| Japanese |
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| Title | I-123 MIBGシンチグラフィにより, 非梗塞心筋虚血による交感神経denervationが示唆された一症例 |
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| Subtitle | 《症例報告》 |
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| Authors | 両角隆一*, 石田良雄*, 谷明博*, 田内潤*, 堀正二*, 北畠顕*, 鎌田武信*, 木村和文**, 中村幸夫***, 小塚隆弘*** |
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| Authors(kana) | |
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| Organization | *大阪大学医学部第一内科, **バイオメディカル教育センター, ***附属病院中央放射線部 |
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| Journal | 核医学 |
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| Volume | 27 |
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| Number | 7 |
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| Page | 735-740 |
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| Year/Month | 1990/7 |
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| Article | 報告 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」病歴, 心電図, 左室造影, Tl-201心筋シンチグラフィ, 心エコー図の結果より心筋梗塞の合併がないと考えられた労作性狭心症患者(右冠動脈一枝病変例)において, PTCAによる冠血行再建術後2週の時期に, Tl-201, I-123 MIBGシンチグラフィを施行した. この結果, Tl-201像は正常像を示したが, I-123 MIBG像の初期像ならびに4時間後の晩期像において, 下壁領域の広範な欠損像が観察された. PTCAによる冠血流改善の後においても, 非梗塞部である下壁にかかる欠損がみられたことは, 右冠動脈狭窄による虚血状態によって生じたNE storeの枯渇(denervaion)が依然持続していることを示すと考えられた. 本症例は, 高度心筋虚血の持続によって, 心筋梗塞に至る以前に, 交感神経傷害が先行して生じる場合があることを示す興味ある症例と考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | I-123 metaiodobenzylguanidine, Adrenergic Denervation, Myocardial Ischemia. |
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| English |
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| Title | Myocardial Adrenergic Derangement due to Myocardial Ischemia : Decreased Myocardial Uptake of I-123 Metaiodobenzylguanidine after PTCA in a Patient with Effort Angina |
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| Subtitle | - Case Reports - |
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| Authors | Takakazu MOROZUMI*, Yoshio ISHIDA*, Akihiro TANI*, Jun TANOUCHI*, Masatsugu HORI*, Akira KITABATAKE*, Takenobu KAMADA*, Kazufumi KIMURA**, Yukio NAKAMURA***, Takahiro KOZUKA*** |
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| Authors(kana) | |
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| Organization | *The First Department of Medicine, **Biomedical Education Center, ***Department of Radiology, Osaka University Medical School |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 27 |
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| Number | 7 |
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| Page | 735-740 |
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| Year/Month | 1990/7 |
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| Article | Report |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Regional denervation of adrenergic nerves has been clinically demonstrated in patients with myocardial infarction using I-123 metaiodobenzylguanidine (MIBG) scintigraphy. However, it is not clarified whether adrenergic denervation can be induced by prolonged myocardial ischemia as well as by myocardial infarction. This case with effort angina had 99% stenosis of right coronary artery and showed perfusion defects at inferior myocardial regions in the exercise thallium-201 study. However, inferior wall motion estimated by echocardiography and left ventriculography was normal indicating the absence of myocardial infarction. After percutaneous transluminal coronary angioplasty for the stenosis, I-123 metaiodobenzylguanidine (MIBG) and thallium-201 (Tl-201) myocardial scintigraphies were done to estimate the therapeutic effect of PTCA. Although the Tl-201 study during exercise showed normal findings indicating the success of PTCA, marked defects was detected at inferior myocardial regions in the I-123 MIBG studies just after and 4 hours after an intravenous injection of I-123 MIBG. These results suggest that adrenergic derangement may be induced by prolonged myocardial ischemia and may persist for periods even though myocardial perfusion is normalized. |
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| Practice | Clinical medicine |
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| Keywords | I-123 metaiodobenzylguanidine, Adrenergic Denervation, Myocardial Ischemia. |
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