Taniguchi Y, Sugihara H, Ootsuki K, Umamoto I, Nakagawa T, Shiga K, Nakamura T, Azuma A, Kohno Y, Nakagawa M
Second Department of Medicine, Kyoto Prefectural University of Medicine.
Kaku Igaku. 1993 Jan;30(1):69-73.
Effect of verapamil on myocardial ischemia in patients with hypertrophic cardiomyopathy (HCM) was evaluated by exercise stress myocardial 201Tl SPECT (EX-Tl). EX-Tl were performed before and after 8.8 weeks of oral verapamil (240 mg/day) in 12 patients with HCM who showed transient 201Tl perfusion defects under control conditions. 201Tl perfusion defect was visually scored and judged for 4 grades as normal (0), mild defect (1), moderate defect (2), and severe defect (3). Transient Dilation Index (TDI) was calculated as an index of subendocardial ischemia. Improvements of defect score were demonstrated in 10 patients after administration of verapamil. Two patients showed no change of defect score. Mean defect score decreased significantly from 5.50 to 3.03 (p < 0.001). Although 11 of 12 patients showed abnormal TDI under control conditions, 10 of them revealed improvements of TDI and 7 of those 10 patients disclosed normal TDI after verapamil. Mean TDI decreased from 1.263 to 1.090 significantly (p < 0.01). In conclusion, verapamil may improve myocardial ischemia in patients with HCM.
通过运动负荷心肌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12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（240毫克/天）8.8周前后进行EX-Tl检查。对201Tl灌注缺损进行视觉评分并判断为4个等级，即正常（0）、轻度缺损（1）、中度缺损（2）和重度缺损（3）。计算短暂扩张指数（TDI）作为心内膜下缺血的指标。维拉帕米给药后10例患者的缺损评分有所改善。2例患者的缺损评分无变化。平均缺损评分从5.50显著降至3.03（p<0.001）。虽然12例患者中有11例在对照条件下TDI异常，但其中10例TDI有所改善，这10例患者中有7例在服用维拉帕米后TDI恢复正常。平均TDI从1.263显著降至1.090（p<0.01）。总之，维拉帕米可能改善HCM患者的心肌缺血。
