Kondo M, Miyazaki S, Takahashi M, Shimono Y
Jpn Circ J. 1984 Mar;48(3):219-24. doi: 10.1253/jcj.48.219.
The viability of the myocardial regions corresponding to pathologic Q waves was evaluated. Thirty-four patients with prior myocardial infarction underwent serial thallium-201 scintigraphy during treadmill exercise testing. On the delayed images, 8 of the initial 85 segmental defects (8 patients, 9%) showed total redistribution (RD) and 11 (6 patients, 13%) showed partial RD. In contrast, 66 segments showed persistent defect. The segments with total RD were more likely to be associated with normal or hypokinetic wall motion than the segments with persistent defect (p less than 0.05). Six of the 38 segments (13%) with collateral vessels showed total RD and 10 (21%) showed partial RD. However, 35 of 38 segments (92%) without collateral vessels showed persistent defect. There was a significant difference (p = 0.02) in myocardial thallium uptake patterns when the segments with and without collateral vessels were compared. It is concluded that (1) exercise-induced thallium RD may occur in patients with prior myocardial infarction, and myocardial infarct regions with total RD are highly associated with good contractility; these suggest the presence of viable but jeopardized myocardium within the infarct zone, and (2) collateral vessels may play a role in limiting infarct size.
对与病理性Q波相对应的心肌区域的存活能力进行了评估。34例有心肌梗死病史的患者在平板运动试验期间接受了系列铊-201闪烁扫描。在延迟图像上，最初85个节段性缺损中的8个（8例患者，9%）显示完全再分布（RD），11个（6例患者，13%）显示部分RD。相比之下，66个节段显示持续缺损。与有持续缺损的节段相比，完全RD的节段更可能与正常或运动减弱的室壁运动相关（p小于0.05）。38个有侧支血管的节段中有6个（13%）显示完全RD，10个（21%）显示部分RD。然而，38个无侧支血管的节段中有35个（92%）显示持续缺损。比较有和无侧支血管的节段时，心肌铊摄取模式存在显著差异（p = 0.02）。得出的结论是：（1）运动诱发的铊RD可能发生在有心肌梗死病史的患者中，完全RD的心肌梗死区域与良好的收缩性高度相关；这些提示梗死区内存在存活但处于危险中的心肌，以及（2）侧支血管可能在限制梗死面积方面起作用。
