第8回体表心臓微小電位研究会 負荷心筋シンチにて一過性心筋虚血を示す狭心症患者の加算平均心電図

【目的】負荷心筋シンチで一過性心筋虚血(TD)を示す労作狭心症(EA)患者の加算平均心電図(SAE)を検討した.【方法】対象は心筋梗塞の既往のない冠動脈に有意狭窄病変を有するEA患者53例で,脚ブロックなどの心電図異常のないものとした.抗不整脈薬非投与下にSAE記録を行い,フィルター化QRS持続時間(fQRSd)を計測した.また201T1-運動負荷心筋シンチを行いTDを認める群(TD(+)群)と認めない群(TD(-)群)に分類し比較検討した.【結果】両群間の患者背景,心機能,冠動脈病変数には差を認めなかった.fQRSdはTD(+)群でTD(-)群に比し有意に延長していた(TD(+)群:117±...

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Published in心臓 Vol. 30; no. Supplement6; pp. 28 - 31
Main Authors 久原, 伊知郎, 大賀, 雅信, 松本, 朗, 池田, 久雄, 濱田, 敬史, 平木, 達朗, 今泉, 勉, 吉田, 輝久
Format Journal Article
LanguageJapanese
Published 公益財団法人 日本心臓財団 1998
Online AccessGet full text
ISSN0586-4488
2186-3016
DOI10.11281/shinzo1969.30.Supplement6_28

