Japanese
Title虚血性心疾患における拡張早期左室充満障害のメカニズムの検討
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
Volume22
Number7
Page961-970
Year/Month1985/7
Article原著
Publisher日本核医学会
Abstract「要旨」冠動脈疾患 (CAD) における拡張早期左室充満障害の機序を検討するため, 健常 (N) 10例, 左室駆出率正常の前下行枝一枝病変18例 (梗塞の既往のないGrI10例, 既往のあるGrII8例) を対象に, 安静時に心電図同期心イメージを撮影, 左室全体での容量曲線 (TAC) のほか, 局所TAC (R-TAC) を中隔側 (Sep) (病変部) , 後側壁側 (PL) (健常部) に作成した. GrIIでのみSepでの局所駆出率 (R-EF) の低下をみ, これはPLでのR-EFの代償性亢進を伴っていた. GrI, GrII両群で拡張早期1/3でのglobal filling rateおよびSepにおけるregional filling rate (R-FR) の低下をみたが, PLでのR-FRはN群と差をみなかった. GrIIではSepでの拡張開始の遅延が著明で, 病変部でのcomplianceの低下による拡張不良に加えて, asynchronous fillingが拡張早期充満障害の主因と考えられたが, GrIでは, 拡張開始の遅延はわずかで, 病変部の拡張不良そのものがその主因と考えられた. また健常心筋部での代償性充満増大の欠如もCADで早期より充満障害を生じる一因と考えられた.
Practice臨床医学：一般
KeywordsDepressed left ventricular filling, Regional time activity curve, Coronary artery disease, Blood pool imaging
English
TitleMechanism of Depressed Left Ventricular Early Diastolic Filling 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 Internal Medicine, Sumitomo Hospital, **Division of Nuclear Medicine, Sumitomo Hospital
JournalThe Japanese Journal of nuclear medicine
Volume22
Number7
Page961-970
Year/Month1985/7
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] To elucidate the possible mechanisms of depressed left ventricular (LV) early diastolic filling in patients with coronary artery disease (CAD) , 10 normal subjects and 18 patients with isolated left anterior descending coronary artery (LAD) disease with normal LV ejection fraction (EF) were studied. Multigated blood pool imaging with Tc-99m were obtained at rest at modified LAO. LV was divided from its geometric center and regional time activity curves (TACs) at septal (LAD distribution) and postero-lateral (non-ischemic) regions were obtained as well as global TACs. From global and regional TACs, global filling rate (1/3 FRm) and regional filling rate (R-FR) were calculated during the first third of diastole of each TAC. Patients with CAD were divided into Group I (n=10, without myocardial infarction) and Group II (n=8, with old anterior infarction) . In Group II, reduced septal regional EF was observed and it was accompanied with compensatory augumentation of postero-lateral regional EF. In both CAD groups, global 1/3 FRm and septal R-FR reduced significantly compared with those of normal subjects (Septal R-FR ; 2.15+-0.38 sec-1 in normal subjects, 1.49+-0.26 sec-1 in Group I, 1.72+-0.19 sec-1 in Group II) , but postero-lateral R-FRs were not different from normal subjects. In Group II, end-ejection in the septal region delayed strikingly (50+-25 msec) and when R-FR was calculated at the same timing as global 1/3 FRm, it reduced significantly (0.83+-0.32 sec-1) . But in Group I, delay of septal end-ejection was minimal (15+-13 msec) and R-FR did not change when it was measured at the same timing as global 1/3 FRm. These results suggest followings ; in Group II, reduced LV early diastolic filling were caused by asynchronous LV filling as well as impaired diastolic filling of diseased myocardium, while in Group I, it was caused by reduced diastolic filling itself. Besides, no compensatory augumentation of diastolic filling in nonischemic myocardium may be a cause of early appearance of reduced diastolic filling in patients with CAD.
PracticeClinical medicine
KeywordsDepressed left ventricular filling, Regional time activity curve, Coronary artery disease, Blood pool imaging

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