| Japanese |
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| Title | 狭心症例におけるPTCAの治療効果の評価 - 運動負荷Tl-201心筋SPECTを用いて - |
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| Subtitle | 原著 |
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| Authors | 内孝* |
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| Organization | *東邦大学内科学第一講座 |
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| Journal | 核医学 |
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| Volume | 28 |
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| Number | 6 |
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| Page | 635-646 |
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| Year/Month | 1991/6 |
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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」PTCA成功症例に対しPTCA前後で運動負荷Tl-201心筋SPECT (Ex-SPECT) を施行し, 虚血検出および虚血心筋改善様式について検討した. 対象は狭心症 (AP) 132例で内43例はEx-SPECT, 冠動脈造影にて経時的観察を行った. PTCA前の虚血検出率は全例では85%であったが, %diameter stenosis (%DS) が90%以上の症例でのそれは100%であった. またPTCA後の虚血改善の検出率は90%であった. PTCA時測定したpressure gradient (PG) とwashout rate (WR) の間に良好な相関が認められ, WRも冠動脈狭窄領域の心筋灌流を反映することが示唆された. 遠隔期にもEx-SPECTにて観察した症例中, PTCA後も再分布が残存した症例は34例であり, この内59%に再狭窄が確認された. また再狭窄のなかった20例中5例ではPTCA 1週間後に比較し, 遠隔期でEx-SPECT上さらに改善が示された. 今回PTCA症例に対し施行したEx-SPECTは虚血性変化, 治療効果, 再狭窄などの評価に有用であった. また長期的観察により一部の症例ではPTCA後のhibernating myocardiumの存在が示唆された. |
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| Practice | 臨床医学：一般 |
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| Keywords | Tl-201 myocardial SPECT, Percutaneous transluminal coronary angioplasty (PTCA), Hibernating myocardium, Re-stenosis. |
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| English |
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| Title | Evaluation of Efficacy of PTCA in Patients with Angina Pectoris by Exercise Tl-201 Myocardial SPECT |
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| Subtitle | Original Articles |
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| Authors | Takashi UCHI |
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| Authors(kana) | |
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| Organization | First Department of Internal Medicine, Toho University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 28 |
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| Number | 6 |
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| Page | 635-646 |
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| Year/Month | 1991/6 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Exercise 201Tl single photon emission computed tomography (Ex-SPECT) was performed before and after percutaneous transluminal coronary angioplasty (PTCA) to detect ischemia and determine the response of the ischemic myocardium. In a series of 132 patients with angina pectoris, 43 were followed up by Ex-SPECT and coronary angiography. Before PTCA, ischemia was detected in 85% of the patients, and in all cases a diameter stenosis (%DS) of 90% or more was seen. After PTCA, 90% of the patients showed improvement of ischemia. An excellent correlation between the pressure gradient (PG) as determined during PTCA and the washout rate (WR) suggests that the WR can be used as a measure for myocardial perfusion in the areas related to coronary stenosis. During follow-up by Ex-SPECT, 34 patients were found with redistribution, and restenosis was present in 59% of these patients. In comparison with the images obtained one week after PTCA, a further improvement was confirmed by Ex-SPECT during follow-up in 5 of 20 patients without restenosis. Ex-SPECT proved to be of use in evaluating the response of the ischemic myocardium to PTCA, as well as the therapeutical effects and the degree of restenosis. Long-term follow-up revealed that some patients had areas of hibernating myocardium. |
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| Practice | Clinical medicine |
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| Keywords | Tl-201 myocardial SPECT, Percutaneous transluminal coronary angioplasty (PTCA), Hibernating myocardium, Re-stenosis. |
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