Cannon P J, Weiss M B, Casarella W J
Semin Nucl Med. 1976 Jul;6(3):279-303. doi: 10.1016/s0001-2998(76)80009-8.
Measurements of regional myocardial blood flow have been performed rapidly and safely in man at the time of coronary arteriography. Xenon-133 was injected into the coronary artery and estimates of myocardial capillary perfusion were made by computer analysis of the multiple precordial tracer washout curves recorded with a scintillation camera. Blood flow rates/100 g/min in different areas of the heart were calculated by the Schmidt-Kety formula, using an assumed partition coefficient, and were related to the coronary vascular lesions by landmarks provided by the arteriograms. The flow significance of lesions was assessed by making measurements at rest and during interventions that increase coronary blood flow. Perfusion was also estimated in areas supplied by collateral vessels, and regions of scar were detected from the initial distribution of peak tracer activity. In patients with less than 50% obstructions apparent on coronary arteriograms and in those with greater than 50% isolated left anterior descending lesions average mean left ventricular (LV) myocardial perfusion values were not reduced below values found in patients with normal coronary arteries and normal cardiac function. However, in patients with significant two-vessel disease (LAD + right, LAD + circ) mean LV perfusion was significantly reduced. Average regional myocardial perfusion distal to significant lesions was not selectively reduced below the remainder of the ventricle unless the lesions were 100% obstructions. However, both total and distal regional myocardial perfusion increased less in 12 patients with greater than 50% lesions than in 12 others with normal arteriograms or less than 50% lesions. Subnormal flow responses in all of the former group were associated with angina pectoris compared with no angina in the latter. The studies indicate the potential utility of the measurements of regional myocardial blood flow in the evaluation of patients with ischemic heart disease who are potential candidates for myocardial revascularization procedures.
在冠状动脉造影时，在人体中已能快速且安全地进行局部心肌血流量的测量。将氙 - 133注入冠状动脉，并通过对用闪烁相机记录的多个心前区示踪剂清除曲线进行计算机分析来估算心肌毛细血管灌注。使用假定的分配系数，通过施密特 - 凯蒂公式计算心脏不同区域的血流速率/100克/分钟，并通过动脉造影片提供的标志物将其与冠状血管病变相关联。通过在静息状态和增加冠状动脉血流量的干预过程中进行测量来评估病变的血流意义。还对侧支血管供应区域的灌注进行了估算，并从示踪剂活性峰值的初始分布中检测出瘢痕区域。在冠状动脉造影片上显示阻塞小于50%的患者以及孤立的左前降支病变大于50%的患者中，平均左心室（LV）心肌灌注值并未降低到低于冠状动脉正常且心功能正常的患者所测得的值。然而，在患有严重双支血管病变（左前降支 + 右冠状动脉，左前降支 + 回旋支）的患者中，平均左心室灌注显著降低。除非病变为100%阻塞，否则严重病变远端的平均局部心肌灌注不会选择性地低于心室其余部分。然而，12例病变大于50%的患者的总局部心肌灌注和远端局部心肌灌注增加量均少于另外12例动脉造影正常或病变小于50%的患者。与后一组无心绞痛相比，前一组所有患者的血流反应异常均与心绞痛相关。这些研究表明，局部心肌血流量测量在评估可能适合心肌血运重建手术的缺血性心脏病患者方面具有潜在用途。
