| Japanese |
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| Title | 虚血性心疾患患者におけるRamp負荷時の左室機能変化 - 左室放射能連続モニタリング法による検討 - |
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| Subtitle | 原著 |
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| Authors | 中山浩二* |
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| Authors(kana) | |
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| Organization | *東海大学医学部第一内科 |
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| Journal | 核医学 |
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| Volume | 30 |
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| Number | 9 |
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| Page | 1081-1090 |
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| Year/Month | 1993/9 |
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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」冠動脈造影を施行された34名を対象に, エルゴメータを用いた直線的漸増負荷 (ramp負荷) 時の左心機能変化を, 無線式携帯型心機能連続監視装置 (WTCMS) を用いて左室放射能を連続モニターする方法により検討した. 左室駆出分画 (EF) は, ±5%以上の変動を有意な変化とすると, 負荷中の変化は正常反応 (上昇型) と異常反応 (水平型, 下降型, 上昇後下降型) の2群に分類された. 冠動脈病変をもたない健常群6例は全例, 正常反応であった. 冠動脈疾患 (CAD) 群では28例中17例が異常反応であった (感度61%) . CAD群を負荷201Tl心筋シンチにおける再分布の有無で比較すると正常反応を示した11例中8例 (73%) が再分布陰性 (R-) 群であった. また, 異常反応を示した17例中12例 (71%) が再分布陽性 (R+) 群であった. R+群や多枝病変例では水平型や下降型が多かった. 負荷後のEFはR-群に比べR+群では有意にover shootまでの時間が延長していた (1.23±0.75分vs. 2.17±0.89分P<0.01) . すなわち負荷Tl試験にて虚血が誘発されるものは, ramp負荷時にEFが下降型あるいは水平型を示すことが多く, また, 負荷後のover shootまでの時間が延長していた. したがって, WTCMSを用いたramp負荷時の心機能変化は, 虚血性心疾患の診断に有用であると考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Wireless telemetric cardiac monitoring system, Ramp exercise, Ischemic heart disease, Left ventricular function, Radionuclide angiography. |
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| English |
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| Title | Sequential Changes in the Left Ventricular Function during Ramp Exercise in Patients with Ischemic Heart Disease : Continuous Assessment of the Left Ventricular Radioactivity with Wireless Telemetric Cardiac Monitoring System |
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| Subtitle | Original Articles |
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| Authors | Koji NAKAYAMA |
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| Authors(kana) | |
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| Organization | First Department of Internal Medicine, Tokai University, School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 30 |
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| Number | 9 |
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| Page | 1081-1090 |
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| Year/Month | 1993/9 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] The left ventricular function during ramp exercise was assessed using 99mTc-labeled red blood cells and a Wireless Telemetric Cardiac Monitoring System (WTCMS) in 34 patients who received coronary angiography. Sequential changes in the left ventricular ejection fraction (EF) during exercise, were classified into the two types, normal response (up slope pattern) and abnormal response (horizontal, down slope and up-down slope pattern) when defined the response as 5 percent or more increment of EF as normal. Six patients without significant stenosis by coronary angiography showed normal response. Seventeen of 28 patients with coronary disease showed abnormal response (sensitivity 61%) . Eight of 11 patients (73%) with coronary disease and normal response showed no redistribution on the stress thallium myocardial scintigraphy. Twelve of 17 patients (71%) with coronary disease and abnormal response showed redistribution by the stress thallium scintigraphy. Horizontal and down slope patterns of EF during exercise were more often noted in the groups with redistribution and multivessel coronary disease. After the exercise, the times to the over shoot was significantly longer in groups with redistribution (p<0.01) in comparison with groups without redistribution. From these results, we conclude that the monitoring the changes in left ventricular activity during ramp exercise with the WTCMS is a very useful method for the evaluation of the sequential changes in left ventricular function in patients with ischemic heart disease. |
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| Practice | Clinical medicine |
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| Keywords | Wireless telemetric cardiac monitoring system, Ramp exercise, Ischemic heart disease, Left ventricular function, Radionuclide angiography. |
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