Yamamoto S, Kawai N, Okada M, Matsushima H, Kato R, Sotobata I, Tanahashi Y
J Cardiogr. 1985 Jun;15(2):513-23.
The usefulness of multigated cardiac blood pool imaging in evaluating left ventricular function and ventricular activation was studied in patients with cardiac arrhythmias. Subjects consisted of 12 patients with the Wolff-Parkinson-White (WPW) syndrome; 20 with ventricular premature contractions (VPC); 21 with various modes of artificial pacemakers; and two normal controls. Phase analysis was useful in localizing the bypass tract in patients with the WPW syndrome. In four patients with the WPW syndrome and five with VVI pacing, the phase difference between the posterolateral wall of the left ventricle (LV) and the right ventricular apex correlated significantly with the activation time difference between these two regions as assessed by endocardial electrograms (r = 0.94, p less than 0.001). Images of VPC were obtained using the bad beat rejection program in an ADAC computer system. The origin of VPCs evaluated by phase image coincided with results of standard 12-lead electrograms. It was in the right ventricle in four patients, the LV in one, and probably in the interventricular septum in one. The LV ejection fraction (LVEF) decreased significantly (p less than 0.001) after the injection of lidocaine (-3.7%) or disopyramide (-6.2%). The percent reduction in LVEF was significantly greater with disopyramide than with lidocaine (-15.1 vs -11.2%). The plasma concentration of disopyramide was higher in four patients with organic heart diseases than in 11 without. There was a significant correlation between the percent reduction in LVEF and the disopyramide plasma concentrations (r = -0.62, p less than 0.001). The influence of the pacing mode and exercise on LV function was studied in 21 patients with artificial pacemakers. In the VDD and DDD modes, end-diastolic volume (EDV) and cardiac output (CO) decreased after converting to VVI mode. CO increased markedly to approximately 250% of the control value in the VDD and DDD, and moderately in the VVI and AAI modes during ergometer exercise. In conclusion, multigated cardiac pool imaging is considered useful in diagnosing and managing patients with cardiac arrhythmias.
我们研究了多门控心血池显像在评估心律失常患者左心室功能和心室激动方面的实用性。研究对象包括12例预激综合征（WPW）患者、20例室性早搏（VPC）患者、21例使用各种模式人工起搏器的患者以及2名正常对照者。相位分析有助于定位WPW综合征患者的旁路传导束。在4例WPW综合征患者和5例VVI起搏患者中，左心室（LV）后外侧壁与右心室尖之间的相位差与通过心内膜电图评估的这两个区域之间的激动时间差显著相关（r = 0.94，p < 0.001）。使用ADAC计算机系统中的早搏剔除程序获取VPC图像。通过相位图像评估的VPC起源与标准1十二导联心电图结果一致。4例患者的VPC起源于右心室，1例起源于左心室，1例可能起源于室间隔。注射利多卡因（-3.7%）或丙吡胺（-6.2%）后，左心室射血分数（LVEF）显著降低（p < 0.001）。丙吡胺导致的LVEF降低百分比显著大于利多卡因（-15.1%对-11.2%）。4例器质性心脏病患者的丙吡胺血浆浓度高于11例无器质性心脏病患者。LVEF降低百分比与丙吡胺血浆浓度之间存在显著相关性（r = -0.62，p < 0.001）。我们研究了21例人工起搏器患者的起搏模式和运动对左心室功能的影响。在VDD和DDD模式下，转换为VVI模式后舒张末期容积（EDV）和心输出量（CO）降低。在测力计运动期间，VDD和DDD模式下CO显著增加至对照值的约250%，VVI和AAI模式下适度增加。总之，多门控心血池显像被认为对心律失常患者的诊断和管理有用。
