| Japanese |
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| Title | 負荷心電図梗塞部ST上昇と残存心筋虚血に関する検討 - 運動負荷心筋スキャンによる心筋虚血の定量的評価を用いて - |
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| Subtitle | 原著 |
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| Authors | 下永田剛*,***, 西村恒彦*, 植原敏勇*, 林田孝平*, 斉藤宗靖**, 住吉徹哉** |
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| Organization | *国立循環器病センター放射線診療部, **内科, ***現;広島大学医学部第一内科 |
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| Journal | 核医学 |
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| Volume | 24 |
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| Number | 12 |
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| Page | 1731-1739 |
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| Year/Month | 1987/12 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」運動負荷心筋スキャンの施行された陳旧性心筋梗塞1枝病変65例にて, 負荷心電図梗塞部ST上昇の持つ意義を検討した. Circumferential profile analysisにより, タリウム虚血スコア(TIS)およびdefect scoreを算出し, 心筋虚血ならびに梗塞巣の拡がりを定量的に評価した. 心筋梗塞発症後3か月未満の症例にて, 有意(<2mm)の梗塞部ST上昇を示す群と有意の梗塞部ST上昇を示さない群の左室駆出分画(LVEF)および左室壁運動異常に差は認めなかった. しかし, 発症3か月以降の症例において, 梗塞部ST上昇を示す群は梗塞部ST上昇を示さない群に比し, dyskinesisを多く認め, defect scoreは有意に高く, LVEFならびにTISは有意に低値を示した. さらに, 梗塞発症後3か月未満の有意の梗塞部ST上昇群において, T波尖鋭化を示す群は, T波尖鋭化を示さない群に比し, defect scoreに差はないものの, 梗塞部一過性欠損像を多く認め, LVEFならびにTISは有意に高値を示した. したがって, 梗塞部ST上昇の有する意義は, 心筋梗塞発症後の経過期間により異なり, 従来, 高度左室壁運動異常に由来するとされた梗塞部ST上昇群にて, 梗塞発症後早期に残存心筋虚血を反映する群の存在が示された. |
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| Practice | 臨床医学：一般 |
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| Keywords | Stress electrocardiogram, Stress thallium scan, Circumferential profile analysis, Myocardial infarction, Residual myocardial ischemia. |
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| English |
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| Title | Exercise Induced ST Elevation and Residual Myocardial Ischemia in Previous Myocardial Infarction |
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| Subtitle | - Original Articles - |
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| Authors | Tsuyoshi SHIMONAGATA, Tsunehiko NISHIMURA, Toshiisa UEHARA, Kohei HAYASHIDA, Muneyasu SAITO, Tetsuya SUMIYOSHI |
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| Organization | Department of Radiology and Cardiology, National Caradiovascular Center |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 24 |
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| Number | 12 |
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| Page | 1731-1739 |
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| Year/Month | 1987/12 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | The purpose of this study was to evaluate the clinical significance of stress induced ST elevation on infarcted area in 65 patients with previous myocardial infarction (single vessel disease) who had stress thallium scan. Stress induced ST changes on infarcted area were compared with quantitative assessment of myocardial ischemia (thallium ischemic score; TIS) and extent of myocardial infarction (defect score; DS) derived from circumferential profile analysis. In patients with previous myocardial infarction in less than 3 month from the onset (n=36), left ventricular ejection fraction (LVEF) and extent of abnormal LV wall motion were not significantly different between patients with stress induced ST elevation (>=2mm, n=26) and those with stress induced ST elevation (<2mm, n=10), while, in patients with previous myocardial infarction in more than 3 month (n=29), patients with stress induced ST elevation (>=2mm, n=15) showed left ventricular dyskinesis more frequently than those with ST elevation (<2mm, n=14). In addition, the former showed significantly higher DS and significantly lower TIS than the latter. In patients with previous myocardial infarction in less than 3 month, patients with ST elevation (>=2mm, n=15) with prominent upright T wave (n=15) had transient thallium defect in infarcted area in 73% and they had significantly higher LVEF and TIS than those with ST elevation (<2mm, n=11). These results indicated that ST elevation in infarcted area reflect different significance according to the recovery of injured myocardium and stress induced ST elevation with prominent upright T wave in infarcted area reflect residual myocardial ischemia in less than 3 month from the onset of myocardial infarction. |
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| Practice | Clinical medicine |
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| Keywords | Stress electrocardiogram, Stress thallium scan, Circumferential profile analysis, Myocardial infarction, Residual myocardial ischemia. |
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