Klepzig H, Standke R, Maul F D, Kaltenbach M, Hör G
Abteilung für Kardiologie, Johann Wolfgang Goethe-Universität, W-Frankfurt, FRG.
Nuklearmedizin. 1991 Apr;30(2):55-60.
The purpose of this study was to evaluate left ventricular function and perfusion at rest before and after percutaneous transluminal coronary angioplasty. In consecutive 69 patients in whom coronary stenoses were dilated, the radionuclide left ventricular ejection fraction at rest increased significantly. In 26 of these patients, the ejection fraction increased by at least 4%. In these patients, exercise-induced ischemic ST depression had been more pronounced than in the others. 36 other patients underwent 201TI myocardial scintigraphy before and after angioplasty. Twelve patients in whom pre-PTCA images had revealed regions with irreversible 201TI uptake defects, showed normal 201TI distribution patterns on post-PTCA scintigrams. Post-exercise 201TI uptake (representing myocardial perfusion and metabolic activity) during pre-PTCA exercise stress tests was significantly lower in these cases. It is concluded that PTCA can improve left ventricular function and perfusion at rest. This improvement is most obvious in patients with pronounced exercise-induced myocardial ischemia as diagnosed by typical ST segment depression and reduced thallium uptake.
本研究的目的是评估经皮腔内冠状动脉成形术前后静息状态下的左心室功能和灌注情况。在连续69例冠状动脉狭窄得到扩张的患者中,静息状态下放射性核素左心室射血分数显著增加。在这些患者中,有26例射血分数至少增加了4%。在这些患者中,运动诱发的缺血性ST段压低比其他患者更为明显。另外36例患者在血管成形术前后进行了201铊心肌闪烁显像。12例术前201铊心肌显像显示有不可逆性201铊摄取缺损区域的患者,术后闪烁显像图上201铊分布模式正常。在这些病例中,术前运动负荷试验期间运动后201铊摄取(代表心肌灌注和代谢活性)显著降低。结论是经皮腔内冠状动脉成形术可改善静息状态下的左心室功能和灌注。这种改善在通过典型ST段压低和铊摄取减少诊断为运动诱发心肌缺血明显的患者中最为明显。