Japanese
Title狭心症1枝病変における負荷心電図ST-T変化と心筋虚血の重症度に関する検討 - 運動負荷心筋スキャンによる定量的評価を用いて -
Subtitle原著
Authors下永田剛*, 西村恒彦**, 植原敏勇**, 林田孝平**, 高宮誠**, 住吉徹哉***, 斉藤宗靖***
Authors(kana)
Organization*広島大学医学部第一内科, **国立循環器病センター放診部, ***内科
Journal核医学
Volume23
Number12
Page1721-1730
Year/Month1986/12
Article原著
Publisher日本核医学会
Abstract「要旨」運動負荷心筋スキャンが施行された狭心症1枝病変(SVD)66例にて, 負荷心電図ST-T変化が心筋虚血の重症度をどの程度反映するか検討した. Circumferential profile analysisを用い, 初期分布時および再分布時のprofile curveにて囲まれる面積を正面, LAO45°, 70°の3方向にて求め, 平均値をthallium ischemic score(TIS)とし, 心筋虚血の定量的評価を行った. SVD 66例にてTISと冠動脈造影所見の対比により, TISは冠動脈狭窄が強く, 虚血が広範囲なほど高値を示した. さらにLAD 46例にて, TISは肺野タリウム集積と良い相関を示し, 心筋虚血の重症度評価に有用であった. 次いで, LAD 46例にて, TISを心筋虚血の重症度評価の指標とし, 負荷心電図所見と対比検討した. 陰性U波群は最もTISは高く, 水平型または下り傾斜型1mm以上ST降下群は, 緩徐上り傾斜型1.5mm以上ST降下群に比しTISは高かった. しかし, いずれの群も心電図変化なしの群とTISに有意差はなく, さらにV2〜6, II, III, aVF ST降下群とV2〜6 ST降下群でTISに有意差はなかった. したがって, 負荷心電図ST-T変化は, 心筋虚血の重症度を反映するが, その評価に限界を有することが示された.
Practice臨床医学：一般
KeywordsStress thallium scan, Circumferential profile analysis, Thallium ischemic score, Stress electrocardiogram, Myocardial ischemia.
English
TitleExercise-Induced ST-T Changes and Severity of Myocardial Ischemia in Single-Vessel Coronary Artery Disease : Quantitative Assessment by Stress Thallium Scan
SubtitleOriginal Articles
AuthorsTsuyoshi SHIMONAGATA, Tsunehiko NISHIMURA, Toshiisa UEHARA, Kohei HAYASHIDA, Makoto TAKAMIYA, Tetsuya SUMIYOSHI, Muneyasu SAITO
Authors(kana)
OrganizationDepartment of Radiology and Cardiology, National Cardiovascular Center
JournalThe Japanese Journal of nuclear medicine
Volume23
Number12
Page1721-1730
Year/Month1986/12
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]The purpose of this study was to evaluate how exercise-induced ST-T changes reflect the severity of myocardial ischemia in 66 patients with single-vessel disease (SVD) who underwent stress thallium scans. Quantitative assessment of myocardial ischemia was performed with thallium ischemic score (TIS) derived from circumferential profile analysis. Circumferential profiles of the initial and 4 hr redistribution myocardial image were generated for each of three views (ANT, LAO 45, LAO 70) and TIS was obtained as the average of the area between the initial and 4 hr redistribution profile for each view. In 66 patients with SVD, TIS were compared with coronary angiographic findings. TIS was correlated well with the severity of coronary artery stenosis. In addition, TIS was also correlated well with lung thallium uptake in 46 LAD disease. Therefore, these data proved that TIS was useful for the evaluation of the severity of myocardial ischemia. In 46 LAD disease, TIS, being as the indicator of the severity of myocardial ischemia, was compared precisely with results of stress electrocardiograms to evaluate how exercise-induced ST-T changes reflect the severity of myocardial ischemia. Patients with negative U wave had the highest mean TIS and those with horizontal or down sloping ST depression of 1.0 mm or more had higher mean TIS than those with slow upsloping ST depression of 1.5 mm or more, but there were no significant differences between these groups and those without ST-T change and the mean TIS was not different significantly between V2-6 ST depression group and V2-6, II, III, aVF ST depression group. In conclusion, these results indicated that exercise-induced ST-T changes reflect the severity of myocardial ischemia in some degree but also has a limitation in evaluation of the severity of myocardial ischemia.
PracticeClinical medicine
KeywordsStress thallium scan, Circumferential profile analysis, Thallium ischemic score, Stress electrocardiogram, Myocardial ischemia.

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