Japanese
Title虚血性心疾患における拡張早期左室壁運動の検討 - 99mTc心プールイメージングによる検討 -
Subtitle原著
Authors成田充啓*, 栗原正*, 村野謙一*, 宇佐美暢久*, 本田稔**, 金尾啓右**
Authors(kana)
Organization*住友病院内科, **アイソトープ室
Journal核医学
Volume20
Number9
Page1273-1287
Year/Month1983/11
Article原著
Publisher日本核医学会
Abstract「要旨」 健常10例, 左室収縮機能良好な冠動脈疾患 (CAD) 22例を対象に99mTc心プールイメージングを安静時に施行し, 左室容積曲線よりearly diastolic phase index (rapid filling前半での左室平均充満速度, FR-in-1/2RF) を求めるとともに, rapid fillingの中間の時点 (1/2RF) での左室拡張壁運動様式を検討した. CADでは健常例に比しFR-in-1/2RFが有意に低く, 77%でFR-in-1/2RFの異常値を示した. 健常例では1/2RFで左室壁がendsystolic (ES) perimeterより外方に存在したが, CAD 22例中19例 (86%) で, いずれかの左室区域において, 1/2RFでの左室辺縁がES perimeterに重なる (no movement) か, ES perimeterの内方に存在 (inward movement) した. 1/2RFにおける壁運動異常より, CADの存在のみでなく, 狭窄冠動脈の診断が62%で可能でありspecificityも97%と高かった. 1/2RFで左室壁がinward movementを示した区域は, そのほとんど (8/9) が梗塞域で, 同域ではregional ESの遅延をみたが, no movement域ではregional ESの遅延はなく, 拡張早期左室充満が緩徐であった.
Practice臨床医学：一般
Keywordsdiastolic left ventricular wall motion, middle of rapid filling phase, gated cardiac blood pool imaging, coronary artery disease
English
TitleAnalysis of Left Ventricular Wall Motion During Early Diastole in Patients with Coronary Artery Disease
SubtitleOriginal Articles
AuthorsMichihiro NARITA*, Tadashi KURIHARA*, Kenichi MURANO*, Masahisa USAMI*, Minoru HONDA**, Keisuke KANAO**
Authors(kana)
Organization*Department of Medicine, Sumitomo Hospital, **Division of Nuclear Medicine, Sumitomo Hospital
JournalThe Japanese Journal of nuclear medicine
Volume20
Number9
Page1273-1287
Year/Month1983/11
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] In order to investigate the left ventricular (LV) wall motion during the early phase of diastole, multigated cardiac blood pool imaging with Tc-99m were performed at rest at anterior and 40-degree left anterior oblique (LAO) positions. Ten normal subjects and 22 patients with CAD with normal LV ejection fraction (>=55%) were studied. Mean LV filling rate during the first half of the rapid filling period (FR-in-1/2RF) was obtained as early diastolic phase index. In LAO images, three regional volume curves (septal, inferoapical and posterolateral) were obtained. For the diastolic wall motion analysis, anterior and LAO LV perimeters were divided into 6 segments, and they were analyzed frame by frame, but final decision was made at the middle of the rapid filling period (1/2RF) . In patients with CAD. FR-in-1/2RF was significantly (p<0.001) lower than that of normal subjects. Abnormal FR-in-1/2FR (<1.37 sec-1) were found in 77% of CAD. In normal subjects, expansion of LV during the early phase of the diastole was rapid, and at 1/2RF LV perimeter moved outward in every segment in comparison with end-systolic (ES) perimeter. But in patients with CAD the following abnormalities were encountered : 1) In 22 segments, LV perimeter at 1/2RF did not move from ES perimeter (no movement) 2) In 9 segments, LV perimeter at 1/2RF moved inward in comparison with ES perimeter. These abnormal diastolic wall motions were found in 83% of CAD and they corresponded to the segments which were supplied by stenosed coronary artery except one. In segments with inward movement, delay of regional ES (60 to 90 msec) were obserbed but in segments with no movement only slow filling of LV were observed by regional volume curve analysis. The investigation of abnormal LV diastolic wall motion at 1/2RF made possible the detection of stenosed coronary artery in 62%.
PracticeClinical medicine
Keywordsdiastolic left ventricular wall motion, middle of rapid filling phase, gated cardiac blood pool imaging, coronary artery disease

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