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经形态学检查证实的实验性心肌缺血的闪烁显像评估

[Scintigraphic evaluation of experimental myocardial ischemia confirmed by morphological examination].

作者信息

Konstantinov V O, Lipovetskiĭ B M, Zel'tser G L, Sinsarenko A A, Iakovleva L A, Sapozhnikova N V

出版信息

Kardiologiia. 1991 Jan;31(1):24-9.

PMID:1646348
Abstract

Due to the fact that there were difficulties in interpreting the cardiac scintigrams after 99mTC pyrophosphate had been given to patients with coronary heart disease without acute myocardial infarction, an experimental study was undertaken. The scintigraphic characteristics were examined in 10 cats following ligation of the interventricular artery at its middle third for more than 20 min, followed by myocardial reperfusion, histochemical and electron microscopic studies. Cat interventricular artery occlusion for a more than 20 min was found to be followed by specific ischemic changes in ECG and myocardial accumulation of 99mTc pyrophosphate. The histochemical and electron microscopic studies indicated that there were both reversible and irreversible cardiomyocyte lesions. Reversible myocardial changes were detected not only in the ischemic area, but in the other myocardial regions away from the basin of the ligated artery. If occlusion was short, the rate of myocardial tracer accumulation rapidly became lower; with long-term occlusion or profound myocardial damage caused by reperfusion, tracer accumulation became higher. There is experimental evidence for applying 99mTc-pyrophosphate scintigraphy in the clinical setting to reveal reversible myocardial changes that are most common in chronic coronary heart disease.

摘要

由于给无急性心肌梗死的冠心病患者注射99m锝焦磷酸盐后,心脏闪烁图的解读存在困难,因此进行了一项实验研究。对10只猫进行实验,在其心室间动脉中三分之一处结扎20多分钟,然后进行心肌再灌注,并进行组织化学和电子显微镜研究,以检查闪烁图特征。发现猫心室间动脉闭塞20多分钟后,心电图出现特异性缺血改变,心肌出现99m锝焦磷酸盐蓄积。组织化学和电子显微镜研究表明,心肌细胞存在可逆性和不可逆性病变。不仅在缺血区域,而且在远离结扎动脉供血区域的其他心肌区域都检测到了可逆性心肌变化。如果闭塞时间短,心肌示踪剂蓄积率迅速降低;如果长期闭塞或再灌注导致严重心肌损伤,示踪剂蓄积则会升高。有实验证据表明,在临床环境中应用99m锝焦磷酸盐闪烁扫描可揭示慢性冠心病中最常见的可逆性心肌变化。

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