Japanese
TitlePTCR例の心電図QS領域における心筋viability
Subtitle《原著》
Authors田中健*, 相澤忠範*, 加藤和三*, 小笠原憲*, 桐ケ谷肇*, 岡本淳*
Authors(kana)
Organization*心臓血管研究所
Journal核医学
Volume27
Number11
Page1247-1253
Year/Month1990/11
Article原著
Publisher日本核医学会
Abstract「要旨」再灌流療法を施行した初回前壁心筋梗塞20例の梗塞部Tl-201摂取率をTl-201心筋SPECT短軸像のプロフィールカーブより求め心筋viabilityの指標として検討した. 対象を慢性期左心駆出率(EF)が50%以上の心機能保持群(A群, 11例EF; 62±10%)と50%未満の心機能低下群(B群, 9例EF; 40±7%)とした. 梗塞部Tl-201摂取率はA群では65±7%で正常より低く, B群の48±7%より高値を示した(p<001). 梗塞範囲は214±83度と243±45度で差を認めなかった. A群ではV 1-3のQSは2例, V 1-4のQSは8例, V 1-5のQSは1例で, B群ではそれぞれ1例, 7例, 1例であった. 急性期におけるmax GOTはA群322±182 B群651±382であった(p<0.05). 梗塞部Tl-201摂取率の差が両群間の心機能の差を, また心筋viabilityの差を示すと考えられた. 梗塞部心筋viability評価に梗塞部Tl-201摂取率は有用と考えられた.
Practice臨床医学：一般
KeywordsMyocardial viability, Tl-201 myocardial SPECT images QS waves in ECG.
English
TitleMyocardial viability in QS Region after PTCR
Subtitle- Original Articles -
AuthorsTakeshi TANAKA, Tadanori AIZAWA, Kazuzo KATOU, Ken OGASAWARA, Hajime KIRIGAYA, Kiyoshi OKAMOTO
Authors(kana)
OrganizationThe Cardiovascular Institute
JournalThe Japanese Journal of nuclear medicine
Volume27
Number11
Page1247-1253
Year/Month1990/11
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractMyocardial viability after PTCR in patients with first anterior myocardial infarction was studied one month after the onset of acute myocardial infarction by profile curve of Tl-201 coronal myocardial SPECT images. Patients were devided into two groups according to left ventricular ejection fraction (EF), i.e. group A (EF more than 50%; 11 cases, EF; 62+-10%) and group B (EF less than 50%; 9 cases, EF; 40 7%). Patients in group A showed an increase in serum GOT at the acute phase of acute myocardial infarction (322+-182 IU), decreased %Tl-201 uptake in QS region (65+-7%) significantly less than the normal range, large size of region of infarction (214+-83 degree) and abnormal QS in ECG (V1-3QS; 2 cases, V1-4QS; 8 cases, V1-5QS; 1 case). Improvement of wall motion in region of infarction was noted in 9 cases. Patients in group B showed an increase in serum GOT (651+-382 IU p; ns), %Tl-201 uptake in QS region (48+-7% p>0.001) significantly less than the %Tl-201 uptake in group A, size of defects (243+-45 p; ns) and abnormal QS in ECG (V1-3QS; 1 case, V1-4QS; 7 cases V1-5QS; 1 case). Improvement of wall motion was noted in 2 cases. The study showed that %Tl-201 uptake in region of infarction in patients with well EF was significantly more than that in patients with depressed EF. Mechanism of mainting well EF after PTCR was suggested as the following, i.e. in the region released from severe ischemic attack part of myocardium resulted in necrosis, accompanying elevation of serum enzyme and appearance of QS, though part of myocardium might be salvaged from necrosis and contribute to EF in chronic phase. It has been generally thought that abnormal QS waves noted in anterior chest leads of ECG in chronic phase indicated transmural myocardial infarction in the anterior region. From this study it was conculuded that QS region with %Tl-201 more than 50% did not generally correspond to transmural myocardial necrosis and that for estimation of myocardial viability %Tl-201 uptake might be more useful than ECG.
PracticeClinical medicine
KeywordsMyocardial viability, Tl-201 myocardial SPECT images QS waves in ECG.

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