Yambe T, Nitta S, Tanaka M, Meguro T, Saijoh Y, Naganuma S, Kobayashi S, Endoh N, Terasawa Y, Katahira Y
Department of Medical Engineering and Cardiology, Tohoku University, Sendai, Japan.
Ann Nucl Med. 1993 Aug;7(3):187-92. doi: 10.1007/BF03164965.
It has been frequently reported that while myocardial viability is neglected in conventional methods of diagnosis such as left ventriculography, ECG, and exercise thallium-201 myocardial scintigraphy (Ex-Tl), revascularization often results in improving left ventricular wall motility. In the present study, the authors contrived a method to accurately evaluate the viability of the myocardium by means of exercise rehabilitation, and tested the method in clinical cases. Among patients with myocardial infarction, we selected a patient with negative viability in the diseased area as determined by chronic ECG, left ventriculography (LVG), coronary angiography and Ex-Tl. This patient went through two weeks of active exercise rehabilitation gauged with an ergometer, and was then re-examined by Ex-Tl. After the evaluation, revascularization was performed for the patient who demonstrated viability of the infarcted myocardium in EX-Tl after rehabilitation, and significant improvement in contractility was shown in the chronic LVG. These findings indicate that our method of detecting potential viability of the infarcted myocardium is of clinical significance.
经常有报道称，在诸如左心室造影、心电图和运动铊-201心肌闪烁显像（Ex-Tl）等传统诊断方法中，心肌活力常被忽视，而血运重建往往会改善左心室壁运动。在本研究中，作者设计了一种通过运动康复准确评估心肌活力的方法，并在临床病例中进行了测试。在心肌梗死患者中，我们选择了一名经慢性心电图、左心室造影（LVG）、冠状动脉造影和Ex-Tl检查确定病变区域心肌活力为阴性的患者。该患者通过测力计进行了为期两周的积极运动康复，然后再次接受Ex-Tl检查。评估后，对康复后Ex-Tl显示梗死心肌有活力的患者进行了血运重建，慢性LVG显示收缩力有显著改善。这些发现表明，我们检测梗死心肌潜在活力的方法具有临床意义。
