| Japanese |
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| Title | 心筋梗塞患者の運動負荷時心拍出予備能の評価 |
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| Subtitle | 原著 |
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| Authors | 金奉賀*, 石田良雄*, 常岡豊*, 平岡俊彦*, 福島正勝*, 松本正幸*, 井上通敏*, 阿部裕*, 木村和文**, 南野隆三*** |
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| Organization | *大阪大学医学部第一内科, **中央放射線部, ***桜橋渡辺病院 |
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| Journal | 核医学 |
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| Volume | 22 |
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| Number | 1 |
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| Page | 1-8 |
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| Year/Month | 1985/1 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」心筋梗塞患者 (MI) の運動負荷時心拍出予備能を評価するため, 狭心症の合併のないMI 18例 (MI-1), 合併するMI 7例 (MI-2), 健常11例 (N) に対して, 安静時および最大運動負荷時に平衡時心プールイメージングを施行した. 心収縮性の指標としてP/V index (収縮期最高血圧/左室収縮末期容積係数), 前負荷の指標として左室拡張末期容積係数 (EDVI) を計測し, 各群で比較検討した. N群のP/V indexは4.7±1.5 mmHg/ml/m2から8.3±3.2 mmHg/ml/m2に有意に増加したが (p<0.01), EDVIは不変であった. MI-1群のP/V indexも2.7±1.2 mmHg/ml/m2から3.5±1.2 mmHg/ml/m2に増加したが (P<0.01), その増加度はN群に比し低値であった. 一方, EDVIは102±26 ml/m2から121±41 ml/m2に増加した (P<0.01). 狭心痛で運動負荷を終了したMI-2群では, P/V indexは4.9±1.6 mmHg/ml/m2から3.8±1.4 mmHg/ml/m2に減少し (P<0.05), EDVIは76±13 ml/m2から95±18 ml/m2に増加した (P<0.05). 以上より, 心収縮性予備能の低下した梗塞心では, Frank-Starling機構が代償的に作動することが示された. |
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| Practice | 臨床医学：一般 |
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| Keywords | Multi-gated radionuclide angiography, Myocardial infarction, Cardiac reserve, P/V index, Preload |
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| English |
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| Title | An Analysis of Cardiac Reserve Mechanism during Supine Bicycle Exercise in Patients with Myocardial Infarction : Evaluation by Multi-gated Radionuclide Angiography |
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| Subtitle | Original Articles |
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| Authors | Bonga-Ha KIM*, Yoshio ISHIDA*, Yutaka TSUNEOKA*, Toshihiko HIRAOKA*, Masakatsu FUKUSHIMA*, Masayuki MATSUMOTO*, Michitoshi INOUE*, Hiroshi ABE*, Kazufumi KIMURA**, Takazo MINAMINO*** |
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| Authors(kana) | |
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| Organization | *The First Department of Medicine, **The Division of Nuclear Medicine, Osaka University Medical School, ***Sakurabashi Watanabe Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 22 |
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| Number | 1 |
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| Page | 1-8 |
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| Year/Month | 1985/1 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] To evaluate the function of cardiac reserve mechanism during supine bicycle exercise (Ex) in patients (pts) with myocardial infarction (MI), multi-gated radionuclide angiography was performed at rest and during maximal Ex in 25 pts with MI and 11 normals (N). Twenty five pts with MI consisted of 2 groups, 18 pts (MI-1) without and 7 pts (MI-2) with effort angina. Myocardial contractility was estimated from P/V index, peak systolic pressure/end-systolic volume index. There was no significant difference in cardiac index, blood pressure and heart rate during Ex between N and MI-1, but the increases in these parameters in MI-2 were less than in N. In N, P/V index siginificantly increased (4.7+-1.5 to 8.3+-3.2 mmHg/ml/m2, p<0.001) without siginificant increases in end-diastolic volume index (EDVI) (78+-12 to 83+-18 ml/m2, NS). In MI-1, P/V index moderately increased from 2.7+-1.2 to 3.5+-1.2 mmHg/ml/m2 with significant increases in EDVI (102+-26 to 121+-41 ml/m2, p<0.01). In MI-2, P/V index significantly decreased from 4.9+-1.6 to 3.8+-1.4 mmHg/ml/m2 with increases in EDVI (76+-13 to 95+-18ml/m2, P<0.05) during anginal attack. There was an inverse correlation between changes in EDVI and P/V index during Ex (r=0.64). These results indicate that in pts with limited augmentation of myocardial contractility (P/V index), increases in cardiac output during Ex may be executed by increasing EDVI, as an index of preload, and heart rate. |
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| Practice | Clinical medicine |
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| Keywords | Multi-gated radionuclide angiography, Myocardial infarction, Cardiac reserve, P/V index, Preload |
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