Japanese
Title心不全の重症度評価におけるI-123MIBG心筋シンチグラフィの意義 - 拡張型心筋症での検討 -
Subtitle原著
Authors両角隆一*, 石田良雄*, 谷明博*, 佐藤秀幸*, 松山泰三*, 尾崎仁*, 堀正二*, 北畠顕*, 鎌田武信*, 木村和文**, 中村幸夫***, 小塚隆弘***
Authors(kana)
Organization*大阪大学第一内科, **バイオメディカル教育センター, ***中央放射線部
Journal核医学
Volume28
Number3
Page271-280
Year/Month1991/3
Article原著
Publisher日本核医学会
Abstract「要旨」心不全の重症度評価におけるI-123MIBG心筋シンチグラフィの意義を, 拡張型心筋症6例, アドリアマイシン心筋症1例の心不全群7例, および労作性狭心症 (PTCA後) 1例, 健常人1例の正常心機能群2例, 計9例において検討した. I-123MIBG (111MBq) 投与後15分 (初期像) と4時間後 (後期像) に心筋SPECTおよび臥位正面よりのPlanar像を連続して撮像した. SPECT像より, 心不全群のI-123MIBG像の特徴として, 心筋のMIBG集積低下と, 約4時間の経過における心筋からのMIBG washoutの亢進が認められ, 心筋norepinephrine (NE) storeの低下 (NE含量の低下) を反映したものであると考えられた. そこで, これらの所見が心不全の重症度評価に役立つかを検討するため, planar像において, 後期像における心筋 / 上縦隔MIBG集積比 (H / B) と心筋MIBG集積の初期像から後期像への変化率 (%washout rate (%WR)) を計測し, 心不全重症度 (安静時左室駆出率 (EF) および運動耐容能 (max VO2, VO2 at anaerobic threshold : AT)) との関係をみた. その結果, H / Bの低下, %WRの上昇例ほどEFはより低値を示し, また運動負荷時の心拍応答の減弱とともに運動耐容能の低下がより強いことが観察された. 以上の結果より, I-123MIBG心筋シンチグラフィによる心筋NE含量の推定が, 慢性心不全患者の重症度評価に有用な方法であることが示唆された.
Practice臨床医学：一般
KeywordsI-123 metaiodobenzylguanidine, congestive heart failure, dilated cardiomyopathy.
English
TitleClinical Significance of I-123 MIBG Myocardial Scintigraphy for Evaluating the Severity of Congestive Heart Failure
SubtitleOriginal Articles
AuthorsTakakazu MOROZUMI*, Yoshio ISHIDA*, Akihiro TANI*, Hideyuki SATO*, Taizo MATSUYAMA*, Hitoshi OZAKI*, Masatsugu HORI*, Akira KITABATAKE*, Takenobu KAMADA*, Kazufumi KIMURA**, Yukio NAKAMURA**, Takahiro KOZUKA***
Authors(kana)
Organization*The First Department of Medicine, **Division of Nuclear Medicine and Department of Radiology, Osaka University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume28
Number3
Page271-280
Year/Month1991/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] We studied the significance of I-123 MIBG (metaiodobenzylguanidine) myocardial scintigraphy for evaluating the severity of congestive heart failure. I-123 MIBG scintigraphy was performed in 7 patients with congestive heart failure (CHF) of NYHA class I - III (6 with dilated cardiomyopathy and 1 with Adriamycine cardiomyopathy) and in 2 normals. The SPECT and anterior planar myocardial images were obtained 15 minutes after (initial images) and 4 hours after (delayed images) an injection of I-123 MIBG (111MBq). Compared with normals, patients with CHF demonstrated (1) low myocardial uptake and (2) rapid myocardial washout of I-123 MIBG, indicating myocardial sympathetic disarrangement. Then, quantitating these abnormalities with the heart to upper mediastinum uptake ratio (H / B) and the percent washout rate (%WR) during 4 hours, respectively, we compared these two indices with LV ejection fraction (EF) at rest measured by echocardiography and exercise capacity (max VO2 and VO2 at anaerobic threshold (AT)) determined with respiratory gas exchange analysis during maximal bicycle exercise. H / B was lower and %WR was greater in patients with CHF than in normals. H / B correlated with EF (r = 0.77, p < 0.05) and AT (r = 0.74, p < 0.05). On the other hand, %WR significantly correlated with EF (r = 0.79, p < 0.05), max VO2 (r = -0.74, p < 0.05) and AT (r = -0.81, p < 0.05). Thus, H / B and %WR were closely related to the severity of CHF. These results suggest that I-123 MIBG myocardial scintigraphy and the quantitative analysis of I-123 MIBG myocardial uptake provide useful information about the severity of CHF.
PracticeClinical medicine
KeywordsI-123 metaiodobenzylguanidine, congestive heart failure, dilated cardiomyopathy.

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