Taniguchi Y, Sugihara H, Ohtsuki K, Umamoto I, Nakagawa T, Shiga K, Nakamura T, Azuma A, Kohno Y, Nakagawa M
Second Department of Internal Medicine, Kyoto Prefectural University of Medicine.
J Cardiol. 1994 Jan-Feb;24(1):45-51.
The effect of verapamil on myocardial ischemia in patients with hypertrophic cardiomyopathy (HCM) was evaluated by exercise myocardial 201Tl SPECT (EX-Tl). EX-Tl was performed before and after 8.1 +/- 6.1 weeks of oral administration of verapamil (240 mg/day) on 20 patients with HCM who showed transient 201Tl perfusion defects under control conditions. SPECT images were divided into nine segments. The 201Tl perfusion defect was visually scored and evaluated for four grades in each segment and the sum total grade was calculated as the defect score. Transient dilation index was calculated as a reflection of subendocardial ischemia. Improvements in defect score were demonstrated in 18 of 20 patients after administration of verapamil. The mean defect score decreased significantly from 5.1 +/- 2.3 to 2.5 +/- 2.4 (p < 0.001). Although 18 of 20 patients showed abnormal transient dilation index under control conditions, 16 showed improvement and 12 were normalized after verapamil therapy. Mean transient dilation index decreased from 1.24 +/- 0.19 to 1.08 +/- 0.10 (p < 0.01). Verapamil improves myocardial ischemia in patients with HCM.
通过运动心肌201Tl单光子发射计算机断层扫描（EX-Tl）评估维拉帕米对肥厚型心肌病（HCM）患者心肌缺血的影响。对20例在对照条件下出现短暂性201Tl灌注缺损的HCM患者，在口服维拉帕米（240mg/天）8.1±6.1周前后进行EX-Tl检查。SPECT图像分为九个节段。对每个节段的201Tl灌注缺损进行视觉评分并评估为四个等级，计算总分等级作为缺损评分。计算瞬时扩张指数以反映心内膜下缺血情况。维拉帕米给药后，20例患者中有18例缺损评分有所改善。平均缺损评分从5.1±2.3显著降至2.5±2.4（p<0.001）。虽然20例患者中有18例在对照条件下瞬时扩张指数异常，但维拉帕米治疗后16例有所改善，12例恢复正常。平均瞬时扩张指数从1.24±0.19降至1.08±0.10（p<0.01）。维拉帕米可改善HCM患者的心肌缺血。
