TRANSIENT TRANSMURAL REDUCTION OF MYOCARDIAL BLOOD-FLOW, DEMONSTRATED BY THALLIUM-201 SCINTIGRAPHY, AS A CAUSE OF VARIANT ANGINA
TRANSIENT TRANSMURAL REDUCTION OF MYOCARDIAL BLOOD-FLOW, DEMONSTRATED BY THALLIUM-201 SCINTIGRAPHY, AS A CAUSE OF VARIANT ANGINA
复制标题
DOI：
10.1161/01.cir.54.2.280
复制
发表时间：
1976-01-01
期刊：
影响因子：
37.8
通讯作者：
PESOLA, A
中科院分区：
文献类型：
--
作者：
MASERI, A;PARODI, O;PESOLA, A
先前的研究表明，变异型心绞痛不能归因于心肌需求的增加。为了研究局部心肌血供减少是否可能与这些缺血发作有关，我们对6名住进冠状动脉监护病房的患者进行了局部心肌灌注研究。静脉注射后5-7分钟摄取心肌闪烁图。在ST段抬高的一段时间注射1mCI的TL-201，显示与ST段抬高的导联相对应的心壁示踪剂摄取的跨壁缺陷。由于先前缺血心肌的晚期摄取，这些局部缺陷在2小时前已消失。在没有急性缺血的情况下(1wk后)进行注射后，没有明显的缺陷。缺血区的示踪剂摄取量是1wk后观察到的60%-85%。在调整了TL-201动力学和计算几何问题后，这些闪烁图实际上代表了对实际流量减少的严重低估。变异型心绞痛似乎是由心肌血供的大量跨壁减少引起的。
Previous studies showed that variant angina could not be attributed to increased myocardial demands. To investigate whether a reduction of regional myocardial blood supply could be responsible for these ischemic episodes, regional myocardial perfusion was studied in 6 patients admitted to the coronary care unit. Myocardial scintigrams, obtained 5-7 min following i.v. injection of 1 mCi of Tl-201, performed during an episode of ST-segment elevation, showed transmural deficits of tracer uptake in the heart wall corresponding to the leads showing ST-segment elevation. These regional deficits had disappeared by 2 h because of late uptake in previously ischemic myocardium. Following injections performed in the absence of acute ischemia (1 wk later), no deficit was apparent. Tracer uptake in ischemic areas was 60-85% of that observed 1 wk later. After adjusting for Tl-201 kinetics and counting geometry problems, these scintigrams actually represented large underestimations of actual flow reduction. Variant angina appeared to be caused by massive transmural reduction of myocardial blood supply.