Ochiai N, Furukawa K, Ebizawa T, Yagi T, Akashi K, Nakamura T, Azuma A, Sugihara H
Department of Cardiology, Saiseikai Kyoto Hospital.
J Cardiol. 2000 Sep;36(3):183-9.
A 64-year-old woman with dilated hypertrophic cardiomyopathy was treated by beta-blocker, because of recurrent episodes of congestive heart failure. Carvedilol administration was started with a dose of 2.5 mg/day, and gradually increased to the dose of 20 mg/day 3 months later. Her functional class recovered from New York Heart Association stage IV to stage II. Thallium-201 scintigraphy demonstrated advanced myocardial damage: defect/low perfusion in the anteroseptal, infero-posterior and apical regions. Iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid scintigraphy confirmed these findings. However, the scintigraphic abnormalities had reversed to near normal perfusion and metabolism similar to those of stunned myocardium after an ischemic episode. This case demonstrates the recovery of myocardial impairment during beta-blocker therapy in a patient with dilated hypertrophic cardiomyopathy.
一名64岁的扩张型肥厚型心肌病女性患者，因充血性心力衰竭反复发作而接受β受体阻滞剂治疗。开始给予卡维地洛，剂量为2.5毫克/天，3个月后逐渐增加至20毫克/天。她的心功能分级从纽约心脏协会IV级恢复到II级。铊-201心肌显像显示存在严重心肌损害：前间隔、下后壁和心尖区域有缺损/灌注减低。碘-123β-甲基-对-碘苯基十五烷酸心肌显像证实了这些发现。然而，这些显像异常已逆转至接近正常灌注和代谢，类似于缺血发作后的心肌顿抑。该病例表明，扩张型肥厚型心肌病患者在β受体阻滞剂治疗期间心肌损伤得到了恢复。
