松浦 泰彦, 林 亨, 森岡 敏一, 陳 若富, 栗原 敏修, 浅生 雅人, 福島 正勝

Yasuhiko MATSUURA, Tohru HAYASHI, Toshikazu MORIOKA, Wakatomi CHIN, Toshinao KURIHARA, Masato ASAO, Masakatsu FUKUSHIMA

国立大阪病院循環器科

Cardiovascular Division of Osaka National Hospital

キーワード : Old myocardial infarction, Myocardial viability, Doppler catheter, Coronary reserve, Iopamidol

To evaluate myocardial viability of patients (pts) with old myocardial infarction (OMI), we measured the rate of increase of diastolic coronary flow velocity (% increase) induced by intracoronary injection of iopamidol using a Doppler cathter. The tip of the catheter was placed at the proximal region of the left anterior descending artery (LAD) at a minimum of 2 cm proximal from the stenotic lesion. The sampling point was set 3 mm distal from the tip. The subjects consisted of 10 pts with revasculized anteroseptal OMI (G-O); 5 pts of angina pectoris (G-A); and 14 normal subjects (G-N). % increase of G-O (26.8±13.6) was significantly lower than that of G-A (52.9±15.0) and G-N (89.1±37.6). When we classified G-O in 4 pts with 90% stenosis (s) and 6 pts with less than 50% stenosis (O) according to the residual stenosis, the % increase of (S) (22.5±15.1) was lower than that of G-A (52.9±15.0), and (O) (29.8±13.0) was also lower than that of G-N (89.1±37.6). When we classified G-O according to the degree of the wall motion by left ventriculography, the % increase of the 7 pts with akinesis (21.2±11.5) was lower than that of the 3 pts with hypokinesis (40.0±7.6) and that of G-N (89.1±37.6).
These results suggest that the % increase induced by intracoronary injection of iopamidol is a good index of the degree of myocardial viability.