| Japanese |
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| Title | 肥大型心筋症の運動負荷タリウム心筋シンチグラムにおける一過性左室内腔拡大所見の検討 |
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| Subtitle | 《原著》 |
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| Authors | 杉原洋樹*, 志賀浩治*, 馬本郁男*, 原田佳明*, 片平敏雄*, 中川達哉*, 中村隆志*, 松原欣也*, 寺嶋知史*, 東秋弘*, 勝目紘*, 中川雅夫* |
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| Authors(kana) | |
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| Organization | *京都府立医科大学第二内科 |
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| Journal | 核医学 |
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| Volume | 27 |
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| Number | 11 |
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| Page | 1281-1289 |
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| Year/Month | 1990/11 |
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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」肥大型心筋症50例を対象として運動負荷タリウム心筋シンチグラムにおける一過性左室内腔拡大所見を検討した. SPECT心筋短軸像の中央部位のイメージにおいて中心より10度毎36本の放射状直線をひき, 各直線上のタリウム活性の最高カウントの点を結びそれにより囲まれる面積を算出した. 負荷直後の面積A(EX)と3時間後の同部位の面積A(RD)の比A(EX)/A(RD)を運動負荷による左室一過性拡大の指標(Transient Dilation Index: TDI)とした. 肥大型心筋症の24例(48%)においてTDI>1.11(コントロールのmean+2SD)を示した. 胸痛歴を有する例および運動負荷心電図陽性例はTDI>1.11を示す群に多かった. TDI>1.11の10例において施行した心プールシンチグラフィでは安静時と運動負荷終了10分後の拡張末期カウントおよび収縮末期カウントに差はなかった. 以上より, 肥大型心筋症における本所見は見かけ上の内腔拡大であり, 一過性の心内膜下虚血による心内膜下のタリウムの取り込み低下の反映と考えられ, TDIはこの定量的指標として有用である. |
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| Practice | 臨床医学：一般 |
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| Keywords | Hypertrophic cardiomyopathy, Exercise Thallium-201 scintigraphy, Transient dilation, Subendocardial ischemia. |
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| English |
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| Title | Assessment of Transient Dilation of the Left Ventricular Cavity in Patients with Hypertrophic Cardiomyopathy by Exercise Thallium-201 Scintigraphy |
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| Subtitle | - Original Articles - |
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| Authors | Hiroki SUGIHARA, Kouji SHIGA, Ikuo UMAMOTO, Yoshiaki HARADA, Toshio KATAHIRA, Tatsuya NAKAGAWA, Kinya MATSUBARA, Takashi NAKAMURA, Satoshi TERASHIMA, Akihiro AZUMA, Hiroshi KATSUME, Masao NAKAGAWA |
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| Authors(kana) | |
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| Organization | Second Department of Medicine, Kyoto Prefectural University of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 27 |
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| Number | 11 |
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| Page | 1281-1289 |
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| Year/Month | 1990/11 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Exercise Tl scintigraphy (EX-Tl) provides a noninvasive means of identifying myocardial perfusion abnormalities in patients (pts) with hypertrophic cardiomyopathy (HCM). We have noted that some pts with HCM have a pattern of transient dilation of the left ventricle (LV) on the immediate post exercise images as compared with 3 hour redistribution images. We presumed that left ventricular dilation was caused by subendocardial hypoperfusion. So we studied transient dilation of the LV in 50 pts with HCM and 20 controls (C). Initial and delayed conventional short tomographic images were obtained after reconstruction of 30 projections acquired over 180 degrees. Thirty six radii every 10 degrees were generated from the center of the middle myocardial images of the short axis. An area surrounded by the thirty six points of maximal count on each radius was calculated in initial and delayed images. Transient Dilation Index (TDI) as an index of dilation was determined by dividing an area in initial image by an area in delayed image. TDI in pts with HCM was larger than that in C. Pts with HCM were classified into the two groups, Group A: TDI>1.11 (mean+2 SD in C), 24 pts, Group B: TDI>1.11, 26 pts. Frequency of pts with history of chest pain in Group A was higher than that in Group B, and frequency of pts with positive exercise ECG in Group A was higher than that in Group B. End diastolic volume in Group B did not change 10 minutes after exercise by radionuclide ventriculography. In conclusion, transient dilation of the LV in pts with HCM by EX-Tl is in appearance, and may reflect subendocardial ischemia. |
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| Practice | Clinical medicine |
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| Keywords | Hypertrophic cardiomyopathy, Exercise Thallium-201 scintigraphy, Transient dilation, Subendocardial ischemia. |
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