Yamamuro M, Yada T, Ichikawa T, Futagami Y, Konishi T, Nakano T, Takezawa H
J Cardiogr. 1986 Jun;16(2):331-42.
The clinical usefulness of radionuclide ventriculography (RNV) was evaluated in patients with right ventricular ischemia. The subjects consisted of 25 patients with acute inferior myocardial infarction, 19 patients with old myocardial infarction and six patients with angina pectoris who had severe stenosis of the right coronary artery. In patients with acute inferior myocardial infarction, follow-up radionuclide studies were performed during the recovery periods on the first, 7th-14th, and 30th hospital day. Fifteen of the 25 patients initially had decreased right ventricular ejection fractions (evidence of right ventricular infarction). The mean value was 28 +/- 8% on the initial day, but 7-14 days and 30 days after the acute attack, it improved markedly to 36 +/- 9% and 39 +/- 9%, respectively. Regional wall motion abnormality resolved in 10 of the 15 patients on the 30th hospital day. In 25 patients with old myocardial infarction or with angina pectoris, RNV was performed at rest and during supine exercise to determine the influence or right coronary artery disease. Right ventricular ejection fraction was changed by exercise from 42 +/- 7% to 44 +/- 10% in patients with proximal artery lesions, and from 45 +/- 7% to 50 +/- 10% in patients with distal artery lesions. Right ventricular ejection fraction increased in patients with isolated right coronary artery disease (rest: 44 +/- 8%, exercise: 49 +/- 9%), decreased in patients with combined left anterior descending artery disease (rest: 40 +/- 6%, exercise: 38 +/- 11%) and increased in patients with combined circumflex artery disease (rest: 43 +/- 5%, exercise: 47 +/- 6%). We concluded that right ventricular infarction is a frequent complication in patients with inferior myocardial infarction. However, right ventricular ejection fraction and right ventricular regional wall motion abnormality improve dramatically within one month. Stress-induced ischemia would be rare in patients with isolated right coronary artery disease. The above findings support the notion that the right ventricular myocardium has peculiar coronary perfusions.
对右心室缺血患者评估了放射性核素心室造影（RNV）的临床实用性。研究对象包括25例急性下壁心肌梗死患者、19例陈旧性心肌梗死患者和6例右冠状动脉严重狭窄的心绞痛患者。对于急性下壁心肌梗死患者，在恢复期间的第1天、第7 - 14天和第30天进行了放射性核素随访研究。25例患者中有15例最初右心室射血分数降低（提示右心室梗死）。初始日平均值为28±8%，但在急性发作后7 - 14天和30天，分别显著改善至36±9%和39±9%。15例患者中有10例在住院第30天时局部室壁运动异常消失。在25例陈旧性心肌梗死或心绞痛患者中，进行了静息和仰卧位运动时的RNV检查，以确定右冠状动脉疾病的影响。近端动脉病变患者运动时右心室射血分数从42±7%变为44±10%，远端动脉病变患者从45±7%变为50±10%。孤立性右冠状动脉疾病患者右心室射血分数增加（静息：44±8%，运动：49±9%），合并左前降支动脉疾病患者降低（静息：40±6%，运动：38±11%），合并回旋支动脉疾病患者增加（静息：43±5%，运动：47±6%）。我们得出结论，右心室梗死是下壁心肌梗死患者常见的并发症。然而，右心室射血分数和右心室局部室壁运动异常在1个月内显著改善。孤立性右冠状动脉疾病患者应激性缺血罕见。上述发现支持右心室心肌有特殊冠状动脉灌注的观点。
