Japanese
Title心プールシンチグラフィを用いたPTMC前後の心肺機能評価
Subtitle≪原著≫
Authors汲田伸一郎*,**, 西村恒彦*, 林田孝平*, 植原敏勇*, 内本定彦***, 石蔵文信***, 永田正毅***, 宮武邦夫***
Authors(kana)
Organization*国立循環器病センター放射線診療部, **現日本医科大学放射線科, ***国立循環器病センター心臓内科
Journal核医学
Volume28
Number12
Page1439-1445
Year/Month1991/12
Article原著
Publisher日本核医学会
Abstract「要旨」経皮経静脈的僧帽弁交連切開術(PTMC)を施行した僧帽弁狭窄(MS)症例12例に対し, 施行前(PRE), 施行後1週間(1W), 1か月(1M)で核医学的手法を用いた心肺機能評価を行った. 99mTc-RBCを用いた心プールシンチグラフィより求めたLVEF (%), RVEF (%)はPTMC前後で差異を認めなかったが, 左室の早期拡張期指標である1/3FF (%), 1/3 FRmはPTMC後にて有意な改善を認めた(1/3 FF : PRE vs. 1M ; p<0.01, 1/3 FRm : PRE vs. 1W, 1M ; p<0.01). 心プールシンチグラフィ施行後, 坐位の被験者より算出した肺血液分布比(PBVR (U/L))は1Mにて有意な低下を示し(p<0.01), 肺血液分布の改善(上肺血液分布低下)を指摘しえた. また, 呼気ガス分析器と携帯型RI心機能測定装置(VEST)を併用した坐位自転車エルゴメータによる運動負荷を施行した際, 嫌気性代謝閾値(ml/min/kg)はPTMC後で有意に改善(PRE vs. 1W, 1M ; p<0.01)した. 軽量負荷におけるLVEF (%), CO (l/min)も有意な増加を示し(LVEF (15W) : PRE vs. 1M ; p<0.05, CO (15, 30 W) : PRE vs. 1W, 1M ; p<0.05), PTMC後における運動耐容能の改善を把握しえた. 本法は非観血的なPTMC前後の心肺機能評価法として臨床的に有用であると考える.
Practice臨床医学：一般
KeywordsCardiac blood pool scintigraphy, Mitral stenosis, Percutaneous transvenous mitral commissurotomy.
English
TitleHemodynamic Assessment before and after PTMC by Using Cardiac Blood Pool Scintigraphy
Subtitle- Original Articles -
AuthorsShin-ichiro KUMITA*,**, Tsunehiko NISHIMURA*, Kohei HAYASHIDA*, Toshiisa UEHARA*, Sadahiko UCHIMOTO***, Huminobu ISHIKURA***, Seiki NAGATA***, Kunio MIYATAKE***
Authors(kana)
Organization*Department of Radiology, ***Department of Cardiology, National Cardiovascular Center, **Department of Radiology, Nippon Medical School
JournalThe Japanese Journal of nuclear medicine
Volume28
Number12
Page1439-1445
Year/Month1991/12
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Rest and exercise cardiac blood pool scintigraphy with 99mTc-RBC were performed in 12 patients with symptomatic mitral stenosis before percutaneous transvenous mitral commissurotomy (PTMC) and at one week, one month after PTMC. Comparison of hemodynamic parameters before and one month after PTMC showed that LVEDV (97.4 +- 8.9 vs. 111.4 +- 12.1 ml ; p<0.01) and diastolic indices (1/3 FF : 23.6 +- 6.5 vs. 30.9 +- 4.1% ; p<0.01) both increased, while there was no significant change in LVEF and RVEF. Comparison of symptom-limited bicycle exercise before and one month after PTMC showed that the duration of exercise time(7.6 +- 1.6 vs. 8.6 +- 1.4 min ; p<0.02) and anaerobic threshold (10.6 +- 3.0 vs. 15.4 +- 3.2 ml min/kg ; p<0.01) increased. In comparison of hemodynamic response before and one month after PTMC, there were significant increases in cardiac output (CO) at the same workload (15W : 3.9 +- 0.8 vs. 4.8 +- 0.8 l/min ; p<0.05, 30 W : 3.9 +- 0.7 vs. 5.2 +- 1.2 l/min ; p<0.05) despite similar CO at rest (3.5 +- 0.8 vs. 3.9 +- 0.7 l/min ; NS). We conclude that cardiac blood pool scintigraphy is useful to evaluate improvement of hemodynamic parameters and exercise capacity after PTMC noninvasively.
PracticeClinical medicine
KeywordsCardiac blood pool scintigraphy, Mitral stenosis, Percutaneous transvenous mitral commissurotomy.

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