Japanese
Title肥大型心筋症と高血圧性肥大心で心筋脂肪酸代謝は異なるか?
Subtitle原著
Authors成田充啓*, 栗原正*, 宇佐美暢久*, 本田稔**
Authors(kana)
Organization*住友病院内科, **アイソトープ検査部
Journal核医学
Volume31
Number12
Page1465-1476
Year/Month1994/12
Article原著
Publisher日本核医学会
Abstract「要旨」肥大型心筋症 (HCM) の脂肪酸代謝の状況を123I-βメチルペンタデカン酸 (BMIPP), 201Tl (Tl) 心筋イメージングより検討し, 高血圧性心肥大例 (HT), 健常例 (N) と対比した. 両イメージングは安静時に行い, 投与量に対して心筋に取り込まれたアイソトープの割合 (%UT) を求めた. BMIPPの%UTをTlの%UTで除した値 (UR) を心筋のBMIPPの取り込みの指標として用い, 3時間でのBMIPPの心筋からの消失 (WOR) も求めた. 局所的なBMIPPの分布異常を断層像とBMIPP/Tlマップ (ピクセルごとに心筋血流で補正したBMIPPマップ) から判定した. URはN, HT, HCMの順に有意の低下を示し, HCM+HT, HTではURと心筋重量に負の相関を見たが, HCM単独では相関を見なかった. WORはN, HT, HCMの順で亢進した. HTでは局所的なBMIPPの取り込み低下を示す症例が少なく, BMIPP/Tlマップの異常は8%に存在したのみであったが, HCMではBMIPP像で欠損が58%にBMIPP/Tlマップの異常が92%に存在し, HTとHCMで脂肪酸代謝に違いのあることが示された.
Practice臨床医学：一般
Keywords123I-BMIPP myocardial imaging, Hypertrophic cardiomyopathy, Hypertensive hypertrophy, BMIPP/Tl map
English
TitleIs Myocardial Fatty Acid Metabolism Different between Hypertrophic Cardiomyopathy and Hypertensive Hypertrophy?
SubtitleOriginal Articles
AuthorsMichihiro NARITA*, Tadashi KURIHARA*, Masahisa USAMI*, Minoru HONDA**
Authors(kana)
Organization*Department of Internal Medicine, Sumitomo Hospital, **Department of Nuclear Medicine, Sumitomo Hospital
JournalThe Japanese Journal of nuclear medicine
Volume31
Number12
Page1465-1476
Year/Month1994/12
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] To investigate the characteristics of fatty acid metabolism in hypertrophic cardiomyopathy (HCM), we performed myocardial imaging with 123I-iodophenyl-3-methylpentadecanoic acid (BMIPP) in 24 patients with HCM, 13 patients with hypertensive hypertrophy (HT) and 10 normal subjects. Rest myocardial imaging with 123I-BMIPP was obtained at 20 minutes and 3 hours after 123I-BMIPP injection. Rest 201Tl imaging was also performed. In addition to ordinary tomography, whole body imaging was performed to calculate %Uptake (percentage of cardiac uptake of the isotope to total injected dose). As global indexes of fatty acid metabolism, we calculated two parameters ; 1) Uptake Ratio (%Uptake of 123I-BMIPP normalized by myocardial perfusion) and 2) WOR (percent reduction of myocardial 123I-BMIPP within 3 hours). Regional abnormality was evaluated by visual assessment of ordinary tomograms and by BMIPP/Tl map. BMIPP/Tl map was made from Bull's-eye maps of 123I-BMIPP and 201Tl, and it represented 123I-BMIPP uptake normalized by myocardial perfusion of each pixel which constructed the image. %Uptake of 123I-BMIPP was not different among three groups. But Uptake Ratio was significantly (p<0.001) different among three groups ; normal (1.13+-0.08) >HT (1.03+-0.08) >HCM (0.87+-0.09). WOR of 123I-BMIPP was accerelated in HCM (12.7+-4.7%) and HT (10.2+-2.9%) comparing with that in normal (5.1+-3.1%) (p<0.01). In patients with HCM, by visual assessment, regional abnormality of 123I-BMIPP distribution was found in 17 of 24 patients (71%) including 3 patients with equivocal abnormality. But in patients with HT, only equivocal abnormality was observed in 23%. In BMIPP/Tl map, abnormality was observed in 92% of HCM and 8% of HT. Although global myocardial fatty acid metabolism was equally disturbed both in HCM and HT, regional abnormality of fatty acid metabolism was observed preferetially in HCM. This indicated myocardial fatty acid metabolism was not identical between HCM and HT.
PracticeClinical medicine
Keywords123I-BMIPP myocardial imaging, Hypertrophic cardiomyopathy, Hypertensive hypertrophy, BMIPP/Tl map

【全文PDF】