Assessment of Takotsubo cardiomyopathy (transient left ventricular apical ballooning) using99mTc-tetrofosmin,123I-BMIPP,123I-MIBG and99mTc-PYP myocardial SPECT
Assessment of Takotsubo cardiomyopathy (transient left ventricular apical ballooning) using99mTc-tetrofosmin,123I-BMIPP,123I-MIBG and99mTc-PYP myocardial SPECT
复制标题
使用 99mTc-替曲膦、123I-BMIPP、123I-MIBG 和 99mTc-PYP 心肌 SPECT 评估 Takotsubo 心肌病（短暂性左心室心尖气球样变）
DOI：
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发表时间：
2005
影响因子：
2.6
通讯作者：
H. Matsubara
中科院分区：
文献类型：
--
作者：
Kazuki fro;H. Sugihara;N. Kinoshita;A. Azuma;H. Matsubara
方法：采用二维echocardiography，99mTc-tetrofosmin，99mTc-PYP，123I-BMIPP和123I-MIBG心肌断层扫描技术，对7例急性心肌梗死患者急性期(急性期)、2-14天(亚急性期)、1个月(慢性期)和3个月(慢性II期)进行检查。在超声心动图和SPECT图像上将左心室分为9个区域，并按正常(0)到严重异常(4)的5个等级对每个区域的异常程度进行评分。结果：冠脉造影显示Takotsubo心肌病患者无狭窄区域，而AMI患者存在严重的狭窄和/或闭塞病变。Takotsubo心肌病组总ST段抬高(Mm)为7.8±3.7，急性心肌梗死组为7.3±3.9。Takotsubo心肌病组急性期、亚急性期、慢性期和慢性期室壁运动异常积分分别为14.2±4.6、4.7±4.0、1.7±2.0和0.5±0.4，而急性心肌梗死组为14.0±4.3、11.4±3.9、8.8±3.6和5.2±4.8。Takotsubo心肌病患者急性期、亚急性期、慢性期和慢性期的心肌灌注异常积分分别为11.8±3.5、3.2±3.0、0.5±1.2和0.2±0.4，而急性心肌梗死分别为16.2±4.3、13.9±4.6、7.9±4.6和5.0±4.5。Takotsubo心肌病患者123I-BMIPP心肌脂肪酸异常积分在亚急性期、慢性期和慢性期分别为12.6±3.7、6.8±3.2和0.4±0.6，而急性心肌梗死组分别为16.5±5.1、14.7±4.8和7.5±4.5。123I-MIBG心肌显像异常心肌交感神经功能评分在亚急性期、慢性期和慢性期分别为14.8±4.0、8.8±4.0和0.4±0.6，而急性心肌梗死分别为18.6±6.5、16.8±6.8和12.9±5.2。心肌99mTC-PYP摄取异常不仅在急性心肌梗死患者，而且在急性心肌病患者中也是如此。结论：冠脉微循环障碍可能是冠脉病变所致的心肌顿抑。
We compared Takotsubo cardiomyopathy (transient left ventricular apical ballooning) with acute myocardial infarction (AMI) using two-dimensional echocardiography,99mTc-tetrofosmin,99mTc-PYP,123I-BMIPP and123I-MIBG myocardial SPECT.Methods: We examined 7 patients with Takotsubo cardiomyopathy and 7 with AMI at the time of emergency admission (acute phase), and 2-14 days (subacute phase), one month (chronic phase), and 3 months (chronic II phase) after the attack. The left ventricle was divided into nine regions on echocardiograms and SPECT images, and the degree of abnormalities in each region was scored according to five grades from normal (0) to severely abnormal (4).Results: Coronary angiography showed the absence of stenotic regions in patients with Takotsubo cardiomyopathy, and severely stenotic and/or occlusive lesions in patients with AMI. The total ST segment elevation on electrocardiograms (mm) was 7.8 ± 3.7 in those with Takotsubo cardiomyopathy, and 7.3 ± 3.9 in patients with AMI. Abnormal wall motion scores on echocardiograms were 14.2 ± 4.6, 4.7 ± 4.0, 1.7 ± 2.0 and 0.5 ± 0.4 during the acute, subacute, chronic and chronic II phases, respectively, in patients with Takotsubo cardiomyopathy, and 14.0 ± 4.3, 11.4 ± 3.9, 8.8 ± 3.6 and 5.2 ± 4.8 in those with AMI. Abnormal myocardial perfusion scores on99mTc-tetrofosmin images were 11.8 ± 3.5, 3.2 ± 3.0, 0.5 ± 1.2 and 0.2 ± 0.4 during the acute, subacute, chronic and chronic II phases, in patients with Takotsubo cardiomyopathy, and 16.2 ± 4.3, 13.9 ± 4.6, 7.9 ± 4.6 and 5.0 ± 4.5, respectively, in those with AMI. Abnormal myocardial fatty acid scores on123I-BMIPP images were 12.6 ± 3.7, 6.8 ± 3.2 and 0.4 ± 0.6 during the subacute, chronic and chronic II phases, respectively, in patients with Takotsubo cardiomyopathy, and 16.5 ±5.1,14.7 ± 4.8 and 7.5 ± 4.5 in those with AMI. Abnormal myocardial sympathetic nerve function scores on123I-MIBG images were 14.8 ± 4.0, 8.8 ± 4.0 and 0.4 ± 0.6 during the subacute, chronic, chronic II phases, respectively, in patients with Takotsubo cardiomyopathy, and 18.6 ± 6.5, 16.8± 6.8 and 12.9 ± 5.2 in those with AMI. Myocardial99mTc-PYP uptake was abnormal not only in patients with AMI but also in those with Takotsubo cardiomyopathy during the acute phase.Conclusions: Takotsubo cardiomyopathy might represent a stunned myocardium caused by a disturbance of the coronary microcirculation.
使用锝-99m-焦磷酸对临时冠状动脉闭塞和回流产生的心肌损伤进行量化。
影响因子：
37.8
作者：
Jansen,DE;Corbett,JR;Buja,LM;Hansen,C;Ugolini,V;Parkey,RW;Willerson,JT
通讯作者：
Willerson,JT