大川井 宏明¹, 仁田 桂子², 高橋 和彦³, 片平 美明², 薗部 太郎¹, 藤田 雅史², 中島 博行², 仁田 新一¹

Hiroaki OKAWAI¹, Keiko NITTA², Kazuhiko TAKAHASHI³, Yoshiaki KATAHIRA², Tarou SONOBE¹, Masashi FUJITA², Hiroyuki NAKAJIMA², Shin-ichi NITTA¹

¹東北大学加齢医学研究所病態計測制御研究分野, ²東北厚生年金病院循環器科, ³宮城県立瀬峰病院循環器科 (現在: 高橋ハートクリニック)

¹Institute of Development, Aging, and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai-shi 980-8575, Japan, ²Department of Cardiovascular Diseases, Tohoku Kosei Nenkin Hospital, 10 Takasago, Hukumuro-aza, Miyagino-ku, Sendai-shi 983-0005,Japan, ³Department of Cardiovascular Diseases, Miyagi Prefectural Semine Hospital, 55-2 Osato, Tominegishi, Semine-cho, Kurihara-gun, Miyagi 989-4500, Japan

キーワード : Coronary stenosis, Regional cardiac function, Regional wall motion abnormality (WMA), Stress echocardiography, Stroke volume

Dobutamine and dipyridamole stress echocardiographies are both well able to detect myocardial ischemia resulting from coronary diseases by recognizing the regional wall motion abnormality (WMA). Here we report a method for describing WMA in detail. In pharmacological stress echocardiography, because of difficulties in recognizing the two-dimensional pattern, accuracy sometimes depends upon the skill of the operator. Two stroke volumes obtained using the M-mode and Doppler methods were examined to detect abnormal regional cardiac function by the dipyridamole stress test. Stroke volume obtained by the M-mode reflects regional cardiac function and that estimated from the outflow using the Doppler method reflects total cardiac function. These two stroke volumes were compared. In normal subjects and patients with coronary-diseases. The results indicated consistent discrepancies between these two stroke volumes in the ischemic hearts as a result of coronary stenosis, whereas changes in stroke volumes in the normal subjects showed the same tendency. This method of combining information about the regional and total functions is thus useful in examining the WMA and regional cardiac function, although it can not be applied to subjects whose stroke volume does not increase under stress.