Mutoh H
First Department of Internal Medicine, Toho University School of Medicine.
Kaku Igaku. 1997 Oct;34(10):917-24.
An investigation on the right ventricular pressure level and the abnormalities in the fatty acid metabolism of myocardium was made using 123I-beta-methyl-iodophenyl pentadecanoic acid (BMIPP) myocardial SPECT in patients with chronic right ventricular overloading. Twenty patients who presented with right ventricular systolic pressure (RVSP) of 35 mmHg or more were used as the subjects. Dual myocardial SPECT with 201TlCl (Tl) and BMIPP was carried out for the subjects and RVc/LVc, a ratio of radioactivity count incorporated in the right ventricular free wall to the left one was determined for Tl and BMIPP. And the correlations between RVc/LVc and RVSP, and RVc/LVc and RVSP/LVSP were examined. The subjects were classified into 3 groups based on the RVSP levels and the count ratio, BMIPP/Tl was compared among the three groups. With respect of Tl uptake, there were significant, positive correlations between RVc/LVc and RVSP (correlation coefficient r = 0.51, p < 0.05) and between RVc/LVc and RVSP/LVSP (correlation coefficient r = 0.59, p < 0.01). On the other hand, no significant correlation was found between them with respect of the uptake of BMIPP. The BMIPP/Tl ratio in the group with higher than 80 mmHg of RVSP was 0.82 +/- 0.06, which was significantly lower than the ratio's for two groups of less than 80 mmHg; 0.91 +/- 0.07 and 0.98 +/- 0.04 in the group with 35-49 and 50-79 mmHg of RVSP, respectively. These results show that when compared with BMIPP, Tl is superior for the estimation of right ventricular pressure. For the patients with right ventricular overloading, it was suggested that when RVSP reaches 80 mmHg or more, there appear some disorders in the fatty acid metabolism in the right ventricular myocardium.
利用123I-β-甲基-碘代苯基十五烷酸（BMIPP）心肌单光子发射计算机断层显像（SPECT），对慢性右心室负荷过重患者的右心室压力水平及心肌脂肪酸代谢异常情况进行了研究。选取20例右心室收缩压（RVSP）为35mmHg及以上的患者作为研究对象。对研究对象进行201TlCl（Tl）和BMIPP双心肌SPECT检查，并测定Tl和BMIPP的右心室游离壁与左心室游离壁放射性计数比值RVc/LVc。同时，研究RVc/LVc与RVSP以及RVc/LVc与RVSP/LVSP之间的相关性。根据RVSP水平和计数比值将研究对象分为3组，比较3组之间的BMIPP/Tl。就Tl摄取而言，RVc/LVc与RVSP之间存在显著正相关（相关系数r = 0.51，p < 0.05），RVc/LVc与RVSP/LVSP之间也存在显著正相关（相关系数r = 0.59，p < 0.01）。另一方面，就BMIPP摄取而言，两者之间未发现显著相关性。RVSP高于80mmHg组的BMIPP/Tl比值为0.82±0.06，显著低于RVSP为35 - 49mmHg组（比值为0.91±0.07）和50 - 79mmHg组（比值为0.98±0.04）。这些结果表明，与BMIPP相比，Tl在评估右心室压力方面更具优势。对于右心室负荷过重的患者，提示当RVSP达到80mmHg及以上时，右心室心肌脂肪酸代谢会出现一些紊乱。
