Nakano A, Lee J D, Shimizu H, Tsubokawa A, Uzui H, Tsuchida T, Takahashi N, Yonekura Y, Ueda T
First Department of Internal Medicine, Fukui Medical University, Japan.
Ann Nucl Med. 2001 Feb;15(1):65-8. doi: 10.1007/BF03012135.
To evaluate the clinical significance of reverse redistribution (RR) of resting 201Tl single photon emission computed tomography (SPECT) in patients with vasospastic angina (VSA), we performed left ventriculography, coronary angiography and resting 201Tl-SPECT in 22 patients with VSA. Left ventriculography showed abnormal wall motion in 17 of 22 patients (77%) and 37 of 154 segments. Thirty-one of these 37 segments (84%) were within the area perfused by coronary arteries showing acetylcholine-induced vasospasm. On 201Tl images, abnormal findings were observed in 11 of 22 patients (50%), and among them, 7 patients (32%) had RR. Seven of 37 segments (19%) having abnormal regional wall motion had RR of 201TI, and in 6 of these 7 segments (86%), accumulation of 123I-BMIPP was found to be reduced. We conclude that repetitive brief myocardial ischemia may cause myocardial injuries in patients with VSA, and that the presence of RR of 201Tl indicates the presence of myocardial injury in these patients.
为评估静息状态下201铊单光子发射计算机断层扫描（SPECT）反向再分布（RR）在变异性心绞痛（VSA）患者中的临床意义，我们对22例VSA患者进行了左心室造影、冠状动脉造影和静息状态下的201铊-SPECT检查。左心室造影显示，22例患者中有17例（77%）、154个节段中有37个节段存在室壁运动异常。这37个节段中的31个（84%）位于显示乙酰胆碱诱导血管痉挛的冠状动脉灌注区域内。在201铊图像上，22例患者中有11例（50%）观察到异常表现，其中7例（32%）存在RR。37个存在局部室壁运动异常的节段中有7个（19%）出现201铊RR，在这7个节段中的6个（86%）发现123I-BMIPP摄取减少。我们得出结论，反复短暂心肌缺血可能导致VSA患者发生心肌损伤，并且201铊RR的存在表明这些患者存在心肌损伤。
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