RELATION BETWEEN MYOCARDIAL THALLIUM UPTAKE & CONTRACTILE RESPONSE TO DOBUTAMINE

在慢性冠状动脉疾病和左心室患者中 功能障碍，重要的是要确定存在和程度 血运重建后可能恢复的存活心肌。两者都有 多巴酚丁胺对铊的摄取和收缩反应 建议准确评估这些患者的心肌存活情况。 然而，这两个变量之间的关系并不是 已经成立了。为了解决这个问题，20名冠状动脉疾病患者 对疾病和慢性收缩功能障碍进行研究。共312个心肌梗死 经食道超声心动图评估的区域，203(65%) 静息性室壁运动异常。心肌节段所占比例 阳性的铊摄取率显著高于 对多巴酚丁胺呈阳性反应的节段。两国之间的关系 找到了这两个变量，这样具有 对多巴酚丁胺的阳性反应在 心肌组织中有铊摄取的区域与 没有铊摄取。这两种技术之间的不一致之处在于 很大程度上是由于存在摄取了铊的心肌区域 但对多巴酚丁胺没有反应。因此，在患有冠状动脉疾病的患者中 疾病和慢性左心功能不全之间确实存在联系 心肌铊摄取与心肌收缩反应之间的关系 多巴酚丁胺。然而，有铊摄取的片段的比例是 显著高于对多巴酚丁胺呈阳性反应的患者， 说明肌力储备需要更高程度的心肌细胞 完整比保存膜的功能要好。

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.