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Left ventricular pump function during ergometer stress in patients with myocardial infarction:In fluence of the extent of infarcted and additional ischemic area, and the myocardial function of non-ischemic area Hideaki Nakatoh 1 , Eiji Murakami 1 , Noboru Takekoshi 1 , Shinobu Matsui 1 , Jiro Emoto 1 , Munetoshi Matoba 1 , Takumi Fukuoka 1 , Hiroto Enyama 1 , Hiroko Doyoshita 1 , Makoto Kosaka 2 1Division of Cardiology, Kanazawa Medical University 2Central Clinical Division of Radiology, Kanazawa Medical University pp.1281-1287
Published Date 1987/12/15
DOI https://doi.org/10.11477/mf.1404205166
  • Abstract
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This study examines the relation between the extent of myocardial necrosis-ischemia and the left ventricular (LV) ejection fraction (EF) response to ergometer stress in patients with myocardial infarc-tion (MI). We studied 32 patients with MI aged 37 to 84 years by radionuclide ventriculography (at rest and during stress) and by stress 201Tl single photon emission computed tomography (SPECT).

During stress, mean blood pressure (MBP) and heart rate (HR) were increased significantly (MBP : 91±13.4→ 109±17.6 mmHg p<0.005, HR : 67±9.0→106±17.6 bpm/min p<0.001). EF was decreased from 37±12.0 to 34±10.8% and 201 Tl defect was increased from 15±11.8 to 20±12.3%, both signifi-cantly (EF p<0.05, 201 Tl defect p<0. 05). During stress, 20 of 32 patients showed an increased 201 T1 defect and a decreased EF, 7 an increased 201 Tl defect and EF, 5 a decreased 201 T1 defect and EF. The change in 201T1 defect (Δd201 T1 defect) during stress did not correlate with that in EF (ΔIEF).

Both before and during stress, there were signi-ficant regressions between 201T1 defect (%) and EF (%). The regression lines were y=-0.730x+48.46before stress (p<0.001) and y=-0.632x+ 47. 19 during stress (p<0.001), where y is EF and x is 201T1 defect. There was no singnificant difference between these two regression lines.

These data suggest that LV pump function during stress in patients with MI could be regulated mainly by the extent of necrotic and ischemic area, and partially by the regional myocardial function of non-ischemic area.


Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.

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