慢性恰加斯心肌病左心室功能的放射性核素评估

Radionuclide evaluation of left-ventricular function in chronic Chagas' cardiomyopathy.

作者信息

Arreaza N, Puigbó J J, Acquatella H, Casal H, Giordano H, Valecillos R, Mendoza I, Pérez J F, Hirschhaut E, Combellas I

出版信息

J Nucl Med. 1983 Jul;24(7):563-7.

Abstract

Left-ventricular ejection fraction (LVEF) and abnormalities of regional wall motion (WMA) were studied by means of radionuclide ventriculography in 41 patients prospectively diagnosed as having chronic Chagas' disease. Thirteen patients were asymptomatic (ASY), 16 were arrhythmic (ARR), and 12 had congestive heart failure (CHF). Mean LVEF was normal in ASY (0.64 +/- 0.06) but markedly depressed in CHF (0.28 +/- 0.08). Regional WMAs were minimal in ASY and their severity increased in ARR. Most CHFs (75%) had diffuse hypokinesia of the left ventricle. The region most frequently affected was the infero-apical (63%). Seven patients had a distinct apical aneurysm. Correlation between radionuclide and contrast ventriculography data was good in 17 patients. For LVEF, r = 0.90. For WMA there was agreement between the two techniques in 77% of 65 segments compared. Best agreement occurred with infero-apical lesions (88%), and worst with septal (69%). Selective coronary arteriography showed normal arteries in all patients. Therefore, chronic Chagas' heart disease joins ischemic heart disease as a cause of regional WMA.

摘要

通过放射性核素心室造影术对41例前瞻性诊断为慢性恰加斯病的患者进行了左心室射血分数（LVEF）及室壁运动异常（WMA）研究。13例患者无症状（ASY），16例有心律失常（ARR），12例有充血性心力衰竭（CHF）。ASY患者的平均LVEF正常（0.64±0.06），而CHF患者则显著降低（0.28±0.08）。ASY患者的室壁运动异常轻微，其严重程度在ARR患者中增加。大多数CHF患者（75%）有左心室弥漫性运动减弱。最常受累的区域是下尖部（63%）。7例患者有明显的心尖部动脉瘤。17例患者放射性核素心室造影与对比心室造影数据之间的相关性良好。对于LVEF，r = 0.90。对于WMA，在比较的65个节段中，两种技术有77%的一致性。下尖部病变的一致性最佳（88%），而间隔部最差（69%）。选择性冠状动脉造影显示所有患者的动脉均正常。因此，慢性恰加斯心脏病与缺血性心脏病一样，是导致室壁运动异常的原因。