| Japanese |
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| Title | Tl-201心筋像が病態評価に有用で心移植に至った拡張型心筋症の一例 |
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| Subtitle | 症例報告 |
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| Authors | 田中健*, 相澤忠範*, 加藤和三*, 小笠原憲*, 桐谷肇*, 岡本淳* |
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| Organization | *心臓血管研究所 |
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| Journal | 核医学 |
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| Volume | 28 |
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| Number | 1 |
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| Page | 83-90 |
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| Year/Month | 1991/1 |
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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」Tl-201心筋像と肺血流像が病態把握に有用で心移植の適応につながった40歳男性の拡張型心筋症を経験した. 心不全のため1988年12月に初回入院となり, 翌月退院となった. しかし89年8月に再入院となり, 小康状態となった10月初旬において心胸比55%, 超音波像LVDd / Ds = -67 / 58で, 心カテーテル所見はLVEF = 37%, PA = 55 / 27mmHg, CI = 1.3L/mM2であった. この後も治療抵抗性で倦怠感の増悪や体重の持続的低下が認められ, 心室細動も生じた. 経過中胸部写真や超音波像は著変を示さなかった. Tl-201心筋像の前壁と下壁に認めた取り込み低下領域はMIBG像では放出昂進を示し経過中Tl-201の取り込みは悪化し欠損となった. 中隔では取り込み低下の増悪とMIBG像の放出昂進を, また抗心筋ミオシン抗体の取り込みを認めた. 肺血流像も悪化し下肺野肺血流の減少が認められた. これらの所見より退院は困難で現時点で心移植の適応があると考えるに至った. 1990年6月1日に心移植を受け, その後の経過は良好である. |
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| Practice | 臨床医学：一般 |
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| Keywords | Dilated cardiomyopathy, Tl-201 myocardial SPECT images, Tc-99m MAA pulmonary perfusion images, Heart transplantation. |
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| English |
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| Title | Tl-201 Myocardial Images in a Patient with Dilated Cardiomyopathy, who Finally Received Heart Transplantation |
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| Authors | Takeshi TANAKA, Tadanori AIZAWA, Kazuzo KATOU, Ken OGASAWARA, Hajime KIRIGAYA, Kiyoshi OKAMOTO |
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| Authors(kana) | |
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| Organization | The Cardiovascular Institute |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 28 |
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| Number | 1 |
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| Page | 83-90 |
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| Year/Month | 1991/1 |
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| Article | Report |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] The patient responded to treatment at the first onset of heart failure but gradually became irresponsive to treatment, experiencing fatigue and malaise as the chief complaints and suffering from gradually progressive decrease in exercise capacity and body weight. Dose of DOA gradually increased to maintain well clinical state of the patient. Unusual for heart failure, he had bradycardia as the basal rhythm without showing a tendancy for tachycardia. Cardiac catheterization revealed pulmonary hypertension and low cardiac output, however, left ventricular ejection fraction was 37%. There were no notable changes in ultrasonic cardiogram or CTR through the clinical course. Tl-201 myocardial images and pulmonary perfusion images showed gradual worsening corresponding to progressive worsening of clinical state. From these findings, the patient was determined as a candidate for heart transplantation. |
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| Practice | Clinical medicine |
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| Keywords | Dilated cardiomyopathy, Tl-201 myocardial SPECT images, Tc-99m MAA pulmonary perfusion images, Heart transplantation. |
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