RELATION BETWEEN MYOCARDIAL THALLIUM UPTAKE & CONTRACTILE RESPONSE TO DOBUTAMINE

在慢性冠状动脉疾病和左心室 功能障碍，重要的是要确定的存在和程度， 血运重建后可能恢复的存活心肌。 两 铊的摄取和对多巴酚丁胺的收缩反应， 建议准确评估这些患者的心肌活力。 然而，这两个变量之间的关系并没有得到 确立了习 为了解决这个问题，20例冠状动脉患者， 疾病和慢性收缩功能障碍进行了研究。 312例心肌梗死 经食管超声心动图评估的区域中，203个（65%） 静息室壁运动异常。 心肌节段比例 铊摄取阳性的人数明显多于 对多巴酚丁胺有阳性反应的节段 之间的关系 这两个变量被发现，这样，具有 对多巴酚丁胺的阳性反应在 心肌区域与铊摄取相比， 无铊摄取。 这两种技术之间的不一致是 这主要是由于心肌区域存在铊吸收 但对多巴酚丁胺没有反应 因此，在冠状动脉 疾病和慢性左心室功能不全， 心肌对铊的摄取与心肌对 多巴胺。 然而，吸收铊的部分的比例是 显著高于多巴酚丁胺阳性反应的患者， 表明正性肌力储备需要更高程度的肌细胞 完整性比保存膜的功能。

In patients with chronic coronary artery disease and left ventricular dysfunction, it is important to determine the presence and extent of viable myocardium that may recover after revascularization. Both thallium uptake and the contractile response to dobutamine have been proposed to accurately assess myocardial viability in these patients. However, the relation between these two variables has not been established. To address this issue, 20 patients with coronary artery disease and chronic systolic dysfunction were studied. Of 312 myocardial regions assessed with transesophageal echocardiography, 203 (65%) had resting wall motion abnormalities. The proportion of myocardial segments with positive thallium uptake was significantly greater than the number of segments with a positive response to dobutamine. A relation between the two variables was found, such that the number of segments with a positive response to dobutamine was significantly greater among the myocardial regions with thallium uptake compared to those regions with no thallium uptake. The discordance between the two techniques was largely due to the presence of myocardial regions with thallium uptake but no response to dobutamine. Hence, in patients with coronary artery disease and chronic left ventricular dysfunction, a relation does exist between myocardial thallium uptake and the contractile response to dobutamine. However, the proportion of segments with thallium uptake is significantly greater than those with a positive response to dobutamine, indicating that inotropic reserve requires a higher degree of myocyte integrity than the preservation of membrane function.