Omura T, Teragaki M, Tani T, Yamagishi H, Yanagi S, Nishikimi T, Yoshiyama M, Toda I, Akioka K, Takeuchi K
Department of Internal Medicine, Osaka City University Medical School, Japan.
Jpn Circ J. 1993 Nov;57(11):1062-70. doi: 10.1253/jcj.57.1062.
To estimate the size of myocardial infarction, serum troponin T concentration was measured in 34 patients with acute myocardial infarction. Left ventriculography, 2-dimensional echocardiography and resting 201thallium myocardial single photon emission computed tomography (SPECT) were performed about 4 weeks after the onset of myocardial infarction and used for correlation with the late serum troponin T peak concentration which occurred on the 3rd to 5th day after onset. Both left ventricular ejection fraction (LVEF) obtained from left ventriculography and wall motion index (WMI) obtained from 2-dimensional echocardiography were inversely related to late troponin T peak value (LVEF: r = 0.68, p < 0.001, WMI: r = 0.70, p < 0.001). Extent score (ES) and severity score (SS), which were estimated from the initial resting 201thallium SPECT image, showed excellent linear correlations with late troponin T peak concentrations (ES: r = 0.77, p < 0.001, SS: r = 0.66, p < 0.001). This correlation was present both in patients with an early troponin T peak on day 1 (group A-16 patients) and in those without an early peak (group B-10 patients). Thus, late troponin T peak concentration can be used to predict infarct size regardless of the kinetics of its appearance in serum.
为评估心肌梗死面积，对34例急性心肌梗死患者测定了血清肌钙蛋白T浓度。在心肌梗死后约4周进行左心室造影、二维超声心动图和静息状态下的铊-201心肌单光子发射计算机断层扫描（SPECT），并用于与发病后第3至5天出现的血清肌钙蛋白T晚期峰值浓度进行相关性分析。从左心室造影获得的左心室射血分数（LVEF）和从二维超声心动图获得的室壁运动指数（WMI）均与肌钙蛋白T晚期峰值呈负相关（LVEF：r = 0.68，p < 0.001；WMI：r = 0.70，p < 0.001）。根据初始静息铊-201 SPECT图像估算的范围评分（ES）和严重程度评分（SS）与肌钙蛋白T晚期峰值浓度呈良好的线性相关（ES：r = 0.77，p < 0.001；SS：r = 0.66，p < 0.001）。这种相关性在发病第1天肌钙蛋白T峰值出现较早的患者（A组-16例患者）和未出现早期峰值的患者（B组-10例患者）中均存在。因此，无论血清中肌钙蛋白T出现的动力学情况如何，肌钙蛋白T晚期峰值浓度均可用于预测梗死面积。
