Morishita S, Kondo Y, Nomura M, Miyajima H, Nada T, Ito S, Nakaya Y
Second Department of Internal Medicine, University of Tokushima, Japan.
Am J Cardiol. 2001 Mar 15;87(6):743-7. doi: 10.1016/s0002-9149(00)01494-6.
The purpose of this study was to determine whether myocardial imaging using technetium-99m tetrofosmin can noninvasively identify myocardial damage in hypertrophic cardiomyopathy (HC). The study consisted of 10 patients with apical HC, 10 with asymmetric septal HC (ASH) group, 5 with dilated cardiomyopathy (DC)-like group, and 20 healthy subjects. With use of a bull's-eye map of single-photon emission computed tomographic imaging, the total defect score of tetrofosmin and the washout rate were assessed in 5 segments (septum, and anterior, lateral, and inferior walls, and apex) of the left ventricle. A localized increase in defect score and washout rate was observed in the hypertrophied region in the group with apical HC. An increased washout rate was observed in the ASH group regardless of hypertrophy, suggesting that tetrofosmin retention by the mitochondria was impaired in the entire left ventricular wall. The washout rate was further increased at all segments in the DC-like group versus the ASH group. Tetrofosmin retention by mitochondria was impaired in the entire left ventricular wall in the ASH group and was increased further in the DC-like group. The dysfunction of myocardial cells was limited to the hypertrophied region in the apical HC group.
本研究的目的是确定使用锝-99m 替曲膦进行心肌成像是否能无创识别肥厚型心肌病（HC）中的心肌损伤。该研究包括 10 例心尖肥厚型心肌病患者、10 例非对称性室间隔肥厚型心肌病（ASH）组患者、5 例扩张型心肌病（DC）样组患者以及 20 名健康受试者。利用单光子发射计算机断层成像的靶心图，在左心室的 5 个节段（室间隔、前壁、侧壁、下壁和心尖）评估替曲膦的总缺损评分和洗脱率。在心尖肥厚型心肌病组的肥厚区域观察到缺损评分和洗脱率局部增加。ASH 组无论是否存在肥厚均观察到洗脱率增加，提示整个左心室壁线粒体对替曲膦的摄取受损。与 ASH 组相比，DC 样组所有节段的洗脱率进一步增加。ASH 组整个左心室壁线粒体对替曲膦的摄取受损，而 DC 样组进一步增加。心尖肥厚型心肌病组心肌细胞功能障碍局限于肥厚区域。
