Gimelli A, Marzullo P, Bartoli M, Sambuceti G, Giorgetti A, Parodi O
CNR Institute of Clinical Physiology, Pisa, Italy.
J Nucl Biol Med (1991). 1993 Sep;37(3):119-25.
To assess whether myocardial stunning occurs following brief episodes of effort ischemia, ventricular function was assessed by radionuclide angiography in 29 patients with coronary artery disease. No patient had evidence of previous myocardial infarction. Patients were divided into two groups according to presence of single (14 patients, Group 1) or multi-vessel (15 patients, Group 2) coronary artery disease. Equilibrium radionuclide angiocardiography was performed in the left anterior oblique projection by a small field-of-view gamma-camera. Acquisition were performed at baseline, at peak exercise, then again at 1 and 5 minutes of the recovery phase. For each acquisition, ejection fraction, peak filling rate and wall motion index were measured and compared. No difference in baseline and stress measurements was found between Group 1 and Group 2, except for the wall motion index that was more impaired during ischemia in patients of Group 2. Global and regional indexes of ventricular function did not show significant differences also in the two recovery periods when compared to the relative baseline values. Transient ischemia caused by an increase of oxygen demand did not reproduce the phenomenon of systolic and diastolic stunning observed in animal experiments, although in all patients the ischemia was of sufficient duration and severity to induce transient ventricular dysfunction.
为评估短暂性劳力性缺血发作后是否会发生心肌顿抑，对29例冠状动脉疾病患者采用放射性核素血管造影术评估心室功能。所有患者均无既往心肌梗死证据。根据单支冠状动脉病变（14例，第1组）或多支冠状动脉病变（15例，第2组）将患者分为两组。采用小视野γ相机在左前斜位进行平衡放射性核素心血管造影。分别在基线、运动高峰以及恢复阶段的第1分钟和第5分钟进行图像采集。每次采集时，测量并比较射血分数、峰值充盈率和室壁运动指数。第1组和第2组在基线和应激测量方面无差异，但第2组患者在缺血期间室壁运动指数受损更严重。与相对基线值相比，在两个恢复期心室功能的整体和局部指标也未显示出显著差异。尽管所有患者的缺血持续时间和严重程度足以诱发短暂性心室功能障碍，但由需氧量增加引起的短暂性缺血并未重现动物实验中观察到的收缩期和舒张期顿抑现象。
