Japanese
Title拡張型心筋症における心筋ミオシン軽鎖測定の意義
Subtitle技術報告
Authors津田隆志*, 和泉徹*, 柴田昭*
Authors(kana)
Organization*新潟大学医学部第一内科
Journal核医学
Volume29
Number8
Page1035-1039
Year/Month1992/8
Article報告
Publisher日本核医学会
Abstract「要旨」拡張型心筋症(DCM)を疑われた55症例を対象に血中心筋ミオシン軽鎖(LC1)を測定し, DCMにおけるLC1測定の臨床的意義を検討した. DCMと診断された44例のうち, LC1高値を示した例は2例(4.5%)ときわめて少数であった. LC1高値を示した2例の臨床的特徴を検討すると, いずれもNYHA II度であり, 心エコー図より求めた心機能は比較的維持されており, 201Tl心筋シンチグラフィでの欠損や血清CPK値上昇などの所見は得られなかった. またDCMを疑われたが二次性心筋症であった11例のうち, LC1高値はミオパチー1例, 甲状腺機能低下症1例に認めた. なお, 過去に当科において診断された甲状腺機能低下症の検討でも, 8例のうち6例(75%)でLC1高値を認めた. 以上より, DCMにおけるLC1測定の臨床的意義は少なく, DCMを疑われた症例でLC1高値を認めた場合, 二次性心筋症も考慮すべきである.
Practice臨床医学：一般
KeywordsCardiac myosin light chain, Dilated cardiomyopathy, Hypothyroidism, Secondary cardiomyopathy.
English
TitleClinical Assessment of Serum Myosin Light Chain I in Patients with Dilated Cardiomyopathy
SubtitleTechnical Report
AuthorsTakashi TSUDA, Tohru IZUMI, Akira SHIBATA
Authors(kana)
OrganizationFirst Department of Internal Medicine, Niigata University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume29
Number8
Page1035-1039
Year/Month1992/8
ArticleReport
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]Serum cardiac myosin light chain I (LCI) levels were quantitated using a radioimmunoassay kit in patients suspected of dilated cardiomyopathy (DCM). In this study, 55 patients were evaluated between 1986 and 1991. They were composed of 40 males and 15 females, and their age was 27-75 years (51+-11 years). The patients with renal dysfunction were excluded due to their serum creatinine levels (>2.0 mg/dl). 1) After cardiac catheterization, endomyocardial biopsy and echocardiography, 44 patients were diagnosed as DCM, 2 as ischemic heart disease, 2 as chronic myocarditis, 1 as restrictive cardiomyopathy, 1 as dilated hypertrophic cardiomyopathy, 1 as cardiac amyloidosis, 2 as myopathy, 1 as polymyositis and 1 as hypothyroidism. 2) Only two patients with DCM had elevated LCI. Besides, two patients with myopathy or hypothyroidism had elevated LCI. 3) In the follow-up, one patient died suddenly 6 months later and another showed normal value of LCI four years later. 4) LCI elevation in DCM was not related to either the severity of heart failure or cardiac function and it showed no finding of 201Tl myocardial defect or elevated CPK. 5) The mechanism for elevated LCI in myopathy is related to a cross-reaction with myosin light chain in the skeletal muscle. In hypothyroidism, it may be related to decreased clearance of normal LCI concentration or increased myosin light chain from damaged skeletal muscle. In conclusion, it is evident that the measurement of LCI is not helpful in clinical assessment of patients with DCM, but may be useful in detection of secondary cardiomyopathy.
PracticeClinical medicine
KeywordsCardiac myosin light chain, Dilated cardiomyopathy, Hypothyroidism, Secondary cardiomyopathy.

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