Moreo Antonella, De Chiara Benedetta, Possa Mario, Sara Roberto, Bossi Irene, Orrego Pedro Silva, Nicolosi Elisa, Mauri Francesco, Parodi Oberdan
Cardiology Department, Niguarda Ca' Granda Hospital, Milan, Italy.
J Cardiovasc Med (Hagerstown). 2007 Mar;8(3):205-9. doi: 10.2459/01.JCM.0000260843.76156.84.
Several cases of transient left ventricular apical ballooning syndrome have already been described, but the pathophysiological mechanisms of this syndrome still remain unclear. We report the case of a patient evaluated in the acute phase of apical ballooning by coronary angiography and echocardiography who was submitted to I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy and dobutamine stress echocardiography one month after the discharge. MIBG scintigraphy demonstrated a decreased tracer uptake in the apical and periapical anterior regions, whilst myocardial perfusion at rest was normal. Dobutamine induced an increased left ventricular outflow tract gradient and hypokinesis in the apical and periapical segments, mimicking the findings that occurred in the acute phase, and in agreement with the location of MIBG abnormalities. After a two-month treatment with carvedilol, MIBG uptake increased in the apical and periapical anterior regions.
已有数例短暂性左心室心尖气球样变综合征的病例被描述，但该综合征的病理生理机制仍不清楚。我们报告了1例在急性期接受冠状动脉造影和超声心动图检查的心尖气球样变患者，出院1个月后接受了间碘苄胍（MIBG）心肌显像和多巴酚丁胺负荷超声心动图检查。MIBG显像显示心尖和心尖周围前壁区域的示踪剂摄取减少，而静息心肌灌注正常。多巴酚丁胺诱发左心室流出道梯度增加以及心尖和心尖周围节段运动减弱，与急性期所见相似，且与MIBG异常部位相符。在用卡维地洛治疗2个月后，心尖和心尖周围前壁区域的MIBG摄取增加。
