Takao M, Miyahara Y, Shinboku H, Nishijima K, Morimitsu T, Hara K
Second Department of Internal Medicine, Nagasaki University, School of Medicine, Japan.
Chest. 1996 Jan;109(1):67-72. doi: 10.1378/chest.109.1.67.
Noninvasive multigated equilibrium radionuclide ventriculography with krypton-81m (81mKr) was used to assess right heart relaxation in patients with chronic pulmonary diseases (CPD). The subjects consisted of 30 patients with CPD and 8 patients free of cardiopulmonary diseases admitted to our department. A region of interest (ROI) was selected on both the right atrium (RA) and right ventricle (RV). A time activity curve was obtained for each ROI. As a diastolic index of the right heart performance, the right atrial early emptying rate (RAER) was obtained from the right atrial time activity curve, while the right ventricular rapid filling rate (RVRFR) was obtained from the right ventricular time activity curve. The mean RAER was significantly lower in CPD patients compared with the control (CPD, 9.5 +/- 4.5; control, 16 +/- 3.4%/100 ms). Similarly, the mean RVRFR was significantly lower in CPD patients compared with the control (CPD, 27.3 +/- 9.9; control, 34 +/- 8.5%/100 ms). A strong negative correlation was noted between the mean pulmonary arterial pressure (mPAP) and RAER (r = -0.77; p < 0.001) and between the mPAP and the RVRFR (r = -0.63; p < 0.001). Our results suggest that RAER and RVRFR measured by 81mKr are clinically useful in the noninvasive assessment of right heart relaxation in patients with CPD.
采用氪-81m(81mKr)进行无创多门控平衡放射性核素心室造影,以评估慢性肺部疾病(CPD)患者的右心舒张功能。研究对象包括30例CPD患者和8例入住我科的无心肺疾病患者。在右心房(RA)和右心室(RV)均选取感兴趣区(ROI)。为每个ROI获取时间-活性曲线。作为右心功能的舒张指标,右心房早期排空率(RAER)从右心房时间-活性曲线得出,而右心室快速充盈率(RVRFR)从右心室时间-活性曲线得出。与对照组相比,CPD患者的平均RAER显著降低(CPD组为9.5±4.5;对照组为16±3.4%/100毫秒)。同样,与对照组相比,CPD患者的平均RVRFR显著降低(CPD组为27.3±9.9;对照组为34±8.5%/100毫秒)。平均肺动脉压(mPAP)与RAER之间存在强负相关(r = -0.77;p < 0.001),mPAP与RVRFR之间也存在强负相关(r = -0.63;p < 0.001)。我们的结果表明,81mKr测量的RAER和RVRFR在无创评估CPD患者右心舒张功能方面具有临床应用价值。