雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Kokyu to Junkan Volume 38, Issue 8 （August 1990）

呼吸と循環 38巻8号（1990年8月発行）

Japanese English

研究

冠動脈内血栓溶解療法が陳旧性心筋梗塞例の心室遅延電位検出に及ぼす効果 The effect of percutaneous transluminal coronary recanaiization (PTCR) on late potentials detected by signal-averaged electrocardiogram in patients with previous myocardial infarction 安部良治 ¹ , 出川敏行 ¹ , 宇井克人 ¹ , 山下一弘 ¹ , 池田隆徳 ¹ , 西脇博一 ¹ , 杉薫 ¹ , 矢吹壮 ¹ , 町井潔 ¹ Ryoji Abe ¹ , Toshiyuki Degawa ¹ , Katsuto Ui ¹ , Kazuhiro Yamashita ¹ , Takanori Ikeda ¹ , Hirokazu Nishiwaki ¹ , Kaoru Sugi ¹ , Sou Yabuki ¹ , Kiyoshi Machii ¹ ¹東邦大学大橋病院第三内科 ¹The 3rd Department of Internal Medicine, Toho University, Ohashi Hospital キーワード：平均加算心電図（Signal-averaged ECG） , 心室遅延電位（Late potentials） , 冠動脈内血栓溶解療法（Percutaneous transluminal coronary recanalization） Keyword: 平均加算心電図（Signal-averaged ECG） , 心室遅延電位（Late potentials） , 冠動脈内血栓溶解療法（Percutaneous transluminal coronary recanalization） pp.791-797

発行日 1990年8月15日 Published Date 1990/8/15

DOI https://doi.org/10.11477/mf.1404900196

PDF(6388KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

　冠動脈内血栓溶解療法（PTCR）が，心筋梗塞例の慢性期で心室遅延電位（LP）検出にどのような影響を与えるかを検討した。対象は陳旧性前壁梗塞54例で，その内PTCR施行（A群）29例と非施行群（B群）25例に分け，各群に平均加算心電図（SAECG）を記録した。更に，ホルター心電図，左室造影所見も併せ検討した。SAECG上，QRS終末40msecの低電位成分が15μV以下の時LP陽（＋）と定義した。LP検出率は，A群で7％，B群で32％であり，B群で有意に高率であった（p＜0.01）。心室期外収縮総数，左心機能には両群間に有意差を認めなかったが，LP（＋）例はLP（−）例と比較し，左室収縮末期容積，梗塞範囲が有意に大であり，左室駆出分画が有意に小であった。再灌流療法の成否では，梗塞責任血管が急性期に開存した（TIMI grade 3）27例は全てLP（−），開存不良（TIMI grade 2）2例は全てLP（＋）であった。以上より，梗塞責任血管を開存することがLP検出率の低下に重要であると考えられた。

The purpose of this study was to assess the effect of percutaneous transluminal coronary recanalization (PTCR) on late potentials (LP) in patients with previous myocardial infarction (MI). The signal-averaged ECG was recorded by Fukuda VCM-3000 in 54 patients with anterior MI (average of 32 months after onset of MI). Fifty four patients weredivided into two groups: Group A was comprised of 29 patients who underwent PTCR, and Group B was comprised of 25 patients who didn't receive PTCR. Ventricular arrhythmias detected by 24 hour Holter monitoring, and left ventriculographic find-ings were also evaluated. The presence of LP was defined as low amplitude signals (＜15,μV) in the last 40msec of the filtered QRS complex. The inci-dence of LP was significantly higher in Group B than in Group A (32% vs 7%, p＜0.01). The pre-sence of PVCs and ejection fraction (EF), LV end-diastolic volume (EDV), LV end-systolic volume(ESV) and % abnormally contracting segment (%ACS) were not significantly different in each respective groups. However, ESV and % ACS were signi-ficantly larger (p＜0.05), and EF was significantly smaller (p＜0.01) in patients with LP (+) than in patients with LP (-).

LP was present in two patients who had under-gone PTCR (TIMI grade 2) unsuccessfully, whereas it was not present in the 27 patients with successful PTCR (TIMI grade 3). It was concluded that successful recanalization of the infarct-related arte-ries may reduce the incidence of LP.