Japanese
Title心電図同期心プールシンチグラフィによる左室圧・容量曲線の作成と心機能解析 - リストモードデータ・生体アナログデータの順方向および逆方向編集法の開発 -
Subtitle原著
Authors稲垣末次*, 杉原洋樹*, 中川達哉*, 片平敏雄*, 窪田靖志*, 勝目紘*, 足立晴彦*, 中川雅夫*, 松井進**, 池谷憲生**, 水川勝海**
Authors(kana)
Organization*京都府立医科大学第二内科, **東芝メディカル
Journal核医学
Volume26
Number2
Page177-187
Year/Month1989/2
Article原著
Publisher日本核医学会
Abstract「要旨」 左室圧・容量曲線(PV-loop)の作成・解析を安全, 容易, かつ高精度にするため, 心電図同期心プールシンチによる新システムを開発した. 本法をアンジオテンシンII投与による昇圧負荷に応用し, 各種心疾患の後負荷増大時の反応を検討した. 対象は各種心疾患の15名. 心プール法は放射性同位元素管理区域内に設置された心カテーテル検査室で施行した. 同時収集した画像データおよび左室圧を, 心電図R波を基準に, 順方向および逆方向に編集し, データ精度の高いPV-loopを作成した. 本法の施行は造影剤が不要, 安全かつ容易で, 昇圧時の反復検査も短時間に可能であった. また心機能指標の算出, PV-loopの時相別表示などの解析処理が簡易化された. Emaxは正常例・狭心症で高値で, 心筋梗塞症や僧帽弁閉鎖不全症で低下した. 従来, PV-loopは作成・解析が煩雑なため臨床応用が制限されていたが, 本法は各種負荷試験に適し, 重症心不全例や壁運動異常例にも適用可能で, かつ多彩な解析処理を容易にする実用的方法であり, 広範な応用が期待される.
Practice臨床医学：一般
KeywordsPressure-volume loop, Radionuclide ventriculography, Left ventricle, Ventricular work, Emax
English
TitleLeft Ventricular Pressure-Volume Diagram Determined by Forward and Backward Formatting of Radionuclide Ventriculography and Analog Pressure Data
Subtitle
AuthorsSuetsugu INAGAKI*, Hiroki SUGIHARA*, Tatsuya NAKAGAWA*, Toshio KATAHIRA*, Yasushi KUBOTA*, Hiroshi KATSUME*, Haruhiko ADACHI*, Masao NAKAGAWA*, Kazuo IKEGAYA**, Susumu MATSUI**, Katsumi MIZUKAWA**
Authors(kana)
Organization*Second Department of Internal Medicine, Kyoto Prefectural University of Medicine, **Toshiba Medical Co.,Ltd
JournalThe Japanese Journal of nuclear medicine
Volume26
Number2
Page177-187
Year/Month1989/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Pressure-volume (PV) loop is of great value for the assessment of left ventricular (LV) function, but its clinical application has been limited by methodological complexity. A new system was developed to make accurate loop with simplified procedure, and was applied to clinical and interventional study. The system constitutes of a mobile gamma camera, a poly-amplifier and a data processor (GMS-550U, Toshiba Medical) installed in cardiac catheterization labo for simultaneous raw data handling and successive analysis. Since LV time activity curve (TAC) obtained by usual ECG gating is not fully reliable for a entire cardiac cycle, radionuclide data acquired in list mode was formatted forward and backward from ECG trigger together with analog data of LV pressure, ECG and PCG. PV loops were drawn in 10 patients (OMI, AP, MR, HCM) and 5 normals before and after infusion of angiotensin-II (AII), and Emax and LV work (systolic;SW, diastolic;DW, net;NW=SW-DW) were measured. Radionuclide ventriculography was safely performed with cardiac catheterization even in patients with congestive heart failure. Satisfactory PV loops were obtained by the advantage of simultaneous acquisition of RNV and analog data. Changes of ECG, PCG, volume, pressure and derived indices through one cardiac cycle were readily comparable each other. Peak LV pressure (mmHg) increased from 134 to 159 and then 182 by infusion of AII, but no change in heart rate was observed Emax was higher in normals and AP (mean 1.96 mmHg/ml/m2) than in OMI and MR (range of 0.85-1.36). SW increased in response to rise of LV pressure in all subjects. NW increased in normals and AP, but decreased in OMI and MR with relative increase in DW. In conclusion, this new system is feasible for repetitive studies under drug intervention, since it makes accurate PV loop under physiologic state, i.e. without pacing and volume overloading. Variable changes of SW, DW, and NW in response to afterloading were clarified, which may be useful for the evaluation of cardiac reserve in normal and diseased heart.
PracticeClinical medicine
KeywordsPressure-volume loop, Radionuclide ventriculography, Left ventricle, Ventricular work, Emax

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