Nakajima K, Bunko H, Taki J, Shimizu M, Muramori A, Hisada K
Department of Nuclear Medicine, Kanazawa University, Japan.
Am Heart J. 1990 Jun;119(6):1329-37. doi: 10.1016/s0002-8703(05)80183-8.
Myocardial scintigraphy with 123I-meta-iodobenzylguanidine (MIBG) and thallium-201 (201Tl) was performed in 29 patients with hypertrophic cardiomyopathy (HCM) using whole-body scintigraphy and single-photon emission computed tomography (SPECT). Nonhypertensive patients were classified into three groups according to the septal thickness determined by ultrasonography; group 1 (wall thickness less than 16 mm, n = 5), group 2 (from 16 to 20 mm, n = 12) and group 3 (greater than 20 mm, n = 4). The regional myocardial uptakes of both 201Tl and 123I-MIBG (percent of injected dose/cm3 myocardium) were higher in the more hypertrophic septa. However, when regional MIBG uptake at 3 hours was divided by the 201Tl uptake to calculate the MIBG uptake per unit of blood flow, the hypertrophic septa showed lower mean values--0.39 +/- 0.23 and 0.50 +/- 0.10 in groups 3 and 2, respectively (p less than 0.1 compared with 0.69 +/- 0.20 in group 1). The regional MIBG clearance rate in the septum was significantly higher in group 3 compared with group 1 (13.4 +/- 8.0%/hr versus 1.5 +/- 6.2%/hr, p less than 0.05). The uptake and 123I-MIBG clearance rate in the lateral wall showed a similar tendency. Myocardial uptake determined by whole-body scintigraphy was slightly increased in group 2 (3.5 +/- 0.6%, p less than 0.05) compared with group 1 (2.7 +/- 0.8%); however, it was lower in group 3 (2.7 +/- 0.4%). Myocardial 123I-MIBG distribution demonstrated various patterns in comparison with 201Tl distribution, suggesting that flow-independent changes in sympathetic innervation or activity may exist in patients with HCM.(ABSTRACT TRUNCATED AT 250 WORDS)
对29例肥厚型心肌病（HCM）患者进行了123I-间碘苄胍（MIBG）和铊-201（201Tl）心肌闪烁显像，采用全身闪烁显像和单光子发射计算机断层扫描（SPECT）。非高血压患者根据超声心动图测定的室间隔厚度分为三组；第1组（室壁厚度小于16mm，n=5），第2组（16至20mm，n=12）和第3组（大于20mm，n=4）。在肥厚程度更高的室间隔中，201Tl和123I-MIBG的局部心肌摄取（每立方厘米心肌的注射剂量百分比）更高。然而，当将3小时时的局部MIBG摄取除以201Tl摄取以计算每单位血流的MIBG摄取时，肥厚的室间隔显示出较低的平均值 - 第3组和第2组分别为0.39±0.23和0.50±0.10（与第1组的0.69±0.20相比，p<0.1）。第3组室间隔的局部MIBG清除率显著高于第1组（13.4±8.0%/小时对1.5±6.2%/小时，p<0.05）。侧壁的摄取和123I-MIBG清除率显示出类似的趋势。与第1组（2.7±0.8%）相比，第2组通过全身闪烁显像测定的心肌摄取略有增加（3.5±0.6%，p<0.05）；然而，第3组较低（2.7±0.4%）。与201Tl分布相比，心肌123I-MIBG分布呈现出各种模式，表明HCM患者可能存在与血流无关的交感神经支配或活性变化。（摘要截短于250字）
