Sugihara H, Taniguchi Y, Ito K, Terada K, Matsumoto K, Kinoshita N, Azuma A, Ushijima Y, Maeda T, Nakagawa M
Department of Radiology, Kyoto Prefectural University of Medicine, Japan.
Ann Nucl Med. 1998 Dec;12(6):349-54. doi: 10.1007/BF03164924.
The effect of diltiazem on myocardial ischemia in patients with hypertrophic cardiomyopathy (HCM) was evaluated by exercise myocardial 201Tl single photon emission computed tomography (SPECT). Exercise myocardial SPECT was performed before and 8 weeks after oral administration of diltiazem (180 mg/day) in 20 patients with HCM who showed transient perfusion defects on exercise myocardial 201Tl SPECT under control conditions. SPECT images were divided into 17 segments. The 201Tl perfusion defects were visually scored and evaluated as the defect score. The transient dilation index was calculated as an index of subendocardial ischemia. Improvement of the defect score was demonstrated in 15 patients after the administration of diltiazem. The mean defect score decreased significantly from 9.90 +/- 5.17 to 5.50 +/- 4.89 (p < 0.0001). Although 16 of 20 patients showed an abnormal transient dilation index before diltiazem treatment, 16 showed improvement and 13 of these normalized after diltiazem therapy. The mean transient dilation index decreased from 1.16 +/- 0.10 to 1.02 +/- 0.09 (p < 0.0001). In conclusion, diltiazem prevents or diminishes myocardial ischemia in patients with HCM.
通过运动心肌201Tl单光子发射计算机断层扫描（SPECT）评估地尔硫䓬对肥厚型心肌病（HCM）患者心肌缺血的影响。对20例在对照条件下运动心肌201Tl SPECT显示短暂灌注缺损的HCM患者，在口服地尔硫䓬（180mg/天）前及用药8周后进行运动心肌SPECT检查。SPECT图像分为17个节段。对201Tl灌注缺损进行视觉评分并评估为缺损分数。计算短暂扩张指数作为心内膜下缺血的指标。地尔硫䓬给药后15例患者的缺损分数得到改善。平均缺损分数从9.90±5.17显著降至5.50±4.89（p<0.0001）。虽然20例患者中有16例在地尔硫䓬治疗前短暂扩张指数异常，但16例显示改善，其中13例在地尔硫䓬治疗后恢复正常。平均短暂扩张指数从1.16±0.10降至1.02±0.09（p<0.0001）。总之，地尔硫䓬可预防或减轻HCM患者的心肌缺血。
