Hashimoto A, Nakata T, Nagao K, Kobayashi H, Hase M, Yoshioka N, Tsuchihashi K, Yonekura S, Tanaka S, Iimura O
Second Department of Internal Medicine, Sapporo Medical University School of Medicine.
J Cardiol. 1995 Aug;26(2):59-68.
The relationships between myocardial perfusion, fatty acid metabolism, and cardiac function were investigated using dual single photon emission computed tomography (SPECT) with thallium and iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid (123I-BMIPP) during the acute (10 +/- 1 days) and recovery (60 +/- 14 days) phases in 29 patients with acute myocardial infarction. There were 18 patients who underwent successful primary coronary angioplasty (PTCA group) and 11 patients who received conservative therapy (non PTCA group). Thallium and BMIPP uptakes were scored visually by a 4-point system and left ventricular ejection fraction (LVEF) was calculated by radionuclide ventriculography. Although significant positive correlations between thallium and 123I-BMIPP scores were observed during both phases, BMIPP scores were significantly lower than thallium scores in both acute and recovery phases in the PTCA group. No significant difference in thallium and 123I-BMIPP scores was observed at the recovery phase in the non PTCA group. LVEF significantly correlated with thallium and 123I-BMIPP scores in both phases in the PTCA group. Furthermore, the difference between thallium and 123I-BMIPP scores during the acute phase significantly correlated with the improvement of LVEF during the follow-up period in the PTCA group (y = 0.92x-0.77, r = 0.65, p < 0.005). These findings suggest that mismatch of perfusion and metabolism in infarcted myocardium assessed by thallium and 123I-BMIPP SPECT is increased by reperfusion therapy and persists at least until the recovery phase of myocardial infarction. The recovery of left ventricular function depends on the extent of the mismatched uptake, indicating a predictor for functional recovery following acute myocardial infarction.
采用铊和碘-123-β-甲基-对碘苯基十五烷酸（123I-BMIPP）双单光子发射计算机断层扫描（SPECT），对29例急性心肌梗死患者在急性期（10±1天）和恢复期（60±14天）心肌灌注、脂肪酸代谢与心功能之间的关系进行了研究。其中18例患者接受了成功的直接冠状动脉血管成形术（PTCA组），11例患者接受了保守治疗（非PTCA组）。铊和BMIPP摄取通过4分制进行视觉评分，左心室射血分数（LVEF）通过放射性核素心室造影计算。尽管在两个阶段均观察到铊和123I-BMIPP评分之间存在显著正相关，但PTCA组在急性期和恢复期的BMIPP评分均显著低于铊评分。非PTCA组在恢复期铊和123I-BMIPP评分无显著差异。PTCA组在两个阶段LVEF均与铊和123I-BMIPP评分显著相关。此外，PTCA组急性期铊和123I-BMIPP评分的差值与随访期LVEF的改善显著相关（y = 0.92x - 0.77，r = 0.65，p < 0.005）。这些发现表明，通过铊和123I-BMIPP SPECT评估的梗死心肌灌注与代谢不匹配因再灌注治疗而增加，并且至少持续到心肌梗死的恢复期。左心室功能的恢复取决于不匹配摄取的程度，这表明是急性心肌梗死后功能恢复的一个预测指标。
