| Japanese |
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| Title | 心筋梗塞におけるTl / BMIPP集積解離の臨床的意義 - 冠動脈病変, 局所壁運動異常との関係 - |
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| Subtitle | 原著 |
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| Authors | 中田智明1, 橋本暁佳1, 宮本憲次郎1, 藤森研司2, 勝賀瀬貴3, 平沢邦彦4, 尾形仁子5, 藤原嗣允6, 美田晃章7, 加藤淳一8, 田中秀一9, 山下裕久10, 油野民雄11, 小林毅12, 古舘正從13 |
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| Authors(kana) | |
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| Organization | 北海道心筋代謝画像検討会, 1札幌医科大学医学部第二内科, 2放射線科, 3日鋼記念病院, 4市立旭川病院, 5札幌社会保険総合病院, 6北海道循環器病院, 7手稲渓仁会病院, 8旭川厚生病院, 9名寄市立病院, 10旭川医科大学第一内科, 11放射線科, 12岩見沢労災病院, 13北海道大学医学部核医学 |
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| Journal | 核医学 |
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| Volume | 32 |
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| Number | 10 |
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| Page | 1061-1071 |
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| Year/Month | 1995/10 |
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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」心筋梗塞100例を対象に局所心筋血流と脂肪酸代謝障害の関係を解析すべく, Tl/BMIPP心筋SPECTを急性期, 回復期にのべ131回施行し, その集積異常をパターン分類し, 冠狭窄度, 局所壁運動と比較検討した. 異常集積部位157領域ではBMIPP集積低下(B)型解離が急性期, 回復期とも解離なし(E)型, Tl集積低下(T)型解離に比し有意に(p<0.05)高頻度(92領域, 59%)で, ことにT型は急性期もっとも低頻度(14領域, 9%)であった. 前壁中隔領域ではB型がE型, T型に比し有意に(p<0.05)多く(68% vs. 27% vs. 5%), 下壁, 後側壁領域ではT型がより高頻度(11〜13%)であった. 高度冠狭窄病変はB型(76%), E型(72%)に比し, T型(43%)で低い傾向を示した. 局所壁運動異常の頻度は, T型で他の2群に比し有意に(p<0.05)低く, 全体ではB型(91%), E型(96%), T型(46%)であった. 以上, 発症90日以内の梗塞心では脂肪酸代謝低下型解離が高頻度で, 高度な壁運動異常, 冠動脈病変を伴う. 心筋血流低下型解離は低頻度で, 下壁, 後側壁に多く, また冠動脈疾患重症度との関係は乏しく, その発生機序にTl減衰の影響も推察された. |
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| Practice | 臨床医学：一般 |
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| Keywords | Myocardial infarction, Myocardial scintigraphy, Fatty acid metabolism, Coronary stenosis, Regional wall motion. |
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| English |
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| Title | Clinical Implications of Mismatched Uptakes of Beta-Methyl Fatty Acid Analogue and Thallium in Infarcted Myocardium : Correlations with Coronary Stenosis and Regional Wall Motion Abnormality |
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| Subtitle | Original Articles |
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| Authors | Tomoaki NAKATA1, Akiyoshi HASHIMOTO1, Kenjiro MIYAMOTO1, Kenji FUJIMORI2, Takashi SHOGASE3, Kunihiko HIRASAWA4, Hitoko OGATA5, Tsugumasa FUJIWARA6, Teruaki MITA7, Junichi KATOH8, Syuichi TANAKA9, Hirohisa YAMASHITA10, Tamio ABURANO11, Takeshi KOBAYASHI12, Masayori FURUDATE13 |
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| Authors(kana) | |
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| Organization | Hokkaido Myocardial Metabolic Imaging Study Group, Sapporo Medical University, School of Medicine, 1Second Department of Internal Medicine and 2Department of Radiology, 3Nikkoh Memorial Hospital, 4Asahikawa City Hospital, 5Sapporo Social Insurance General Hospital, 6Sapporo Circulation Hospital, 7Teinekeijinkai Hospital, 8Asahikawa-Kousei General Hospital, 9Nayoro City Hospital, Asahikawa Medical College, 10First Department of Internal Medicine and 11Department of Radiology, 12Iwamizawa Rousai Hospital, 13Hokkaido University, Department of Nuclear Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 32 |
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| Number | 10 |
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| Page | 1061-1071 |
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| Year/Month | 1995/10 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Myocardial perfusion and fatty acid metabolism were assessed by using myocardial single-photon emission computed tomography with thallium and beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) during acute and/or late stages of myocardial infarction in 157 infarcted segments of 100 patients. The incidence of reduced thallium perfusion relative to BMIPP uptake ("T-type" mismatch) was significantly (p<0.05) lower (9%) compared to that of reduced BMIPP uptake relative to thallium perfusion ("B-type" mismatch)(59%) or non-mismatched segment (32%). In an anteroseptal region, B-type dissociation had a significantly higher incidence compared to no or T-type mismatch; 68% vs. 27% vs. 5%, respectively, whereas the incidence of T-type uptake was relatively high in inferior and posterolateral regions; 13%, 11%, respectively. Severe coronary stenosis was observed in 76% of B-type segments and 72% of non-mismatched segments but in only 43% of T-type segments. The incidence of regional wall motion abnormality was significantly lower (46%) in the T-type mismatch segments when compared to the B-type (91%) or non-mismatched segments (96%). In conclusion, myocardial fatty acid metabolism was more markedly impaired compared to an involved coronary perfusion, resulting in the mismatch of perfusion and fatty acid metabolism. Coronary stenosis and regional wall motion abnormality are more closely related to "B-type" mismatch but not necessarily to "T-type" dissociation, probably because of attenuation artifacts in inferior and posterolateral regions in thallium scan. |
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| Practice | Clinical medicine |
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| Keywords | Myocardial infarction, Myocardial scintigraphy, Fatty acid metabolism, Coronary stenosis, Regional wall motion. |
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