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Journal of Medical Ultrasonics

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1991 - Vol.18

Vol.18 No.03

Original Article(原著)

(0238 - 0247)


Clinical Use of Exercise Two-Dimensional Echocardiography for Evaluating Effects of Percutaneous Transluminal Coronary Angioplasty and Coronary Artery Bypass Graft

山沢  正則1, 椎名  明1, 藤田  俊弘1, 黒田  敏男1, 鈴木  修2, 飯野  智也1, 野田  敏剛1, 夏目  隆史1, 柳沼  淑夫3, 細田  瑳一4

Masanori YAMASAWA1, Akira SHIINA1, Tosihiro FUJITA1, Toshio KURODA1, Osamu SUZUKI2, Tomoya IINO1, Toshitaka NODA1, Takashi NATSUME1, Toshio YAGINUWA3, Saichi HOSODA4

1自治医科大学循環器内科, 2自治医科大学臨床病理部, 3自治医科大学大宮医療センター, 4東京女子医科大学日本心臓血圧研究所循環器内科

1Department of Cardiology, Jichi Medical School, 2Department Clinical Pathology, Jichi Medical School, 3Jichi Medical School, Ohmiya Medical Center, 4Department Medical Cardiology, The Heart Institute Japan, Tokyo Women's Medical College

キーワード : Exercise two-dimensional echocardiography, Percutaneous Transluminal Coronary Angioplasty, Coronary Artery Bypass Graft, Angina Pectoris, Myocardial Infarction

Exercise two-dimensional echocardiography (exercise 2DE) was performed in 13 patients with angina pectoris and 4 patients with myocardial infarction before and after successful percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass graft (CABG) to observe regional wall motion during a supine ergometer stress test.
Before PTCA/CABG, newly developed or worsening asynergy was induced by exercise in all patients with angina pectoris. After PTCA/CABG, exercise-induced asynergy was improved in 8 patients with angina pectoris. In these patients, the exercise duration became significantly longer after PTCA/CABG (222±151 sec to 485±90 sec, p Three patients underwent PTCA/CABG in the infarcted area. Exercise-induced asynergy of infarcted area was improved in one patient, and the other two patients did not improve after CABG/PTCA. On the other hand exercise-induced asynergy of the noninfarcted area improved in all two patients after CABG.
The findings of exercise 2DE were compared with those of exercise201T1 scintigraphy and exercise ECG. Sixteen of these patients had exercise201T1 scintigraphy before and after PTCA/CABG. Before PTCA/CABG all 15 patients with exercise-induced asynergy by 2DE showed reversible thallium defects, and after PTCA/CABG 3 of 6 patients with exercise-induced asynergy showed reversible thallium defect. Before PTCA/CABG 12 of 16 patients with exercise-induced asynergy by 2DE were positive by exercise ECG, and after PTCA/CABG only 1 of the 6 patients with exercise-induced asynergy by 2DE was positive by exercise ECG.
It was concluded that exercise 2DE provided reliable and specific information for evaluating myocardial ischemia and was of great value for assessing the effects of PTCA/CABG.