| Japanese |
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| Title | 冠攣縮性狭心症の冠循環と運動負荷201Tl心筋シンチグラフィの特徴 |
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| Subtitle | 原著 |
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| Authors | 松村憲太郎*, 中瀬恵美子*, 灰山徹**, 長谷川章**, 斉藤孝行** |
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| Organization | *京都南病院内科, **放射線科 |
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| Journal | 核医学 |
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| Volume | 29 |
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| Number | 5 |
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| Page | 615-623 |
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| Year/Month | 1992/5 |
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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」冠攣縮性狭心症に運動負荷201Tl心筋シンチグラフィと冠動脈DSAを施行し, それぞれの特徴と関連性を検討した. 運動負荷201Tl心筋SPECTで灌流欠損は75%に見られ, そのうち89%に再分布現象が見られた. 運動負荷時201Tl肺集積は明らかに高く, 運動負荷時の左室機能障害の顕在化が示唆された. この傾向は201Tl心筋SPECTで多発性小欠損を示す群で強く見られた. 多発性小欠損群では冠動脈造影上エルゴノビン負荷にて心筋虚血を伴う多枝攣縮例が多く見られた. DSAを用いた左冠動脈循環時間(CCT)は冠攣縮性狭心症で明らかに延長しており, 心外膜冠動脈の十分な拡張が得られたあとでも冠末梢循環障害が残っていることが推測される. 201Tl心筋SPECTの欠損部位や冠攣縮部位と無関係にCCTは延長しており, 冠攣縮性狭心症では心外膜冠動脈のスパスム以外に, 冠微小循環障害が病態の一部を形成している可能性がある. |
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| Practice | 臨床医学：一般 |
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| Keywords | Vasospastic angina, Coronary hemodynamics, Digital subtraction angiography(DSA), 201Tl-myocardial scintigraphy, Pulmonary 201Tl uptake. |
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| English |
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| Title | Evaluation of Coronary Hemodynamics and Exercise 201Tl-Myocardial Scintigraphy in Patients with Vasospastic Angina |
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| Subtitle | Original Articles |
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| Authors | Kentaro MATSUMURA*, Emiko NAKASE*, Tohru HAIYAMA**, Akira HASEGAWA**, Takayuki SAITO** |
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| Authors(kana) | |
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| Organization | *Department of Internal Medicine, **Department of Radiology, Kyoto Minami Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 29 |
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| Number | 5 |
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| Page | 615-623 |
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| Year/Month | 1992/5 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]To clarify the coronary hemodynamics and myocardial perfusion in patients with vasospastic angina, we performed exercise-201Tl-myocardial scintigraphy (planar and SPECT) in 72 patients and left coronary digital subtraction angiography (DSA) in 37 patients without significant organic coronary artery stenosis. Coronary artery spasm was documented by coronary angiography in all patients. Fifty-four patients (75%) developed exercise-induced 201Tl-myocardial perfusion defect on SPECT. 201Tl pulmonary uptake (L/H) was significantly increased in patients with vasospastic angina. Especially, L/H was higher in patients with multiple small perfusion defect on 201Tl-SPECT, so that exercise-induced left ventricular dysfunction existed in patients with vasospastic angina and especially in cases with multiple small perfusion defect on 201Tl-SPECT. The left coronary circulation time (CCT) was prolonged in patients with vasospastic angina. The mechanism of prolonged CCT is still unknown, but we suspected that prolonged CCT was induced by increased peripheral coronary vascular resistance in patients with vasospastic angina. It was concluded that the peripheral coronary circulation was disturbed in patients with vasospastic angina, but its abnormal coronary circulation had no relation to location of spasm-induced vessels. We concluded that impaired coronary microcirculation was taken a part of pathophysiology in vasospastic angina. |
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| Practice | Clinical medicine |
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| Keywords | Vasospastic angina, Coronary hemodynamics, Digital subtraction angiography(DSA), 201Tl-myocardial scintigraphy, Pulmonary 201Tl uptake. |
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