Ido A, Hasebe N, Nakamura H, Ohi S, Tsuji S, Yokoyama A, Kido S, Ishii Y, Kawamura Y, Yamashita H, Kikuchi K, Yamamoto W, Shuuke N, Aburano T
First Department of Internal Medicine, Asahikawa Medical College.
Kaku Igaku. 1997 Sep;34(9):807-14.
We studied the abnormality of myocardial sympathetic nervous system in patients with hypertrophic cardiomyopathy using 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy in comparison with the parameters of other clinical examinations. In 50 patients with HCM, the heart to mediastinum 123I-MIBG uptake ratio (H/M) was significantly low and washout rate (WR) of 123I-MIBG was significantly high respectively compared with normal subjects (n = 8). H/M was negatively correlated with serum norepinephrine level, wall thickness of left ventricle, left ventricular mass index, left ventricular end diastolic pressure respectively, and WR was positively correlated with those parameters respectively. On the other hand, LF/HF calculated by spectral analysis in holter electrocardiogram was positively correlated with H/M, and negatively correlated with WR. In HCM, H/M in patients with subjective symptoms was significantly lower than that without subjective symptoms, and WR in patients with paroxysmal atrial fibrillation was significantly higher than that without paroxysmal atrial fibrillation. This study revealed that H/M and WR reflected the severity and the difference of disease type in HCM. In conclusion, 123I-MIBG contributes to evaluating more details in diagnosis and pathophysiology of HCM.
我们采用123I-间碘苄胍(MIBG)心肌闪烁显像技术,与其他临床检查参数相比较,研究肥厚型心肌病患者心肌交感神经系统的异常情况。在50例肥厚型心肌病患者中,与正常受试者(n = 8)相比,心脏与纵隔的123I-MIBG摄取率(H/M)显著降低,123I-MIBG的洗脱率(WR)显著升高。H/M分别与血清去甲肾上腺素水平、左心室壁厚度、左心室质量指数、左心室舒张末期压力呈负相关,而WR分别与这些参数呈正相关。另一方面,动态心电图频谱分析计算得到的低频/高频比值(LF/HF)与H/M呈正相关,与WR呈负相关。在肥厚型心肌病中,有主观症状患者的H/M显著低于无主观症状者,阵发性心房颤动患者的WR显著高于无阵发性心房颤动者。本研究表明,H/M和WR反映了肥厚型心肌病的严重程度和疾病类型差异。总之,123I-MIBG有助于在肥厚型心肌病的诊断和病理生理学方面进行更详细的评估。