Schofer J, Spielmann R, Sheehan F H, Lampe M, Schlüter M, Mathey D G
Department of Cardiology, University Hospital Eppendorf, Hamburg, F.R.G.
Int J Card Imaging. 1988;3(4):203-8. doi: 10.1007/BF01797718.
In 32 patients with acute myocardial infarction, who had undergone successful intracoronary thrombolysis, the results of regional wall motion measured from contrast cineangiograms 10 to 21 days after thrombolysis were related to the results of thallium single-photon emission computed tomography (SPECT) after intravenous dipyridamole. Wall motion was measured by means of the centerline method, and thallium defect size was estimated by comparing the patient's circumferential profile with that of 20 normals. No correlation was found between ejection fraction or regional wall motion and thallium defect size. The time from symptom onset to thrombolysis was inversely correlated with the degree of hypokinesis (r = -0.51) but not with thallium defect size. In patients treated within 3 hours, hypokinesis was significantly less than in patients treated later (-1.1 +/- 0.6 SD vs -2.2 +/- 0.8 SD, p less than 0.01) whereas thallium defect size was not significantly different in both groups. It is concluded that, in patients after thrombolysis, thallium defect size determined by SPECT does not reflect the degree of left ventricular dysfunction.
在32例成功接受冠状动脉内溶栓治疗的急性心肌梗死患者中,溶栓后10至21天从对比心血管造影测量的局部室壁运动结果与静脉注射双嘧达莫后的铊单光子发射计算机断层扫描(SPECT)结果相关。通过中心线法测量室壁运动,并通过将患者的圆周轮廓与20名正常人的轮廓进行比较来估计铊缺损大小。未发现射血分数或局部室壁运动与铊缺损大小之间存在相关性。从症状发作到溶栓的时间与运动减弱程度呈负相关(r = -0.51),但与铊缺损大小无关。在3小时内接受治疗的患者中,运动减弱明显少于后期治疗的患者(-1.1±0.6标准差对-2.2±0.8标准差,p小于0.01),而两组的铊缺损大小无显著差异。结论是,在溶栓后的患者中,SPECT确定的铊缺损大小不能反映左心室功能障碍的程度。