Watanabe K, Oda H, Tsuda T, Shibata A
Jpn Heart J. 1985 May;26(3):379-89. doi: 10.1536/ihj.26.379.
Twenty-six patients with idiopathic dilated cardiomyopathy (DCM) underwent thallium-201 myocardial scintigraphy. Nine patients (group A) showed a perfusion defect in the interventricular septum (IVS) and 7 patients (group B) showed a defect in the left ventricular posterior wall (LVPW). Hemodynamic responses and catecholamine levels were compared between 16 patients (DCM group) and 6 control subjects (control group) following dopamine infusion (6 micrograms/Kg/min). The end-diastolic thickness of the IVS and LVPW, and the percentage wall thickening were assessed by echocardiography. Plasma dopamine and norepinephrine concentrations in the DCM group were not different from those of the control group at rest. During the dopamine infusion, however, norepinephrine increased only in the control group. There were significant differences in the thickness of the IVS among the 3 groups [7.3 +/- 1.4 mm for group A (p less than 0.001 vs control and p less than 0.05 vs group B), 8.9 +/- 1.5 mm for group B (p less than 0.01 vs control), 10.2 +/- 1.5 mm for the control group]. The percentage thickening of the IVS increased during the dopamine infusion in group B only and the thickening of the LVPW increased in group A only. Thus, in the myocardium of DCM patients with thallium perfusion defects, the degree of thickening did not change during dopamine infusion, but in the myocardium of DCM patients with normal thallium uptake the percentage thickening increased more than in the control group.
26例特发性扩张型心肌病（DCM）患者接受了铊-201心肌闪烁扫描。9例患者（A组）在室间隔（IVS）出现灌注缺损，7例患者（B组）在左心室后壁（LVPW）出现缺损。在16例患者（DCM组）和6例对照受试者（对照组）静脉输注多巴胺（6微克/千克/分钟）后，比较血流动力学反应和儿茶酚胺水平。通过超声心动图评估IVS和LVPW的舒张末期厚度以及室壁增厚百分比。DCM组静息时血浆多巴胺和去甲肾上腺素浓度与对照组无差异。然而，在输注多巴胺期间，仅对照组的去甲肾上腺素升高。3组之间IVS厚度存在显著差异[A组为7.3±1.4毫米（与对照组相比p<0.001，与B组相比p<0.05），B组为8.9±1.5毫米（与对照组相比p<0.01），对照组为10.2±1.5毫米]。仅B组在输注多巴胺期间IVS增厚百分比增加，仅A组LVPW增厚。因此，在有铊灌注缺损的DCM患者心肌中，多巴胺输注期间增厚程度未改变，但在铊摄取正常的DCM患者心肌中，增厚百分比的增加幅度大于对照组。
