Kondo C, Nakazawa M, Kusakabe K, Momma K
Department of Pediatric Cardiology, Tokyo Women's Medical College, Japan.
J Nucl Cardiol. 1996 Jan-Feb;3(1):30-6. doi: 10.1016/s1071-3581(96)90021-5.
Myocardial contractile dysfunction has been frequently observed in adolescents or adults with cyanotic congenital heart disease. Impaired energy metabolism may be present in such dysfunctional myocardium.
To evaluate the findings of myocardial free fatty acid metabolism, and its relations to ventricular wall motion and myocardial perfusion in cyanotic congenital heart disease, we performed a combined study of iodine 123-labeled 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) scintigraphy, thallium scintigraphy, and contrast cine-angiography in seven patients with single right or left ventricle. The results showed that wall motion was reduced in 17 of 35 ventricular segments (49%), which were mostly identical in location to decreased BMIPP uptake. The severity of BMIPP uptake deficit correlated positively with the degree of impairment of wall motion. On the other hand, thallium uptake was abnormal only in 5 of 35 segments (14%), and the severity of the perfusion defect did not correlate with the degree of wall motion abnormality.
Contractile dysfunction in cyanotic heart disease was primarily linked to impaired free fatty acid metabolism rather than to myocardial scar as represented by perfusion defect on thallium imaging.
在患有紫绀型先天性心脏病的青少年或成人中，经常观察到心肌收缩功能障碍。这种功能失调的心肌中可能存在能量代谢受损。
为了评估紫绀型先天性心脏病中心肌游离脂肪酸代谢的结果及其与心室壁运动和心肌灌注的关系，我们对7名单一右心室或左心室患者进行了碘123标记的15 - （对碘苯基）-3 - （R，S）-甲基十五烷酸（BMIPP）闪烁扫描、铊闪烁扫描和对比电影血管造影的联合研究。结果显示，35个心室节段中有17个（49%）壁运动减弱，其位置大多与BMIPP摄取减少的位置相同。BMIPP摄取缺陷的严重程度与壁运动受损程度呈正相关。另一方面，35个节段中只有5个（14%）铊摄取异常，灌注缺损的严重程度与壁运动异常程度无关。
紫绀型心脏病中的收缩功能障碍主要与游离脂肪酸代谢受损有关，而非与铊显像上灌注缺损所代表的心肌瘢痕有关。
