| Japanese |
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| Title | 無症候左脚ブロックにおける運動負荷タリウム心筋シンチグラフィー |
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| Subtitle | 短報 |
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| Authors | 成田充啓*, 栗原正*, 村野謙一*, 宇佐美暢久*, 本田稔**, 金尾啓右** |
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| Organization | *住友病院内科, **アイソトープ室 |
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| Journal | 核医学 |
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| Volume | 21 |
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| Number | 11 |
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| Page | 1463-1467 |
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| Year/Month | 1984/11 |
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| Article | 報告 |
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| Publisher | 日本核医学会 |
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| Abstract | 「I. 緒言」運動負荷201Tl心筋シンチグラフィーは, 左脚ブロック (LBBB) 例において, その基礎に虚血性心疾患 (CAD) が存在するか否かの鑑別に有用とされてきたが, 近年, 冠動脈狭窄のないLBBB 例で, 運動負荷Tl心筋シンチでdefectが出現する例のあることも報告されている. したがって無症候のLBBBを対象に, 運動負荷Tl心筋シンチおよび心プールシンチを行い, その特徴を検討した. 「II. 対象と方法」「対象」胸痛その他の自覚症状のない完全LBBBを有する7例 (平均年齢57.1±6.4歳) である. 内3例に軽症高血圧が存在したが, 全例心エコー図でLBBBに伴う変化以外には, 病的所見を認めなかった. 「方法」Tlによる心筋平面像 (planar image), 心プールシンチにはall purpose collimatorを装着したPho/Gamma V型カメラを, 心筋断層像には7-pinohole collimator (7-Pin) を装置したLFOVカメラを用い, いずれもminicomputer (Scintipac 1200) にon lineで接続した. |
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| Practice | 臨床医学：一般 |
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| Keywords | Left bundle branch block, Myocardial perfusion imaging, Gated blood pool imaging, Asynchronous left ventricular contraction |
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| English |
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| Title | Exercise Stress Myocardial Imaging with Thallium-201 in Asymptomatic Patients with Left Bundle Branch Block |
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| Subtitle | Short Communications |
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| Authors | Michihiro NARITA*, Tadashi KURIHARA*, Kenichi MURANO*, Masahisa USAMI*, Minoru HONDA**, Keisuke KANAO** |
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| Authors(kana) | |
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| Organization | *Department of Internal Medicine, Sumitomo Hospital, **Division of Nuclear Medicine, Sumitomo Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 21 |
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| Number | 11 |
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| Page | 1463-1467 |
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| Year/Month | 1984/11 |
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| Article | Report |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Seven asymptomatic patients with left bundle branch block (LBBB) were examined by exercise stress myocardial imaging with Tl-201 and exercise stress gated blood pool imaging with Tc-99m. In 4 of them, exercise stress myocardial imaging elicited small but significant upper septal (4/4) and anterior (2/4) defects in planar images and anterior septal defects (4/4) in myocardial tomography with 7-pinhole collimator. Three hours later these myocardial perfusion abnormalities were filled in incompletely. In 3 patients with myocardial perfusion abnormality, coronary angiography was performed and there was no abnormality in coronary artery. Gated blood pool imaging at rest showed subnormal left ventricular ejection fraction (LVEF 53.6+-1.1%) and mild septal hypokinesis in 6 of 7 patients. Exercise stress caused decrease in LVEF (49.0+-2.0%) and worsening or development of septal hypokinesis. LV functional impairment by exercise stress developed in the same degree irrespective of the appearance of myocardial perfusion abnormality or not. And regional LV volume curve analysis revealed that the impairment of LV function originated from asynchronous LV contraction which was exaggerated by exercise stress, and these phenomena were considered to be specific for LBBB. Although the precise mechanism of exercise induced myocardial perfusion abnormality was not clear, we concluded that usual noninvasive diagnostic test for coronary artery disease are of limited values in patients with LBBB. |
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| Practice | Clinical medicine |
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| Keywords | Left bundle branch block, Myocardial perfusion imaging, Gated blood pool imaging, Asynchronous left ventricular contraction |
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