performed in 26 stable coronary patients and in 8 age-matched controls. Percent increase (%IR) in myocardial count during symptom-limited submaximal exercise-stress was calculated in 16 non-infarcted polar map segments and in each coronary territory by a subtraction technique with corrections for physical decay and injected tracer doses, and the results were compared with those of angiographically quantified coronary diameter stenosis (%DS). Percent IR and peak heart rate during exercise showed a positive linear correlation both in coronary territories with significant stenosis (%DS ≥ 75%) and in control or non-stenotic (%DS < 75%) territories. The regression line in stenotic regions was, however, significantly (p < 0.01) shifted downward compared to that in non-stenotic regions. Percent IR in stenotic regions showed a significant inverse correlation with %DS. Coronary stenosis of 75% or more was identified by a %IR cutoff value of 40% with 77% sensitivity, 70% specificity, and an accuracy of 72%. In coronary territories with a %DS of less than 75%, %IR in diabetic patients was significantly lower (46 ± 15%) than that in non-diabetic patients (61 ± 25%). Thus, blunted exercise-related augmentation of myocardial uptake of Tc-99m-tetrofosmin correlates with the severity of coronary narrowing and diabetic state.

• Japanese Heart Journal Associationの論文

著者

• Tsuchihashi Kazufumi

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Shimamoto Kazuaki

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Shimamoto Kazuaki

  札幌医科大学 医学部内科学第二

• NAKATA Tomoaki

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• HASHIMOTO Akiyoshi

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Wakabayashi Takeru

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Nakata Tomoaki

  Second Department Of Internal Medicine (cardiology) Sapporo Medical University School Of Medicine

• Tsuchihashi Kazufumi

  Second Department Of Internal Medicine Sapporo Medical University School Of Medicine

• Sasao Hisataka

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Nakahara Norifumi

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Doi Atsushi

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Kobayashi Hiroshi

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Nakahara Norifumi

  Second Department Of Internal Medicine (cardiovascular Medicine) Sapporo Medical University School O

• Hashimoto Akiyoshi

  Second Department Of Internal Medicine (cardiology) Sapporo Medical University School Of Medicine

• Shimamoto Kazuaki

  Second Department Of Internal Medicine (cardiovascular Medicine) Sapporo Medical University School O

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