顿抑心肌灌注、葡萄糖利用及脂肪酸利用的恢复

Recovery of perfusion, glucose utilization and fatty acid utilization in stunned myocardium.

作者信息

Tsubokawa A, Lee J D, Shimizu H, Nakano A, Uzui H, Takeuchi M, Tsuchida T, Yonekura Y, Ishii Y, Ueda T

机构信息

First Department of Internal Medicine, Biomedical Imaging Research Center, Fukui, Japan.

出版信息

J Nucl Med. 1997 Dec;38(12):1835-7.

PMID:9430454

Abstract

We describe the clinical features and results of cardiac catheterization, PET ([13N]ammonia, 18F-fluorodeoxyglucose (FDG)) and SPECT [123I-labeled 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP)], in a patient with acute myocardial infarction successfully treated with intracoronary thrombolytic therapy. We compared the clinical and electrocardiographic changes with the myocardial glucose and fatty acid metabolism in stunned myocardium over a period of several months. The patient we studied illustrates the features of stunned myocardium. In the subacute phase, there was a concordant depression of myocardial [13N]ammonia and FDG uptake, and the metabolic abnormalities persisted even after regional wall motion at rest had returned to normal. The electrocardiographic recovery of deep negative T waves appeared to be related to the metabolic recovery in regions of stunned myocardium in this patient.

摘要

我们描述了一名急性心肌梗死患者经冠状动脉内溶栓治疗成功后的临床特征以及心脏导管检查、正电子发射断层扫描（PET，使用[13N]氨、18F-氟脱氧葡萄糖（FDG））和单光子发射计算机断层扫描（SPECT，使用[123I]标记的15-（对碘苯基）-3-R，S-甲基十五烷酸（BMIPP））的结果。我们在几个月的时间里比较了临床和心电图变化与顿抑心肌中心肌葡萄糖和脂肪酸代谢的情况。我们研究的这名患者展现出了顿抑心肌的特征。在亚急性期，心肌[13N]氨摄取和FDG摄取一致降低，即使静息时局部室壁运动已恢复正常，代谢异常仍持续存在。在该患者中，深倒置T波的心电图恢复似乎与顿抑心肌区域的代谢恢复有关。