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Abstract 【目的】負荷心筋シンチで一過性心筋虚血(TD)を示す労作狭心症(EA)患者の加算平均心電図(SAE)を検討した.【方法】対象は心筋梗塞の既往のない冠動脈に有意狭窄病変を有するEA患者53例で,脚ブロックなどの心電図異常のないものとした.抗不整脈薬非投与下にSAE記録を行い,フィルター化QRS持続時間(fQRSd)を計測した.また201T1-運動負荷心筋シンチを行いTDを認める群(TD(+)群)と認めない群(TD(-)群)に分類し比較検討した.【結果】両群間の患者背景,心機能,冠動脈病変数には差を認めなかった.fQRSdはTD(+)群でTD(-)群に比し有意に延長していた(TD(+)群:117±10ms,TD(-)群:110±9ms;p<0.05).【結語】負荷心筋シンチにてTDを認めるEA患者は,fQRSdが延長していた.EA患者において,SAEにより無症状安静時に非侵襲的に負荷心筋シンチにてTDを認める患者を検出し得る可能性が示唆された.
AbstractList 【目的】負荷心筋シンチで一過性心筋虚血(TD)を示す労作狭心症(EA)患者の加算平均心電図(SAE)を検討した.【方法】対象は心筋梗塞の既往のない冠動脈に有意狭窄病変を有するEA患者53例で,脚ブロックなどの心電図異常のないものとした.抗不整脈薬非投与下にSAE記録を行い,フィルター化QRS持続時間(fQRSd)を計測した.また201T1-運動負荷心筋シンチを行いTDを認める群(TD(+)群)と認めない群(TD(-)群)に分類し比較検討した.【結果】両群間の患者背景,心機能,冠動脈病変数には差を認めなかった.fQRSdはTD(+)群でTD(-)群に比し有意に延長していた(TD(+)群:117±10ms,TD(-)群:110±9ms;p<0.05).【結語】負荷心筋シンチにてTDを認めるEA患者は,fQRSdが延長していた.EA患者において,SAEにより無症状安静時に非侵襲的に負荷心筋シンチにてTDを認める患者を検出し得る可能性が示唆された.
Author 大賀, 雅信
池田, 久雄
濱田, 敬史
久原, 伊知郎
平木, 達朗
今泉, 勉
吉田, 輝久
松本, 朗
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References 3) Beauregard LAM, Waxman HL, Volosin R,Volosin KJ and Kurnik PB : Signal-averaged ECG prior to and serially after thrombolytic threrapy for acute myocardial infarction.PACE 1996 ; 19 : 883-889
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5) Abboud S, Smith JM, Shargorodsky B, Laniado S, Sadeh D and Cohen RJ : High frequency electrocardiography of three orthogonal leads in dogs during a coronary artery occlusion.PACE 1989 ; 12 : 574-581
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l0) Tamura K, Tsuji I-I, Masui A, et al : Preva-lence, resolution, and determinants of late potentials in patients with unstable angina and left ventricular wall motion abnormalities. Am Heart J 1996 ; 131 : 731-735
6) Abboud S, Cohen RJ, Selwyn A, Ganz P, Sadeh D and Friedman PJ : Detection of transient myocardial ischemia by computer analysis of standard and signal-averaged high-frequency electrocardiograms in patients undergoing per-cutaneous transluminal coronary angioplasty.Circulation 1987 ; 76 (3) : 585-596
7) Turitto G, Zanchi E, Risa AL, et al : Lack of correlation between transient myocardial is-chemia and late potentials on the signal-aver-aged electrocardiogram. Am J Carcliol 1990 ;65 : 290-296
8) Caref EB, Goldberg N, Mendelson L, et al :Effects of exercise on the signal-averaged electrocardiogram in coronary artery disease.Am J Cardiol 1990 ; 66 : 54-58
2) Peters W, Kowallik P, Wilhelm K and Mees-mann M : Evolution of late potential during the first 8 hours of myocardial infarction treated with thrombolysis. PACE 1996 ; 19 (pt. 2) : 1918-1922
1) Steinberg JS, Hochman JS, Morgan CD, et al :Effects of thrombolytic therapy administered 6 to 24 hours after myocardial infarction on the signal-averaged ECG : results of a multicenter randomized trial. Circulation 1994 ; 90 : 746-752
References_xml – reference: l0) Tamura K, Tsuji I-I, Masui A, et al : Preva-lence, resolution, and determinants of late potentials in patients with unstable angina and left ventricular wall motion abnormalities. Am Heart J 1996 ; 131 : 731-735
– reference: 8) Caref EB, Goldberg N, Mendelson L, et al :Effects of exercise on the signal-averaged electrocardiogram in coronary artery disease.Am J Cardiol 1990 ; 66 : 54-58
– reference: 5) Abboud S, Smith JM, Shargorodsky B, Laniado S, Sadeh D and Cohen RJ : High frequency electrocardiography of three orthogonal leads in dogs during a coronary artery occlusion.PACE 1989 ; 12 : 574-581
– reference: 6) Abboud S, Cohen RJ, Selwyn A, Ganz P, Sadeh D and Friedman PJ : Detection of transient myocardial ischemia by computer analysis of standard and signal-averaged high-frequency electrocardiograms in patients undergoing per-cutaneous transluminal coronary angioplasty.Circulation 1987 ; 76 (3) : 585-596
– reference: 2) Peters W, Kowallik P, Wilhelm K and Mees-mann M : Evolution of late potential during the first 8 hours of myocardial infarction treated with thrombolysis. PACE 1996 ; 19 (pt. 2) : 1918-1922
– reference: 4) Rubin DA, Sorbera C, Cook J, McAllister A,Burke RM and Weiss MB : Reversible late potentials due to ischemia. PACE 1992 ; 15 :2250-2254
– reference: 1) Steinberg JS, Hochman JS, Morgan CD, et al :Effects of thrombolytic therapy administered 6 to 24 hours after myocardial infarction on the signal-averaged ECG : results of a multicenter randomized trial. Circulation 1994 ; 90 : 746-752
– reference: 3) Beauregard LAM, Waxman HL, Volosin R,Volosin KJ and Kurnik PB : Signal-averaged ECG prior to and serially after thrombolytic threrapy for acute myocardial infarction.PACE 1996 ; 19 : 883-889
– reference: 11) Masui A, Tsuji II, Tamura K, et al : The effects of successful angioplasty on variables of signal-averaged electrocardiogram and ventricular wall motion in patients with a first myocarclial infarction. Clin Cardiol 1994 ; 17 : 479-483
– reference: 9) Turitto G, Caref EB, Zanchi E, Menghini F,Kelen G and El - Sherif N : Spontaneous myocarclial ischemia and the signal-averaged electrocardiogram. Am j Cardiol 1991 ; 67 :676-680
– reference: 7) Turitto G, Zanchi E, Risa AL, et al : Lack of correlation between transient myocardial is-chemia and late potentials on the signal-aver-aged electrocardiogram. Am J Carcliol 1990 ;65 : 290-296
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Snippet 【目的】負荷心筋シンチで一過性心筋虚血(TD)を示す労作狭心症(EA)患者の加算平均心電図(SAE)を検討した.【方法】対象は心筋梗塞の既往のない冠動脈に有意狭窄病変を有するEA...
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