[用201Tl心肌单光子发射计算机断层显像评估扩张型心肌病和左心室离心性肥厚患者的心肌病变]

[Evaluation of myocardial disorders in patients with dilated cardiomyopathy and left ventricular eccentric hypertrophy--by 201Tl myocardial SPECT].

作者信息

Yamazaki J, Ohsawa H, Uchi T, Iida M, Wakakura M, Okamoto K, Hosoi H, Morishita T, Nakano H, Yabe Y

机构信息

First Department of Internal Medicine, Toho University School of Medicine.

出版信息

Kokyu To Junkan. 1992 Mar;40(3):275-81.

PMID:1533725

Abstract

201Tl myocardial SPECT was performed in cases of dilated cardiomyopathy and valvular heart disease with left ventricular eccentric hypertrophy, and the two groups were compared from the standpoint of the mechanism of onset of myocardial disorders. Significant coefficients of correlation were seen between the Tl score and LVDd (r = 0.792, r = 0.785) and Tl score and LVEF (r = -0.634, r = -0.555) in both dilated cardiomyopathy and valvular heart disease. In cases of valvular heart disease, significant correlation coefficients (r = -0.756, r = -0.720) between LVDd and r-WR (relative-washout rate), and Tl score and r-WR were observed, but no such correlation was seen in dilated cardiomyopathy. In valvular heart disease, a decrease in myocardial perfusion associated with enlargement of the left ventricle appeared, while in dilated cardiomyopathy, there was a marked decrease in LVEF in proportion to the thallium defect. Therefore, it was assumed that left ventricular wall disorders occur due to myocardial metabolic disorders and coronary microcirculation disorders.

摘要

对扩张型心肌病和伴有左心室离心性肥厚的瓣膜性心脏病患者进行了201铊心肌单光子发射计算机断层扫描（SPECT），并从心肌疾病的发病机制角度对两组进行了比较。在扩张型心肌病和瓣膜性心脏病中，铊评分与左心室舒张末期内径（LVDd）之间（r = 0.792，r = 0.785）以及铊评分与左心室射血分数（LVEF）之间（r = -0.634，r = -0.555）均可见显著的相关系数。在瓣膜性心脏病病例中，观察到左心室舒张末期内径与相对洗脱率（r-WR）之间（r = -0.756，r = -0.720）以及铊评分与相对洗脱率之间存在显著相关系数，但在扩张型心肌病中未观察到此类相关性。在瓣膜性心脏病中，出现了与左心室扩大相关的心肌灌注减少，而在扩张型心肌病中，左心室射血分数与铊缺损成比例地显著降低。因此，推测左心室壁疾病是由于心肌代谢紊乱和冠状动脉微循环紊乱所致。