| Japanese |
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| Title | バイパス術前後における心機能評価 : 携帯型持続心機能モニターを用いて |
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| Subtitle | 原著 |
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| Authors | 滝淳一*, 村守朗*, 中嶋憲一*, 分校久志*, 谷口充*, 松成一朗*, 川筋道雄**, 利波紀久*, 久田欣一* |
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| Organization | *金沢大学医学部核医学科, **第一外科 |
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| Journal | 核医学 |
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| Volume | 28 |
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| Number | 11 |
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| Page | 1313-1320 |
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| Year/Month | 1991/11 |
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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」CdTe検出器を用いた携帯型持続心機能モニター(VEST)にてバイパス術前後での運動負荷に対する心機能の経時的評価を試みた. 虚血性心疾患39名(男性30名, 女性9名, 平均年齢57±8歳, 23例の陳旧性心筋梗塞(OMI)を含む)を対象とした. 平均バイパス数は2.7本であった. 負荷中のEF変化は上昇型(A型), 上昇下降型(B型), 不変型(C型), 下降型(D型)に分類された. 術前A, B, C, D型はそれぞれ4, 2, 12, 21例で, 術後18, 10, 9, 2例へと改善を示した. 安静時から最大負荷時へのEF変化(ΔEF)および負荷後オーバーシュート(OS)へのAEFは, それぞれ-6.4±8.8%から5.0±7.4%(p<0.001), 9.9±5.2%から14.9±5.3%(p<0.001)へと増加し, またOSへの時間も162±86秒から80±48秒(p<0.001)へ短縮した. 術前A, B型とC, D型の負荷後EFのOSは, 前者でより早くかつ大きく上昇し, EF-OSは負荷中の心機能を反映するものと考えられた. またOMI, 非OMI群を比較すると, 術後OMI群ではEF-OSまでの時間は非OMI群と同様に改善したが, OSでのEFの上昇度は有意な改善を示さず, OMIによる心筋障害によるEF上昇制限が示唆された. |
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| Practice | 臨床医学：一般 |
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| Keywords | Ambulatory ventricular function monitor, Coronary artery bypass grafting, Left ventricular function, Ischemic heart disease. |
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| English |
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| Title | Cardiac Response to Exercise before and after Coronary Artery Bypass Grafting : Evaluation by Continuous Ventricular Function Monitor |
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| Authors | Junichi TAKI*, Akira MURAMORI*, Kenichi NAKAJIMA*, Hisashi BUNKO*, Mitsuru TANIGUCHI*, Ichiro MATSUNARI*, Michio KAWASUJI**, Norihisa TONAMI*, Kinichi HISADA* |
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| Authors(kana) | |
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| Organization | *Department of Nuclear Medicine, **Second Department of Surgery, Kanazawa 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 | 11 |
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| Page | 1313-1320 |
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| Year/Month | 1991/11 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]Cardiac response to exercise was evaluated with continuous ventricular function monitor (VEST) with cadmium telluride detector. Thirty-nine patients (30 male and 9 female, aged 57 +- 8, 23 had old myocardial infarction) were monitored with VEST during and after supine ergometer exercise before and 4 weeks after coronary artery bypass grafting (CABG). Left ventricular ejection fraction (EF) responses were classified into 4 types; type A showed EF increase >5% till end of exercise, type B demonstrated initial increase followed by decrease in EF, type C revealed no significant EF change, type D showed continuous EF decrease. Before CABG, each EF response type A, B, C, and D consisted of 4, 2, 12, 21 patients respectively and after CABG each type included 18, 10, 9, 2. The EF change from rest to peak exercise (ΔEF-Ex) improved from -6.4 +- 8.8% to 5.0 +- 7.4% (p<0.001) after CABG. All patients showed rapid EF increase after exercise or "EF overshoot" (EF-OS). After CABG, the EF change from rest to EF-OS (ΔEF-OS) and time to EF-OS (T-OS) were improved from 9.9 +- 5.2% to 14.9 +- 5.3% (p<0.001) and 162 +- 86 sec to 80 +- 48 sec (p<0.001) respectively. Type A, B patients showed higher ΔEF-OS and shorter T-OS than type C, D patients, suggesting EF overshoot was contingent upon cardiac function during exercise. After CABG, in patients with myocardial infarction, T-OS shortened but ΔEF-OS showed less improvement than patients without infarction, suggesting loss of myocardium hampered EF-OS. |
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| Practice | Clinical medicine |
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| Keywords | Ambulatory ventricular function monitor, Coronary artery bypass grafting, Left ventricular function, Ischemic heart disease. |
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