Japanese
Title再灌流後の局所心筋糖代謝 - PETによる検討 -
Subtitle原著
Authors星崎洋*
Authors(kana)
Organization*群馬大学医学部第二内科
Journal核医学
Volume29
Number11
Page1307-1318
Year/Month1992/11
Article原著
Publisher日本核医学会
Abstract「要旨」一過性虚血後の糖代謝の意義を検討するため, イヌの冠動脈左前下行枝を90分または3時間閉塞後再灌流し, 12時間および4週後にポジトロン断層法(PET)を用いて虚血域の血流量と糖代謝を測定, 心筋壊死量と比較した. 糖代謝は再灌流12時間, 4週後では心筋壊死量と逆相関した(それぞれr=-0.89, r=-0.82). 壊死量が10%未満の領域では, 再灌流12時間でいわゆる血流と代謝のmismatchを示したが4週後には消失し, 壊死量が10%以上50%未満の領域ではmismatchが4週後まで遷延した. 50%以上の領域ではmismatchは認められなかった. 以上より, 一過性虚血後の糖代謝は再灌流早期より残存心筋量(心筋viability)の指標となり, 血流と代謝のmismatchは残存心筋量と虚血障害の程度と関連する. なお, PETで梗塞心筋と判定された領域には組織学的に心筋壊死量の少ない領域も含まれ, PETによる判定は心筋viabilityを過小評価する可能性もある.
Practice臨床医学：一般
KeywordsPET, Myocardial viability, Transient ischemia, Percent necrosis, Glucose metabolism.
English
TitleTime Course of Regional Myocardial Glucose Metabolism after Transient Ischemia Assessed by Positron Emission Tomography
SubtitleOriginal Articles
AuthorsHiroshi HOSHIZAKI
Authors(kana)
OrganizationSecond Department of Internal Medicine, Gunma University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume29
Number11
Page1307-1318
Year/Month1992/11
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]The purpose of this study was to examine the significance of glucose metabolism in ischemic canine myocardium after reperfusion. Transient ischemia was induced by 90 or 180 minutes occlusion of the left anterior descending coronary artery. Twelve hours and 4 weeks after reperfusion, myocardial blood flow (MBF) and glucose metabolism were assessed (with H215O and 18FFDG, respectively) by positron emission tomography (PET) under the fasting state, and the metabolic findings were compared with the histologic examination. Glucose metabolism in ischemic regions was inversely related to the amount of tissue necrosis 12 hours and 4 weeks after reperfusion (r=-0.89 and r=-0.82, respectively). The perfusion-metabolism mismatch pattern was seen in the area with less than 10 percent necrosis 12 hours after reperfusion, but this pattern disappeared after 4 weeks. The area with 10 to 50 percent necrosis showed the mismatch pattern until 4 weeks after reperfusion, and in the area with more than 50 percent necrosis, perfusion-metabolism concordantly decreased. Thus, metabolic index assessed early after reperfusion by PET identified myocardial viability, and the perfusion-metabolism mismatch pattern sustained in relation to the degree of ischemic injury. Since some regions estimated to be irreversible by PET were viable by the histologic examination, PET study might underestimate the myocardial viability.
PracticeClinical medicine
KeywordsPET, Myocardial viability, Transient ischemia, Percent necrosis, Glucose metabolism

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