| Japanese |
|---|
| Title | 正常冠動脈例における右室心内膜ペーシング時タリウム心筋シンチの異常欠損と左室壁動態について |
|---|
| Subtitle | 原著 |
|---|
| Authors | 松村和彦*, 尾崎正治*, 山岸隆*, 石根顕史*, 古谷雄司*, 長野裕之*, 山本浩造*, 前田敏明*, 高橋徹郎*, 伊達敏明*, 楠川禮造* |
|---|
| Authors(kana) | |
|---|
| Organization | *山口大学医学部第二内科 |
|---|
| Journal | 核医学 |
|---|
| Volume | 24 |
|---|
| Number | 7 |
|---|
| Page | 955-962 |
|---|
| Year/Month | 1987/7 |
|---|
| Article | 原著 |
|---|
| Publisher | 日本核医学会 |
|---|
| Abstract | 「要旨」高頻度右室心内膜ペーシング時のThallium-201(Tl-201)心筋シンチグラフィーを正常冠動脈を有する10例に行い, 左室局所心筋血流分布と心エコー法による左室壁動態の変化について検討した. ペーシング時心筋シンチグラムで10例中9例の心室中隔部領域に可逆性欠損を認めたが, 運動負荷時には, 全例同部の欠損は認めなかった. 中隔壁部の後側壁部に対する局所心筋Tl-201摂取比は, 運動負荷時に比しペーシング時は著しく低下していた. ペーシング時のWashout rateは, 後側壁部に対し中隔壁部では低下していたが, 運動負荷時には有意差はなかった. 計測し得た10例中8例の心室中隔壁厚増加率は, ペーシング開始前に対しペーシング中は有意に低下したが, ペーシング終了後は直ちに復した. 以上より, 右室ペーシング時におけるTl-201心筋シンチグラム上の心室中隔および下壁の局所Tl-201活性の低下は, 冠動脈病変などの虚血性変化とは異なり, 刺激伝導様式の異常に伴う局所の壁運動異常が相対的な局所心筋血流低下を生じさせたためと考えた. |
|---|
| Practice | 臨床医学：一般 |
|---|
| Keywords | Right ventricular pacing, Regional thallium defects, Left ventricular wall motion. |
|---|
| English |
|---|
| Title | Thallium Myocardial Perfusion Defects and Wall Motion Abnormalities during Right Ventricular Pacing in Patients with Normal Coronary Artery |
|---|
| Subtitle | Original Articles |
|---|
| Authors | Kazuhiko MATSUMURA, Masaharu OZAKI, Takashi YAMAGISHI, Kenji ISHINE, Yuji FURUTANI, Hiroyuki NAGANO, Kouzo YAMAMOTO, Toshiaki MAEDA, Tetsuro TAKAHASHI, Toshiaki DATE, Reizo KUSUKAWA |
|---|
| Authors(kana) | |
|---|
| Organization | Second Department of Internal Medicine, Yamaguchi University School of Medicine |
|---|
| Journal | The Japanese Journal of nuclear medicine |
|---|
| Volume | 24 |
|---|
| Number | 7 |
|---|
| Page | 955-962 |
|---|
| Year/Month | 1987/7 |
|---|
| Article | Original article |
|---|
| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
|---|
| Abstract | [Summary]To study on the regional myocardial perfusion during right ventricular endocardial high rate pacing (150 bpm), thallium-201 (Tl-201) myocardial scintigraphies were performed during pacing and exercise as comparative study in 10 patients with normal coronary angiogram. Echocardiogram (UCG) was simultaneously recorded. Nine of these 10 patients had low uptake of Tl-201 in the interventricular septum (IVS) during pacing, but, none had low uptake of Tl-201 during exercise. The ratio of the Tl-201 uptake in the IVS to that in the posterolateral wall (PL) (Tl-201 uptake ratio) was significantly decreased during pacing compared to that during exercise (0.77+-0.05, 0.96+-0.07, p<0.001). During pacing, washout rate (%) in the IVS was significantly decreased compared to that in the PL (28+-12%, 48+-12%, p<0.001). Percent systolic wall thickening (%) (100×(Ws-Wd)/Wd; Ws, Wd: systolic and diastolic wall thickness, respectively) of the IVS measured by UCG was markedly decreased during pacing compared to that at rest (34+-6%, 13+-7%, p<0.01), but it returned to the level at rest immediately after pacing off (36+-9% measured at the 5th beat after pacing off, NS vs that at rest). This finding was not consistent with the findings observed during exercise in patients with coronary artery disease. These results suggest that regional myocardial blood flow decreased in the IVS, which is the region near the pacing site, in comparison with that in the PL. However, in this study, the echocardiogram showed no evidence of myocardial ischemia. This finding suggests that the relative decrease in myocardial blood flow is probably caused by the abnormal septal wall motion associated with the conduction abnormality. |
|---|
| Practice | Clinical medicine |
|---|
| Keywords | Right ventricular pacing, Regional thallium defects, Left ventricular wall motion. |
|---|