Japanese
Title肥大型心筋症における123I-BMIPP心筋シンチグラフィの意義 - 左室局所機能障害との関係 -
Subtitle原著
Authors両角隆一*, 石田良雄*, 堀正二*, 鎌田武信*, 山上英利**, 小塚隆弘**, 楠岡英雄***, 西村恒彦***
Authors(kana)
Organization*大阪大学医学部第一内科, **放射線科, ***トレーサ情報解析
Journal核医学
Volume30
Number9
Page1037-1047
Year/Month1993/9
Article原著
Publisher日本核医学会
Abstract「要旨」肥大型心筋症 (HCM) における局所心筋脂肪酸代謝異常 (β-メチル-P- (123I) -ヨードフェニルペンタデカン酸:123I-BMIPPの心筋取り込み異常) と左室壁厚および局所左室壁運動異常 (局所拡張能) との関係を検討すべく, HCM 9例および胸痛症候群4例に対し, 123I-BMIPP心筋SPECT, 運動負荷/再分布Thallium-201心筋SPECT (201TI) および心電図同期マルチゲート心プールシンチ (99mTc標識赤血球) を行った. 123I-BMIPP心筋SPECTおよび201TIは, 左室全体を13のセグメントに分け, 3段階のscoring (defect score:DS) を行って局所心筋摂取量を定量的に評価した. 局所拡張機能は, 心プールシンチ・セクタ解析により求めた. 各セクタの容積曲線より, 局所最大左室充満速度 (rPFR) , 局所最大左室充満速度到達時間 (rTPFR) および局所拡張早期3分の1充満速度 (1/3 fil) の3つの指標を求め局所拡張期能を評価した. その結果, 123I-BMIPP心筋SPECT異常は主として壁肥厚の著しい部位に認められたが, 著しい非対称性中隔肥厚を認める症例でも123I-BMIPP集積異常が認められない場合があり, 必ずしも肥厚の程度との関連は明らかでなかった. しかし, 中隔肥厚 (+) かつ123I-BMIPP欠損 (+) 部の局所左室拡張能は, 123I-BMIPP欠損 (-) 部位に比し有意に低下しており, さらに後側壁部位と中隔部位の局所拡張機能指標の差 (d-rTPFRおよびd-1/3 fil) は中隔部DSと正の相関関係を認めた (vs. d-rTPFR:r=0.71, P<0.05, vs. d-1/3 fil:r=0.69, p<0.05) . 123I-BMIPP心筋SPECT像は, 肥厚の程度よりもむしろ局所の拡張機能障害との間に密接な関係が認められ, 本症における臨床的有用性が示唆された.
Practice臨床医学：一般
Keywords123I-BMIPP, Hypertrophic cardiomyopathy, Diastolic function.
English
TitleRelationship between Reduced Myocardial Uptake of Beta-Methyl-p-(123I)-Iodophenyl-Pentadecanoic Acid (123I-BMIPP) and Regional Diastolic Ventricular Dysfunction in Patients with Hypertrophic Cardiomyopathy
SubtitleOriginal Articles
AuthorsTakakazu MOROZUMI*, Yoshio ISHIDA*, Masatsugu HORI*, Takenobu KAMADA*, Hidetoshi YAMAGAMI**, Takahiro KOZUKA**, Hideo KUSUOKA***, Tsunehiko NISHIMURA***
Authors(kana)
Organization*First Department of Medicine, Osaka University School of Medicine, **Department of Radiology, Osaka University School of Medicine, ***Department of Tracer Kinetics, Biomedical Research Center, Osaka University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume30
Number9
Page1037-1047
Year/Month1993/9
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] To assess whether regionally depressed myocardial uptake of beta-methyl-p-(123I)-iodophenyl-pentadecanoic acid (123I-BMIPP) , is related to regional ventricular diastolic dysfunction in patients (pts) with hypertrophic cardiomyopathy (HCM) , we carried out 123I-BMIPP myocardial SPECT and radionuclide ventriculography (RNV) at rest in 9 HCM pts (eight pts with asymmetric septal hypertrophy (ASH) , and one patient with apical hypertrophy) . The defects of 123I-BMIPP were semiquantitatively estimated by segmental analysis. Regional LV function was determined by sector analysis in RNV:regional peak filling rate (rPFR) , regional time to peak filling rate (rTPFR) , and early 1/3 filling rate (1/3fil) were estimated in the LV septal and posterior sectors. Wall thickness was evaluated with M-mode echocardiography. As results, the defects of 123I-BMIPP myocardial SPECT, were found frequently in septal wall, but any defect was not recognized in all septum with significant hypertrophy. Also, the degree of septal hypertrophy was not significantly related to BMIPP defect score. However, the regional diastolic function (rPFR, rTPFR, 1/3fil) in the septal lesions with 123I-BMIPP defects was decreased more than those without 123I-BMIPP defect in HCM. Furthermore, the relative regional diastolic dysfunction (the differences between rTPFR and 1/3fil in the septum and in the posterior wall) was significantly related to BMIPP defect score. In conclusion, this results suggest that the decreased uptake of 123I-BMIPP is related to regional diastolic dysfunction more than wall hypertrophy.
PracticeClinical medicine
Keywords123I-BMIPP, Hypertrophic cardiomyopathy, Diastolic function.

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