The clinical and prognostic significance of dipyridamole Tl-201 emission computed tomography in patients with dilated cardiomyopathy.
The clinical and prognostic significance of dipyridamole Tl-201 emission computed tomography in patients with dilated cardiomyopathy.
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双嘧达莫 Tl-201 发射计算机断层扫描对扩张型心肌病患者的临床和预后意义。
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发表时间：
1987
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通讯作者：
Hisashi Fukuzaki
中科院分区：
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作者：
Hideyuki Shiotani;Hirshi Yamabe;Hisashi Fukuzaki
为明确扩张型心肌病（DCM）左心室局部心肌灌注异常的临床意义，对20例DCM患者行双嘧达莫Tl-201发射ct （ECT）检查。将受试者分为2组：1组（n = 9）具有可逆性缺陷，2组（n = 11）仅具有持久性缺陷。2组患者心衰进展明显，预后明显差于1组（2年生存率55% vs 11%， p < 0.05）。超声心动图显示，2组左室舒张末期尺寸大于1组（68.3 +/- 8.2 mm vs 61.9 +/- 4.0 mm, p < 0.05），缩短率小于1组（18.0 +/- 4.5% vs 24.5 +/- 6.9%, p < 0.05）。此外，13节段可逆性缺损中有12节段左室壁运动保存较好，而58节段持续性缺损中有35节段左室壁运动严重受损（1/13 vs 35/58, p < 0.01）。双嘧达莫Tl-201 ECT证实两种类型的缺陷（可逆性和持续性）不仅可用于评估心肌灌注异常，而且可用于评估DCM的心肌损害和预后。
To clarify the clinical significance of regional myocardial perfusion abnormality of the left ventricle in dilated cardiomyopathy (DCM), 20 patients with DCM underwent dipyridamole Tl-201 emission computed tomography (ECT). The subjects were divided into 2 groups: group 1 had (n = 9) reversible defects and group 2 (n = 11) had persistent defects only. Group 2 patients significantly advanced heart failure and significantly poorer prognoses than group 1 (55% vs 11% in 2 years survival rate, p less than 0.05). The echocardiographic left ventricular end-diastolic dimension was larger in group 2 than group 1 (68.3 +/- 8.2 mm vs 61.9 +/- 4.0 mm, p less than 0.05) and % fractional shortening was smaller in group 2 than group 1 (18.0 +/- 4.5% vs 24.5 +/- 6.9%, p less than 0.05). Moreover, 12 of the 13 segments with reversible defect showed fairly well preserved left ventricular wall motion, whereas 35 of 58 segments with persistent defect had severely impaired wall motion (1/13 vs 35/58, p less than 0.01). Dipyridamole Tl-201 ECT demonstrated conclusively that the two types of defects (reversible and persistent) are useful to evaluate not only the abnormal myocardial perfusion but also myocardial damage and the prognosis in DCM.