[Aspects of recovery from regional wall motion abnormalities after exercise in patients with ischemic heart disease using 201Tl myocardial dynamic SPECT].
Using 201Tl myocardial dynamic SPECT (dynamic SPECT), we studied various aspects of the recovery from exercise-induced ischemia, particularly the mechanism of delayed recovery from wall motion abnormality. The subjects were 23 patients with ischemic heart disease who underwent coronary angiography, exercise stress two-dimensional echocardiography (ESE), and dynamic SPECT. Using a 3-head SPECT system, dynamic SPECT was performed for 33 min consecutively from 5 min after the intravenous injection of 201TlCl (Tl). The regional early washout rate (early WR) was determined at 20, 29, and 38 min after Tl injection, and the delayed washout rate (delayed WR) was determined at 240 min. From the duration of regional wall motion abnormalities on ESE, the patients were divided into Group A (wall motion abnormalities persisting for > or = 20 min, n = 8) and Group B (< 20 min, n = 15). At each point of assessment, early WR was significantly lower in Group A than in the control group (5 healthy subjects) and Group B (p < 0.01). In addition, the early WR at 20 min was negative in all Group A patients. The present study suggests that a persistent relative and reduction in myocardial blood flow is one factor responsible for prolonged abnormal regional wall motion.
Ishiguro
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First Department of Internal Medicine, Toho University School of Medicine.
D000368:Aged; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes