McFalls E O, Araujo L I, Lammertsma A, Rhodes C G, Bloomfield P, Pupita G, Jones T, Maseri A
Department of Cardiology, VA Hospital, University of Minnesota, Minneapolis 55417.
Eur Heart J. 1993 Mar;14(3):336-43. doi: 10.1093/eurheartj/14.3.336.
Myocardial blood flow can be accurately quantitated in patients using positron emission tomography and oxygen-15 labelled water. The purpose of this study was to determine the vasodilator reserve in myocardium completely perfused by intramyocardial collateral blood flow. We hypothesized that altered relative flow reserve in such regions would correlate with the degree of ischaemia observed in these patients during exercise. The technique involves the inhalation of the positron emitting tracer C15O2 which is converted to freely diffusible H2(15)O by the lung. With rapid dynamic scanning, arterial and regional myocardial tissue concentrations can be obtained and time activity curves generated. With a two-compartment kinetic model, myocardial blood flow can be accurately quantitated over a wide range of blood flows. Five patients with stable exertional angina and normal ventricular function studies and who had an occluded major epicardial artery which completely opacified via intramyocardial collateral blood flow were studied. Myocardial blood flow (MBF) was measured both at rest and following an infusion of intravenous dipyridamole (0.56 mg.kg-1) and the results were compared with measurements obtained from a group of eight normal volunteers. During resting conditions, MBF in the control group was 0.86 +/- 0.10 ml.g-1.min-1 and in the patient group was 0.99 +/- 0.10 ml.g-1.min-1 in normally perfused myocardium (ns) and 0.86 +/- 0.14 ml.g-1.min-1 in collateral-dependent myocardium (ns). Following dipyridamole, MBF increased to 3.58 +/- 0.89 ml.g-1.min-1 in the control group and to 2.97 +/- 0.94 ml.g-1.min-1 in the normal regions of the patients (ns).(ABSTRACT TRUNCATED AT 250 WORDS)
使用正电子发射断层扫描和氧 - 15标记水，可准确测定患者的心肌血流量。本研究的目的是确定由心肌内 collateral 血流完全灌注的心肌中的血管扩张储备。我们假设，这些区域相对血流储备的改变与这些患者运动期间观察到的缺血程度相关。该技术包括吸入正电子发射示踪剂C15O2，其在肺中转化为可自由扩散的H2(15)O。通过快速动态扫描，可获得动脉和局部心肌组织浓度并生成时间 - 活性曲线。使用双室动力学模型，可在很宽的血流范围内准确测定心肌血流量。研究了5例稳定型劳力性心绞痛且心室功能正常的患者，他们有一条主要的心外膜动脉闭塞，通过心肌内 collateral 血流完全显影。在静息状态和静脉输注双嘧达莫（0.56 mg·kg-1）后测量心肌血流量（MBF），并将结果与一组8名正常志愿者的测量结果进行比较。在静息状态下，对照组正常灌注心肌的MBF为0.86±0.10 ml·g-1·min-1，患者组为0.99±0.10 ml·g-1·min-1（无显著差异），依赖 collateral 的心肌为0.86±0.14 ml·g-1·min-1（无显著差异）。输注双嘧达莫后，对照组的MBF增加到3.58±0.89 ml·g-1·min-·1，患者正常区域的MBF增加到2.97±0.94 ml·g-1·min-1（无显著差异）。（摘要截断于250字） 注：“collateral”此处结合语境推测为“侧支的”意思，但原文该词表述不太完整准确。
