アクセス数 : ?
ダウンロード数 : ?
ID 110803
著者
オザキ, ユウジ Department of Internal Medicine, Kochi Red Cross Hospital|Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
野村, 昌弘 Faculty of Integrated Art and Sciences, Department of Human and Social Sciences, The University of Tokushima
ナカヤマ, トオル Department of Internal Medicine, Kochi Red Cross Hospital
オガタ, タツロウ Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
中安, 紀美子 Faculty of Integrated Art and Sciences, Department of Human and Social Sciences, The University of Tokushima
中屋, 豊 Department of Nutrition and Metabolism, Institute of Health Biosciences, The University of Tokushima Graduate School 徳島大学 教育研究者総覧 KAKEN研究者をさがす
伊東, 進 Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School 徳島大学 教育研究者総覧
キーワード
acute myocardial infarction
coronary microcirculation
thrombus suction therapy
F myocardial scintigraphy
資料タイプ
学術雑誌論文
抄録
Several studies have reported that the use of a distal protection device decreases the incidence of slow-flow and/or no-reflow in patients with myocardial infarctions. In the present study, we investigated the influence of a RESCUE/Thrombuster system and a PercuSurge Guard Wire catheter on coronary microcirculation disorders in patients with acute myocardial infarction using the natriuretic polypeptide (ANP), the brain natriuretic peptide (BNP), and 99mTc-tetrofosmin myocardial scintigraphy (TF). The group consisted of a77patients with initial inferior myocardial infarction who had undergone emergency coronary angioplasty. The patients were randomly divided into : Group D (n=28), in which a direct stent alone was inserted, Group R/T (n=25), in which a stent was inserted after RESCUE system or a Thrombuster system was performed, and Group P (n=24), in which a stent was inserted after thrombus suction using a PercuSurge Guard Wire catheter. Patients with coronary slow-flow/no-reflow were 3, 2 and 0cases in Group D, Group R / T and Group P, respectively. In the present study, patients with good-reflow were enrolled in order to investigate the coronary microcirculation disorder in patients with visually similar coronary blood flow obtained in coronary angiography after percutaneous coronary reperfusion therapy. TF myocardial scintigraphy was performed 10±3 days after admission. Bull’s eye images were divided into 8 sections, and each section was evaluated in 4 grades. The grade of each segment was regarded as the defect score. The results were compared with the database prepared based on bull’s eye maps from50 healthy adults in our hospital, and count areas of -2×SD(standard deviation) or less were calculated as the extent score (%), reflecting the area in which myocardial blood flow was decreased. The extent and severity scores in Groups P and R/T were significantly lower than those in Group D. Coronary angiography at the chronic stage (6 months after surgery) showed the patency of the responsible vascular lesion in all patients. However, the ANP, BNP, cardiac index, and pulmonary capillary wedge pressure (PCWP) were significantly improved in Groups R/T and P, compared to Group D (p<0.01). These results suggest that the use of a RESCUE/ Thrombuster system and a PercuSurge GuardWire catheter systemin patients with acute inferior wall infarction improves coronary microcirculation disorders and acute- to chronicphase cardiac function.
掲載誌名
The journal of medical investigation : JMI
ISSN
13431420
cat書誌ID
AA11166929
53
1-2
開始ページ
167
終了ページ
173
並び順
167
発行日
2006-02
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
医学系