非侵襲的検査法による心筋梗塞左室機能異常の推定に関する研究

超音波心断層法とタリウム心筋エミッションCTによる検討

抄録

Two dimensional echocardiography (2-DE) and ²⁰¹TI single photon emission computed tomography (SPECT) were performed in 51 patients with acute myocardial infarction (AMI) and the results were compared with those obtained by left ventriculography(LVG). After Loh et al., the image of the left ventricular (LV) wall was divided into 9 segments. LV wall motion and Ti up take in each segment were evaluated according to the irseverity and assigneds coresfrom 1 to 5. The degree of global abnormality in each patient as determined by each method was obtained by the sum of the scores assigned to the 9 segments, and expressed as ΣLVG, Σ2-DE or ΣSPECT, Σ′LVG, Σ′2-DE and Σ'SPECT were also measured for 5 LV segments which weree quivalent to the right anterior oblique view in LVG. Ejection fraction (EF) was measured by LVG using Kennedy's method.
The results may be summarized as follows:
1) The meanv alueo f Σ2-DE (Σ2-DE) w as almostt he samea s that of ΣLVG (ΣLVG), but that of ΣSPECT (ΣSPECT) was significantlyh igher than ΣLVG (p<0.05).
2) The correlation coefficient of ILVG with 12-DE was 0.85 (p<0.001) and with ISPECT, 0.72 (p<0.001).
3) ZING, 1'2-DE and Z′SPECT correlated significantly with EF (LVGr: = 0.82; 2 -DE: r =0.74; S PECT: r=0.63).
4) Using multiple regression analysis, ΣLVG and EF were estimated from the sum of the 2-DE and SPECT scores in each segment and expressed as ΣLVG and EF.
Inconclusion, LV wall motion and ejection fraction can be estimated precisely by noninvasive diagnostic methods such as 2-DE and SPECT.