Japanese
Title肥大心におけるnifedipineの左室収縮および拡張機能に及ぼす影響 - 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
Volume21
Number10
Page1267-1276
Year/Month1984/10
Article原著
Publisher日本核医学会
Abstract「要旨」肥大心におけるCa拮抗剤nifedipine(Nif)の左室収縮, 拡張機能に及ぼす急性影響を検討するため, 肥大型心筋症(HCM)10例, 高血圧性心肥大(TH)8例, 健常9例で, Nif投与前後に99mTc心プールイメージングを行った. コントロールでの左室収縮機能(左室駆出率, 駆出早期1/3での平均駆出速度)はHCM群で他群より高く, 左室拡張機能(拡張早期1/3での左室平均充満速度, 拡張期最大充満速度)は, HCM, HT両群で健常群より有意に低かった. Nifの投与で, 収縮機能はHT群で増加したが, 他群で不変, 拡張機能はHCM, HT両群で有意に改善, 健常群で不変であった. HCMの内, 有症状例で拡張機能の改善が著しかった. Nifによる心拍数の増加は3群間で差をみず, 血圧の下降は, 前より血圧の高いHT群で著しかった. 拡張機能の改善の作用機序としてHTでは左室後負荷の軽減による収縮機能の改善が, HCMではNifの未梢循環や左室収縮機能の変化を介さぬ機序が示唆された.
Practice臨床医学：一般
Keywordsleft ventricular diastolic function, gated blood pool imaging, hypertrophic heart, nifedipine.
English
TitleEffects of Nifedipine on Left Ventricular Systolic and Diastolic Functions in Patients with Left Ventricular Hypertrophy
SubtitleOriginal Articles
AuthorsMichihiro NARITA*, Tadashi KURIHARA*, Kenichi MURANO*, Masahisa USAMI*, Minoru HONDA**, Keisuke KANAO**
Authors(kana)
Organization*Department of Internal Medicine, **Division of Nuclear Medicine, Sumitomo Hospital
JournalThe Japanese Journal of nuclear medicine
Volume21
Number10
Page1267-1276
Year/Month1984/10
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]The effect of nifedpine on left ventricular (LV) systolic and diastolic function was studied in 10 patients with hypertrophic cadiomyopathy (HCM), 8 patients with hypertensive hypertrophy (HT) and 9 normal subjects. Multigated cardiac blood pool imaging with Tc-99m were obtained at 40-degree left anterior oblique position before and after nifedipine administration (10 mg, sublingually). As systolic indices, we obtained LV ejection fraction and mean first third ejection rate. And as diastolic indices, mean filling rate during first third of diastole (1/3 FRmean) and diastolic maximal filling rate were calculated. Before nifedipine, systolic indices were significantly superior in HCM group than in other 2 groups, and diastolic indices were significantly lower in HCM and HT groups than in normal. After nifedipine, systolic indices improved in HT group but they did not change in other 2 groups. Diastolic indices improved significantly in HCM and HT groups after nifedpine. In HCM group, 1/3 FRmean improved more markedly in symptomatic patients than in asymptomatic patients. The ratio of diastolic function to systolic function (1/3 FRmean/1/3 ERmean) did not hang in normal and HT groups but it increased significantly in HCM group. There we a slight increase in heart rate (HR) and decrease in systemic arterial pressure (BP). The increase in HR was similar among 3 groups but the decrease in BP was significantly greater in HT group in whom control BP was significantly higher than other groups. LV end-diastolic volume did not change in 3 groups by nifedipine administration. These data suggested that abnormal diastolic function in HCM and HT was faborably modified by nifedipine, but their mechanisms were different. In HT, it was considered to relate with improved systolic function due to LV afterload reduction, while in HCM, it was not related to the peripheral hemodynamic effects nor improved systolic function.
PracticeClinical medicine
Keywordsleft ventricular diastolic function, gated blood pool imaging, hypertrophic heart, nifedipine.

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