Japanese
Title1枝病変心筋梗塞症における運動負荷時非梗塞部ST低下とTl-201心筋イメージ所見の対比
Subtitle《原著》
Authors片岡一*,†, 大窪利隆*, 高岡茂*, 田渕博己*, 中村一彦*, 橋本修治*
Authors(kana)
Organization*鹿児島大学医学部第二内科, †現大分医科大学第二内科
Journal核医学
Volume23
Number10
Page1369-1380
Year/Month1986/10
Article原著
Publisher日本核医学会
Abstract「要旨」: 1枝病変心筋梗塞症患者を対象として, 慢性期に施行した運動負荷心電図の非梗塞部ST低下に及ぼす梗塞巣の拡がりの影響を負荷Tl-201心筋イメージング所見を分析することで検討した. 対象は前壁梗塞15例, 下壁梗塞16例で, 仰臥位エルゴメータにより負荷を加え, 負荷心電図を記録するとともに, 直後と3時間後に多方向のTl-201心筋イメージをえた. 非梗塞部ST低下は前壁梗塞の13.3%, 下壁梗塞の31.3%にみられた. 心筋イメージの201Tl集積低下域とST低下との関連をみると, 前壁梗塞では有意でなかったが, 下壁梗塞の前胸部V1〜V4誘導でのST低下は, 下部心室中隔の201Tl集積低下を有する症例に多く, ST非低下群と有意差を認めた (80% vs. 9.1%, p<0.05) . 以上, 1枝病変心筋梗塞症例の非梗塞部ST低下は心筋イメージの201Tl集積低下域の拡がりと関連することが示された.
Practice臨床医学：一般
KeywordsExercise induced ST depression, One-vessel old myocardial infarction, Tl-201 myocardial image.
English
TitleCorrelation between Tl-201 Myocardial Scintigraphic Findings and Exercise-induced ST Depression in Non-infarct-related Leads in Old Myocardial Infarction with One-vessel Coronary Disease
SubtitleOriginal Articles
AuthorsHajime KATAOKA*,**, Toshitaka OHKUBO*, Shigeru TAKAOKA*, Hiromi TABUCHI*, Kazuhiko NAKAMURA*, Shuji HASHIMOTO*
Authors(kana)
Organization*Second Department of Internal Medicine, Kagoshima University, **Second Department of Internal Medicine, Medical College of Oita
JournalThe Japanese Journal of nuclear medicine
Volume23
Number10
Page1369-1380
Year/Month1986/10
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] : The influence of the infarct extension on the exercise-induced ST depression in non-infarct-related leads, i.e., II, III and aVF in anterior old myocardial infarction (OMI) and V1 to V4 in inferior OMI, was evaluated in the patients with OMI without significant stenosis other than infarct-related coronary artery. Study population were 15 patients with anterior OMI due to anterior descending coronary artery disease and 16 with inferior OMI due to right coronary artery disease. Stress thallium-201 myocardial images were obtained in anterior, 30° and 60° left anterior oblique views, immediately and 3 to 4 hour delayed after submaximal exercise stress using bicycle ergometer. Exercise 12-lead electrocardiogram was recorded simultaneously during myocardial imaging. Significant ST depression was defined as>=1 mm of the horizontal or downsloping ST depression or>=15 mm of the uprising ST depression 60 msec after the J point. ST depression in non-infarct-related leads was observed in 2 of 15 (13.3%) in anterior OMI and 5 of 16 (31.3%) in inferior OMI. In anterior OMI, no significant association was found between the ST depression and the infarct extension. However, significant relationship was found between the precordial ST depression and inferoseptal defect on myocardial image in inferior OMI. That is, incidence of the exercise-induced precordial ST depression was significantly higher in the patients with inferoseptal defect compared with those without it (80% vs. 9.1%, p<0.05) . Exercise-induced ST elevation in the infarct-related leads or infarct size did not significantly affect the exercise-induced precordial ST depression. Thus, infarct extension from the inferior wall into the inferoseptal wall may affect the exercise-induced ST displacement in OMI with one-vessel coronary artery disease and caution is needed to interpret such ST displacement.
PracticeClinical medicine
KeywordsExercise induced ST depression, One-vessel old myocardial infarction, Tl-201 myocardial image.

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