Japanese
Title冠動脈疾患における運動負荷タリウム心筋シンチグラムのWashout Rate解析の臨床的意義
Subtitle《原著》
Authors津田隆志*
Authors(kana)
Organization*新潟大学医学部第一内科
Journal核医学
Volume23
Number11
Page1573-1584
Year/Month1986/11
Article原著
Publisher日本核医学会
Abstract「要旨」: 冠動脈疾患を対象に, 運動負荷心筋シンチグラムによるWashout Rate (WR) を測定し, その臨床的意義を検討した. 対象は狭心症21例, 陳旧性心筋梗塞30例 (平均年齢53歳) で, 冠動脈造影により得られた冠動脈狭窄度とWRとを比較検討した. 結果 1) 非梗塞のLAD領域では冠動脈病変の重症化とともに, WRは有意に低下したが, RCA, LCX領域では有意差はなかった. 2) 梗塞のLAD領域ではWRは有意に低下し, RCA, LCX領域でも低下したが, 有意差はなかった. 梗塞領域に対する責任冠動脈の重症度や側副血行路の有無によって, WRに有意差を認めなかった. 3) 非梗塞, 梗塞領域ともに, 再分布を認めた部位で, WRは有意に低下した. 4) 健常部位でのWRは, 最大負荷時の心拍数とDouble Productに対し有意な正相関を示した. 以上より, WRは 1) 非梗塞領域のLAD病変の重症度評価, 2) 非梗塞, 梗塞領域を含めた心筋虚血部位の検出に有用な指標であると考えられた.
Practice臨床医学：一般
KeywordsThallium-201, Coronary artery disease, Myocardial planar image, Washout rate, Redistribution.
English
TitleAssessment of the Clinical Significance of Washout Rate Analysis by Exercise Stress Thallium-201 Myocardial Scintigram in Coronary Artery Disease
SubtitleOriginal Articles
AuthorsTakashi TSUDA
Authors(kana)
OrganizationThe First Department of Internal Medicine, Niigata University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume23
Number11
Page1573-1584
Year/Month1986/11
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] : This study assesses the clinical significance of washout rate (WR) analysis by exercise stress Thallium-201 myocardial scintigram (Tl-201 test) in coronary artery disease. Among 51 patients (47 males and 4 females age range from 31 to 65 years, mean 53 years) , 21 had angina pectoris, and 30 had old myocardial infarction. Patients underwent symptom-limited supine ergometer Tl-201 test. Selective coronary arteriography was performed within one month after Tl-201 test. Coronary artery stenosis was graded according to AHA criteria. The relations between WR and percent narrowing, between WR and presence of collateral and between WR and Tl-201 redistribution, were evaluated. Results were as follows. 1) In patients with LAD lesions, WR in non-infarcted region showed significantly lower value (from 12.7+-14.7% to -8.7+-7.2%) compared with control (22.3+-9.4%) as stenosis became severer (p<0.05-0.001) . However, WR did not differ significantly in patients with RCA or LCX lesions. 2) In patients with LAD lesions, WR in infarcted region showed significantly lower value (-9.6+-23.9%) compared with control (22.3+-9.4%) (p<0.001) . Lower WR was seen in RCA or LCX lesions, but it was not different significantly. Among infarcted regions, there was no relation between WR and coronary artery stenosis, and between WR and presence of collaterals. 3) WR in segments with redistribution was significantly lower than that in segments without redistribution in both non-infarcted region (-1.5+-16.5% vs. 19.6+-9.7%, p<0.001) , and infarcted regions (-11.5+-23.6% vs. 11.2+-13.3%, p<0.005) .4) There was a fair correlation between WR and peak heart rate (r=0.55, p<0.001) , and between WR and peak double product (r=0.42, p<0.01) in non-ischemic region. These results showed that WR was a useful index for detecting myocardial ischemia among both non-infarcted and infarcted regions and that WR was effective index for evaluating severity of LAD non-infarcted lesions.
PracticeClinical medicine
KeywordsThallium-201, Coronary artery disease, Myocardial planar image, Washout rate, Redistribution.

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