Outcome significance of thallium-201 and iodine-123-BMIPP perfusion-metabolism mismatch in preinfarction angina.
Outcome significance of thallium-201 and iodine-123-BMIPP perfusion-metabolism mismatch in preinfarction angina.
复制标题
梗死前心绞痛中 201 铊和 123-BMIPP 灌注代谢不匹配的结果意义。
DOI：
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发表时间：
1998
影响因子：
9.3
通讯作者：
K. Shimamoto
中科院分区：
文献类型：
--
作者：
T. Nakata;A. Hashimoto;H. Kobayashi;K. Miyamoto;K. Tsuchihashi;T. Miura;K. Shimamoto
未标记
在人类中，短暂的缺血与心肌细胞活力和心脏功能的保护的相关性仍然存在争议。尽管冠状动脉灌注恢复，但功能障碍但存活的心肌显示脂肪酸代谢受损。我们询问是否梗死前心绞痛可能与保存细胞活力和更好的功能恢复相比，受损的脂肪酸代谢。
方法
对32例首次急性心肌梗死并接受直接冠状动脉成形术的患者进行了铊和β-甲基-对碘苯基十五烷酸（BMIPP）断层显像，其中20例梗死前有心绞痛（A组），12例无心绞痛（B组）。铊和BMIPP异常通过极坐标图定量为严重程度指数。通过心室造影和随访对局部功能进行量化。
结果
尽管在冠状动脉危险因素、心功能和血管造影结果方面无显著差异，但铊严重程度指数显著低于BMIPP A组（62+/-45 vs 96+/-59），但B组未发生（104+/-65对115+/-68）; A组的铊严重指数明显低于B组，但BMIPP异常率两组间无显著性差异。BMIPP严重程度指数与两组中的铊显著相关。但A组的回归线下移，与B组相比有统计学差异。急性期局部功能从107+/-31 s.d.显著改善至70+/-31 s.d./ A组随访期间的腱索，但B组没有（109+/-62 vs 106+/-52）。急性期铊严重指数与BMIPP严重指数的比值与再灌注患者随访期间局部室壁运动改善显著相关（y=-53x +65，r=0.667）。
结论
梗死前心绞痛相对于脂肪酸代谢保留了心肌细胞活力，导致成功再灌注患者的灌注-代谢不匹配增强和功能改善，表明梗死前心绞痛具有心脏保护作用。
UNLABELLED
The relevance of brief antecedent ischemia to preservation of myocyte viability and cardiac function is still controversial in humans. Dysfunctioning but viable myocardium shows impaired fatty acid metabolism despite restored coronary perfusion. We asked whether preinfarction angina might be related to preservation of cell viability and better functional recovery in comparison with impaired fatty acid metabolism.
METHODS
Tomographic imagings with thallium and beta-methyl-p-iodophenyl penta-decanoic acid (BMIPP) were performed in 32 patients with first acute myocardial infarction who received primary coronary angioplasty: 20 patients with preexisting angina before infarction (Group A) and 12 without (Group B). Thallium and BMIPP abnormalities were quantified as a severity index by a polar map. Regional function was quantified by ventriculography and followed up.
RESULTS
Despite no significant difference in coronary risk factors, cardiac function and angiographic findings, the thallium severity index was significantly lower than that of BMIPP (62+/-45 versus 96+/-59) in Group A but not in Group B (104+/-65 versus 115+/-68); the thallium severity index in Group A was significantly lower than that in Group B, but there was no significant difference in BMIPP abnormality between them. The BMIPP severity index correlated significantly with that of thallium in both groups. However, the regression line in Group A shifted downward and was statistically different compared with that in Group B. Regional function at an acute stage was significantly improved from 107+/-31 to 70+/-31 s.d./chord during follow-up in Group A but not in Group B (109+/-62 versus 106+/-52). The ratio of the thallium severity index to that of BMIPP at an acute stage was significantly related to improved regional wall motion during follow-up in the reperfused patients (y=-53x + 65, r=0.667).
CONCLUSION
Preinfarction angina preserves myocyte viability relative to fatty acid metabolism, resulting in augmented perfusion-metabolism mismatch and functional improvement in patients undergoing successful reperfusion, indicating cardioprotective effects of preinfarction angina.
影响因子：
20.1
作者：
MURRY, CE;RICHARD, VJ;JENNINGS, RB
通讯作者：
JENNINGS, RB