Toyama T, Nishimura T, Uehara T, Hayashida K, Shimonagata T, Hirose Y, Kaminaga T, Yoshimaru K, Nonogi H, Haze K
Department of Radiology, National Cardiovascular Center, Osaka.
Kaku Igaku. 1992 Nov;29(11):1293-8.
Sixty-four patients with single left anterior descending artery disease having effort angina (group A: 40 patients without hypertension, group B: 10 patients with hypertrophic hypertension, group C: 14 patients with non-hypertrophic hypertension) were assessed the influence of hypertensive left ventricular (LV) hypertrophy on detection of ischemic area. The criterion of hypertrophy by two-dimensional echocardiography was > 12 mm in the wall thickness of interventricular septal or posterior wall. Population in Group B might show low detectability in ischemic area by 201Tl myocardial scintigraphy (positive thallium rate 60%, defect score 2.7 +/- 3.6), and high lung thallium uptake and high frequence of ECG positive among three groups. In semiquantitative analysis, the washout rate of the posterolateral wall and %RD (delayed %uptake-initial %uptake) of the septal wall in patients with Group B were lowest among three groups. However, the washout rate in the septal wall against the posterior wall, and the initial %uptake and the delayed %uptake of the septal wall were not significantly different among three groups. We could conclude that the decreased washout rate in nonischemic area with hypertensive LV hypertrophy might make the ischemic area masked.
对64例患有单支左前降支动脉疾病且有劳力性心绞痛的患者（A组：40例无高血压患者；B组：10例肥厚性高血压患者；C组：14例非肥厚性高血压患者）评估高血压性左心室（LV）肥厚对缺血区域检测的影响。二维超声心动图诊断肥厚的标准为室间隔或后壁厚度>12mm。B组患者可能在201Tl心肌闪烁显像中显示出较低的缺血区域检出率（铊阳性率60%，缺损评分2.7±3.6），且在三组中肺铊摄取率高、心电图阳性频率高。在半定量分析中，B组患者后侧壁的洗脱率和间隔壁的%RD（延迟%摄取-初始%摄取）在三组中最低。然而，间隔壁相对于后壁的洗脱率以及间隔壁的初始%摄取和延迟%摄取在三组之间无显著差异。我们可以得出结论，高血压性LV肥厚的非缺血区域洗脱率降低可能会使缺血区域被掩盖。
