| Japanese |
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| Title | 負荷心RIアンギオグラフィによるPTCA後早期ならびに遠隔期における心機能および局所壁動態についての検討 - 冠動脈完全血行再建術の効果 - |
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| Subtitle | 原著 |
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| Authors | 吉野孝司* |
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| Authors(kana) | |
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| Organization | *大阪府立成人病センター循環動態診療科 |
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| Journal | 核医学 |
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| Volume | 26 |
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| Number | 4 |
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| Page | 487-498 |
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| Year/Month | 1989/4 |
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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」 PTCAによる冠動脈完全血行再建 (CR) の運動負荷時の心機能に対する効果を検討する目的でCRに成功した23例に術前, 術後早期 (2週間) と遠隔期 (7.7か月) に第一循環時法によるRIアンギオグラフィ (FRNA) を施行した. 対象を遠隔期の造影よりCRの得られた群 (I群 : n = 14) とCRの得られなかった群 (II群 : n = 9) に分け, 運動負荷に伴う心血行動態諸指標 (左室駆出率 : EF, 左室拡張および収縮末期容量係数 : EDVI, ESVI, 収縮期血圧/左室収縮末期容量係数 : SP/ESVI) の変化を検討し, あわせて正常群 (C群 : n = 7) と比較検討した. さらに, 左前下行枝の拡大例 (n = 15) における拡大持続群 (ILAD群 : n = 9) と再狭窄群 (IILAD群 : n = 6) の壁動態 (局所駆出率 : REF) の改善度を検討し以下の結論を得た. 1) 運動負荷に対する心機能の反応は, I群では術後早期EF, EDVI, ESVI, SP/ESVIの全てが有意に改善し遠隔期まで維持された. II群では術後早期においてすでに改善が不十分であり, かつ遠隔期では術前と有意差はなかった. 2) 遠隔期のEFとSP/ESVIの改善度はI群でもC群に比べ有意に低値であった. 3) 運動負荷に対する壁動態の変化は, ILAD群では術後早期および遠隔期ともに有意に改善した. IILAD群ではいずれの時期との間にも有意差はなかった. 以上の結果より, FRNAはPTCAによる冠動脈血行再建度を評価するために有用であり, PTCA後の指針を決定するのに有用な非侵襲的検査法であることが示された. |
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| Practice | 臨床医学：一般 |
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| Keywords | Complete revascularization, PTCA, LV function, First-pass radionuclide angiography |
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| English |
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| Title | Serial Changes in Left Ventricular Global and Regional Function During Exercise After Percutaneous Transluminal Coronary Angioplasty ; Effect of Complete Coronary Revascularization |
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| Subtitle | Original Articles |
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| Authors | Takashi YOSHINO |
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| Authors(kana) | |
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| Organization | Department of Circulatory Dynamics, The Center for Adult Diseases |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 26 |
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| Number | 4 |
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| Page | 487-498 |
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| Year/Month | 1989/4 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] In order to evaluate the effect of complete coronary revascularization (CR) with PTCA on global LV function at rest and during exercise, EF, LV volumes and systolic blood pressure/end-systolic volume index (SP/ESVI) were assessed in 23 patients with CR before, 14 days after (early FU) and 4 to 12 months after PTCA (late FU) by first-pass radionuclide angiography (FRNA) . The subjects were divided into 3 groups in this study, G-I which consisted of 14 patients with continued CR, G-II, 9 patients with discontinued CR due to restenosis and G-C, 7 normal subjects. To further assess anterior (Ant) and apical (Ap) regional EFs, 15 patients with dilatation of left anterior descending artery were subdivided into 9 patients with continued success (G-I LAD) and 6 patients with restenosis (G-II LAD) . Exercise-induced global LV dysfunction improved significantly both at early FU and late FU in G-I, however improved insignificantly at early FU and did not change at late FU in G-II. Even response to exercise (ΔEF, %ΔSP/ESVI) at late FU in G-I was significantly (p < 0.05) less than those in G-C. Regional dysfunction during exercise already improved significantly (Ant : p < 0.05, Ap : p < 0.01) at early FU in G-I LAD, but did not improve sufficiently in G-II LAD. In conclusion, FRNA may be useful for the assessment of completeness of coronary revascularization by PTCA and may give guidelines for repeat angiography. |
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| Practice | Clinical medicine |
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| Keywords | Complete revascularization, PTCA, LV function, First-pass radionuclide angiography |
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