| Japanese |
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| Title | 運動負荷時肺血液量変化よりみた冠動脈疾患の心機能評価 |
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| Subtitle | 原著 |
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| Authors | 富谷久雄* |
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| Authors(kana) | |
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| Organization | *千葉大学医学部内科学第三講座 |
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| Journal | 核医学 |
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| Volume | 26 |
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| Number | 3 |
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| Page | 385-398 |
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| Year/Month | 1989/3 |
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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」 冠動脈疾患の心機能評価を運動負荷中の肺血液量の変動から検討した. 対象は労作性狭心症を伴った陳旧性心筋梗塞 (M群) 25例, 労作性狭心症 (A群) 18例, 健常 (N群) 17例で, 運動負荷は定量負荷型臥位自転車エルゴメータによった. 運動中, 血圧, 心拍数, Swan-Ganzカテーテルによる肺動脈圧, 色素希釈法による心拍出量, 左室駆出分画 (EF) , 肺血液量を測定した. EFはTc-99m体内標識赤血球20mCiを用い, マルチゲート法により求めた. 肺血液量は, その心・肺プール像にて関心領域を右上・下肺野に設定しTc-99mの放射能の測定から求めた. 運動終了40分後にニトログリセリンを1錠舌下し5分後に同一の運動負荷試験を行った. その結果, (1)EFは運動によりN群で増加, M, A群では低下した. (2)運動時肺動脈拡張期圧 (PAd) はN群に比べM, A群で著明に上昇した. (3)肺血液量はN群で不変ないし軽度減少, M, A群で著明に増加した. (4)この増加はEFの低下度, 運動時PAdと, それぞれr = 0.68 (n = 60, p < 0.01), r = 0.83 (n = 43, p < 0.01) のよい相関があり, 左室機能障害による肺欝血を反映するものと考えられた. (5)ニトログリセリン舌下後の運動負荷では, PAdの上昇, 肺血液量の増加はともに抑制された. とくにA群で明らかであった. 以上より, 運動負荷時の肺血液量測定は非侵襲的に肺欝血の程度を知ることができ, 冠動脈疾患の心機能評価にきわめて有用であると考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Coronary artery disease, Exercise test, Pulmonary artery pressure, Pulmonary blood volume, Nitroglycerin |
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| English |
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| Title | Evaluation of the Cardiac Performance in Patients with Coronary Artery Disease by the Pulmonary Blood Volume Change in Exercise Testing |
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| Subtitle | |
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| Authors | Hisao TOMIYA |
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| Authors(kana) | |
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| Organization | The Third Departmnet of Internal Medicine, Chiba University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 26 |
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| Number | 3 |
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| Page | 385-398 |
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| Year/Month | 1989/3 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Evaluation of the cardiac performance was studied by the change of the pulmonary blood volume (PBV) during the exercise testing in 17 normal subjects (group N), 18 patients with angina pectoris (group A) and 25 with both old myocardial infarction and angina pectoris (group M). The exercise testing was performed by bicycle ergometer in supine position. Blood pressure, heart rate, cardiac output measured by dye dilution method, left ventricular ejection fraction (EF) by multi-gate method, pulmonary artery pressure by Swan-Ganz catheter and PBV was measured during exercise. PBV was estimated by the radioactivity of the systemically administered Tc-99m labeled RBC in the lung field. ROI was adjusted over the right upper and lower lung field. And also the effect of the nitroglycerin was examined. In the result, (1) EF at the peak exercise increased in group N but decreased in group A and M. (2) Increased pulmonary artery diastolic pressure at the peak exercise (PAd at exercise) was remarkably higher in group A and M than group N. (3) PBV was unchanged in group N, however, increased 9.6% in group A and 10.9% in group M. (4) Increased rate of PBV revealed good correlation with ΔEF (r = -0.68, p < 0.01) and PAd at exercise (r = 0.83, p < 0.01), and was considered as the pulmonary congestion due to left ventricular dysfunction. (5) After the sublingual administration of nitroglycerin, the increased PAd and PBV at the peak exercise was suppressed. Particularly, it was remarkable in group A. Then it was concluded that the noninvasive measurement of PBV during exercise could suggest the extent of the pulmonary congestion and was very useful for evaluation of the cardiac performance in coronary artery disease. |
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| Practice | Clinical medicine |
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| Keywords | Coronary artery disease, Exercise test, Pulmonary artery pressure, Pulmonary blood volume, Nitroglycerin |
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