Japanese
Title携帯用RI心機能モニター (VEST) による運動負荷時および負荷後の心機能の経時的変化の検討
Subtitle原著
Authors玉木長良*, Ishtiaque H.MOHIUDDIN*, 大草知子**, 大谷弘*, 不藤哲郎**, 林正隆**, 野原隆司**, 米倉義晴*, 神原啓文**, 河合忠一**, 小西淳二*
Authors(kana)
Organization*京都大学医学部放射線核医学科, **第三内科
Journal核医学
Volume26
Number3
Page399-408
Year/Month1989/3
Article原著
Publisher日本核医学会
Abstract「要旨」 冠動脈造影の施行された31例に, 携帯用RI心機能モニター (VEST) を用いて運動負荷前後の左心機能の経時的変化を解析した. まず安静坐位でのEFの変動を検討し, 6%以上のEFの変動を有意な変化とした. 運動負荷時のEFの変化は上昇 (A型), 上昇後下行 (B型), 不変 (C型), 上昇後ベースラインより低下 (D型), べースラインより低下 (E型) の5型に分類できた. 有意な冠動脈病変を持たない健常 (N) 例ではA型3例, B型2例, C型2例, D型1例で, 冠動脈疾患 (CAD) 例との重なり (おのおの5, 4, 4, 5, 3例) がみられた. しかしCADの中でもA, B型を示す例はすべて一枝病変例で, 負荷T1スキャンで再分布のない例 (63%) が多かった. 一方, 負荷終了からEFが最大に達する時間は, CAD例がN例に比べ有意に長く (1.88士1.24分 vs. 0.88 士 0.55分, p < 0.05), とりわけ多枝病変例で著しく延長していた. VESTは運動負荷前後の左心機能モニターに適しており, 負荷中のEFの低下および負荷後の回復遅延により, 虚血の重症度の推定が可能と考えられた.
Practice臨床医学：一般
KeywordsRadionuclide ventriculography, Ambulatory monitor, Ischemia, Ejection fracting, Exercise
English
TitleSerial Assessment of Cardiac Function During and After Exercise by an Ambulatory Ventricular Function Monitor (VEST)
Subtitle
AuthorsNagara TAMAKI*, Ishtiaque H.MOHIUDDIN*, Tomoko OHKUSA**, Hiroshi OHTANI*, Tetsuro FUDO**, Masataka HAYASHI**, Ryuji NOHARA**, Yoshiharu YONEKURA*, Hirofumi KAMBARA**, Chuichi KAWAI**, Junji KONISHI*
Authors(kana)
Organization*Department of Radiology and Nuclear Medicine, **The Third Division, Department of Internal Medicine, Kyoto University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume26
Number3
Page399-408
Year/Month1989/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Cardiac function was serially assessed during and after exercise by an ambulatory ventricular function monitor (VEST) in 31 patients who received coronary angiography. Based on the study of fluctuation during the baseline recording, >-6% change in ejection fraction (EF) was considered significant. The serial changes in EF during exercise was divided into 5 types, including continuous increase (type A), initial increase but return to the baseline (type B), no change (type C), initial increase but later decrease below the baseline (type D), and continuous decrease (type E). Among 8 normal subjects, their EF changes during exercise showed type A in 3, type B in 2, type C in 2, and type D in 1. Among 21 patients with coronary artery disease, the EF changes showed type A in 5, type B in 4, type C in 4, type D in 5 and type E in 3. Thus, there was a significant overlap in EF response between normal and coronary patients. However, every patient showing type A and B had single-vessel disease, and 63% of them had persistent thallium defect without redistribution. After the exercise, 29 patients showed rapid increase in EF. The time to the peak EF was significantly longer in coronary patients (1.88+-1.24 min) than that in normal cases (0.88+-0.55 min) (p < 0.05) particularly in patients with multi-vessel disease (2.22+-1.29 min). In addition, those showing type C, D or E tended to have a longer time to peak EF and more increase in EF after exercise than those showing type A or B. These data suggest that VEST is suitable for continuous measurement of cardiac function during and after exercise which provided valuable indices for assessment of severity of ischemia in coronary artery disease.
PracticeClinical medicine
KeywordsRadionuclide ventriculography, Ambulatory monitor, Ischemia, Ejection fracting, Exercise

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