八木田 あけみ¹, 中 真砂士¹, 山本 一博², 土井 泰治², 今井 克次¹, 塩谷 一成¹, 赤松 義樹¹, 菱田 英二¹, 増山 理², 木下 直和¹

Akemi YAGITA¹, Masashi NAKA¹, Kazuhiro YAMAMOTO², Yasuji DOI², Katsuji IMAI¹, Issei SHIOTANI¹, Yoshiki AKAMATSU¹, Eiji HISHIDA¹, Tohru MASUYAMA², Naokazu KINOSHITA¹

¹国立大阪南病院循環器科, ²大阪大学第1内科

¹Cardiovascular Division, Osaka Minami National Hospital, ²First Department of Internal Medicine, Osaka University School of Medicine

キーワード : Dobutamine, Ischemia, Diastole, pulsed Doppler echocardiography

To investigate the clinical significance of left ventricular early diastolic filling during the dobutamine stress test(up to 40 μg/kg/min)to detect myocardial ischemia, we detemined peak early diastolic filling velocity from the pulsed wave Doppler transmitral flow velocity curve (E)and flow propagation velocity (FPV) of early diastolic filling from color M-mode Doppler echocardiography, both at baseline and at peak dose infusion of dobutamine in 9 control patients with chest pain syndrome and normal coronary arteries and 23 patients with ischemic heart disease(IHD). The E and FPV ratios were defined as ratio of value at peak dose of dobutamine to that at baseline. Wall motion score index (WMSI) was calculated using a score model with 16 segments and four grades in which scores ranged from 1(normal) to 4(dyskinesis). Wall motion abnormalities worsened or new ones developed during dobutamine infusion in all patients with IHD, and patients with IHD were classified into one of two groups: group A contained 11 patients with little abnormality of wall motion (WMSK