Differentiation of regional perfusion and fatty acid uptake in zones of myocardial injury.
Differentiation of regional perfusion and fatty acid uptake in zones of myocardial injury.
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心肌损伤区域局部灌注和脂肪酸摄取的分化。
DOI：
10.1097/00006231-199108000-00002
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发表时间：
1991
影响因子：
1.5
通讯作者：
Fischman,AJ
中科院分区：
文献类型：
--
作者：
Saito,T;Yasuda,T;Gold,HK;Leinbach,R;Livni,E;Elmaleh,D;Callahan,R;Barlai-Kovach,M;Wilkinson,R;Fischman,AJ
本文测定了8例不稳定型心绞痛（UA）和6例急性心肌梗塞（MI）患者再灌注4、1h内的~（9 Tl）和修饰脂肪酸（MFA）的心肌相对分布。放射性核素显像的结果与放射性核素程序后10天内进行的冠状动脉造影和定量左心室造影相关。损伤区域被确定为冠状动脉狭窄部位远端9 Tl摄取减少的区域。在这些地区观察到区域脂肪酸浓度几乎平行减少。比较两种药物的区域分布，发现它们在缺血区的分布存在细微差异。识别出三种模式：（a）MFA摄取大于T1（MFA> T1），（B）MFA和T1匹配降低（MFA= T1），（c）MFA摄取小于T1（MFA<T1）。8例UA患者中有7例在定量左心室造影中运动正常或运动功能减退。七个中的五个显示MFA> T1模式，而一个具有MFA<T1模式，一个具有MFA= T1模式。第8例UA患者有运动不能和MFA= T1型。所有6例急性梗死患者的心室造影均显示运动不能。这些患者中的一个具有MFA> T1模式，两个具有MFA= T1模式，并且三个具有MFA<T1模式。这些结果表明，脂肪酸和铊在急性心肌缺血区的分布大体相似。仔细检查，在室壁运动正常的急性缺血区更常观察到脂肪酸浓度轻微相对过量的区域。
The relative myocardial distribution of 9Tl and modified fatty acid (9-labelled 3-methyl-p-[iodo]-phenyl pentadecanoic acid, MFA) was determined in eight patients with unstable angina (UA) and six patients with acute myocardial infarction treated with reperfusion therapy within 4, 1 h (MI). The results of radionuclide imaging were correlated with coronary angiography and quantitative left ventriculography performed within 10 days of the radionuclide procedures. Zones of injury were identified as areas with diminished 9Tl uptake distal to sites of coronary narrowing. A nearly parallel reduction in regional fatty acid concentration was observed in these areas. Comparison of the regional distributions of the two agents revealed subtle differences in their distributions in the ischaemic zones. Three patterns were recognized:(a) MFA uptake greater than Tl (MFA> Tl),(b) matched decrease of MFA and Tl (MFA= Tl),(c) MFA uptake less than Tl (MFA< Tl). Seven of eight patients with UA had normokinesis or hypokinesis on quantitative left ventriculography. Five of the seven showed the MFA> Tl pattern, while one had the MFA< Tl pattern and one had the MFA= Tl pattern. The eighth patient with UA had akinesis and the MFA= Tl pattern. All six patients with acute infarction had akinesis on ventriculography. One of these patients had the MFA> Tl pattern, two had the MFA= Tl pattern and three had the MFA< Tl pattern. These results suggest that fatty acid and thallium have grossly similar distributions in areas of acute myocardial ischaemia. On careful inspection, zones of slight relative excess fatty acid concentration are observed more often in areas of acute ischaemia with normal wall motion.