Japanese
Title1枝病変心筋梗塞症における運動負荷時壁運動異常の定量的評価 - 梗塞部位の違いによる反応の差異について -
Subtitle原著
Authors古寺邦夫*
Authors(kana)
Organization*新潟大学医学部第一内科
Journal核医学
Volume25
Number7
Page615-624
Year/Month1988/7
Article原著
Publisher日本核医学会
Abstract「要旨」梗塞部位の違いによる運動負荷時局所壁運動異常の差異を明らかにする目的で, 残存虚血のない1枝病変心筋梗塞症 (LAD群13例, RCA群10例) に運動負荷心プールシンチグラフィを行い, 梗塞部, 非梗塞部の壁運動を定量的に評価した. なお健常者12例と残存虚血を有する多枝病変群12例を対照として用いた. 壁運動量の指標として左室駆出率 (EF) , 局所駆出率 (REF) を, asynchronyの指標として左室位相角の平均値の標準偏差 (SD) , 局所標準偏差 (RSD) を用いた. 1) 安静時, LAD, RCA両群の梗塞部で有意なREFの低下とRSDの増加が同時に認められた. 2) 運動負荷により両群でのEFは有意に増加したが, LAD群では増加の程度はRCA群に比しわずかであった. SDは両群で有意な変化を認めなかった. 一方, 多枝病変群ではEFに有意の変化はなかったが, SDは有意に増加した. 3) 両群の梗塞部, 非梗塞部のREFは運動負荷にて有意に増加したが, RSDには有意な変化を認めなかった. 4) 梗塞部のREFは最大負荷時でも健常者に比し両群で有意に低下していた. 最大負荷時, 非梗塞部のREFはRCA群では健常者と有意差はなかったが, LAD群では有意な低下を示した. 以上よりLAD群とRCA群で運動負荷時の非梗塞部の反応に有意差を認め, 前壁梗塞と下壁梗塞の負荷によるEFの変化の差を説明しうる所見と思われた.
Practice臨床医学：一般
KeywordsSingle vessel myocardial infarction, Site of infarction, Gated radionuclide ventriculography, Exercise stress, Wall motion.
English
TitleQuantitative Analysis of Left Ventricular Wall Motion at Exercise Stress in Myocardial Infarction with Single Vessel Coronary Artery Disease - Difference in Response According to Site of Infarction -
SubtitleOriginal Articles
AuthorsKunio KODERA
Authors(kana)
OrganizationThe First Department of Internal Medicine, Niigata University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume25
Number7
Page615-624
Year/Month1988/7
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] The wall site involved by myocardial infarction (MI) is one of major factors to determine a cardiac pump function of the patient. Generally, anterior MI has a lower cardiac function at rest than inferior MI. However, the difference in cardiac function during exercise between anterior MI and inferior MI is controversial. To clarify the difference, regional wall motion at infarcted area and non-infarcted area were examined quantitatively by exercise radionuclide ventriculography in 23 patients with MI. MI group consisted of 13 patients with isolated left anterior descending coronary artery (LAD) lesion and 10 patients with isolated right coronary artery (RCA) lesion without residual ischemia, and was compared to 12 normal controls (NC) and also to 12 patients with multivessel (MV) lesions. Left ventricular ejection fraction (EF) and regional EF (REF) as parameters of amplitude, and standard deviation (SD) of mean of left ventricular phase angle, regional SD (RSD) as parameters of asynchrony were obtained. At rest, infarcted area showed significant decrease in REF and increase in RSD but non-infarcted area in LAD group showed significant decrease in REF. MI group revealed increase in EF and REF, even at infarcted area significantly during exercise, but LAD group showed less increase in EF than RCA group. MI group had no significant changes in SD and RSD during exercise. MV group had significant increase in SD but no significant changes in EF during exercise. At peak exercise, non-infarcted area in RCA group showed the same degree of increase in REF as the same segments in NC. But non-infarcted area in LAD group showed significantly less increase in REF than the same segments in NC. In conclusion, the difference in response of EF between anterior MI and inferior MI was greatly related with REF at non-infarcted area rather than infarcted area.
PracticeClinical medicine
KeywordsSingle vessel myocardial infarction, Site of infarction, Gated radionuclide ventriculography, Exercise stress, Wall motion.

【全文PDF】