臨床 心腔内血栓の成長に対するアスピリンの阻止効果 In-111-oxine標識血小板による血栓シンチグラフィーおよび超音波心断層法,左心室造影法による評価判定
心腔内血栓を持つ患者5人に対して,左室造影(LVG)超音波心断層法(2-DE),In-111-oxine標識血小板を用いた血栓シンチグラフィーによる検索を行った.その結果,血栓シンチグラフィー上7部位(心室5,心房2),2-DE上4部位(心室3,心房1),LVG上4部位(心室4)で血栓が描出された.さらに,これらの患者にアスピリンを投与すると,血栓シンチグラフィー上,血栓は5部位で陰性化し,2部位で偽陽性となったが,アスピリンの投与を中止すると,再び6部位で描出された.一方2-DEにおいては,アスピリンの投与および中止に関係なく4部位とも血栓が描出された. 以上より,In-111-oxine標...
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| Published in | 心臓 Vol. 16; no. 10; pp. 1041 - 1048 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
公益財団法人 日本心臓財団
15.10.1984
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0586-4488 2186-3016 |
| DOI | 10.11281/shinzo1969.16.10_1041 |
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| Abstract | 心腔内血栓を持つ患者5人に対して,左室造影(LVG)超音波心断層法(2-DE),In-111-oxine標識血小板を用いた血栓シンチグラフィーによる検索を行った.その結果,血栓シンチグラフィー上7部位(心室5,心房2),2-DE上4部位(心室3,心房1),LVG上4部位(心室4)で血栓が描出された.さらに,これらの患者にアスピリンを投与すると,血栓シンチグラフィー上,血栓は5部位で陰性化し,2部位で偽陽性となったが,アスピリンの投与を中止すると,再び6部位で描出された.一方2-DEにおいては,アスピリンの投与および中止に関係なく4部位とも血栓が描出された. 以上より,In-111-oxine標識血小板を用いた血栓シンチグラフィーは,血栓検索の感度にすぐれているばかりでなく,従来のLVGや2-DEが血栓の形態のみを捕えていたのに対して,血栓表面の血小板凝集状態を観察することが可能で,抗凝固療法を行う際の指標として非常に有用な手段であると考えられた. |
|---|---|
| AbstractList | 心腔内血栓を持つ患者5人に対して,左室造影(LVG)超音波心断層法(2-DE),In-111-oxine標識血小板を用いた血栓シンチグラフィーによる検索を行った.その結果,血栓シンチグラフィー上7部位(心室5,心房2),2-DE上4部位(心室3,心房1),LVG上4部位(心室4)で血栓が描出された.さらに,これらの患者にアスピリンを投与すると,血栓シンチグラフィー上,血栓は5部位で陰性化し,2部位で偽陽性となったが,アスピリンの投与を中止すると,再び6部位で描出された.一方2-DEにおいては,アスピリンの投与および中止に関係なく4部位とも血栓が描出された. 以上より,In-111-oxine標識血小板を用いた血栓シンチグラフィーは,血栓検索の感度にすぐれているばかりでなく,従来のLVGや2-DEが血栓の形態のみを捕えていたのに対して,血栓表面の血小板凝集状態を観察することが可能で,抗凝固療法を行う際の指標として非常に有用な手段であると考えられた. |
| Author | 中, 真砂士 辻, 和夫 吉岡, 敏治 新井, 英和 入野, 忠芳 杉本, 侃 渋谷, 正徳 |
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| References | 7) Meltzer, R. S., Guthaner, D., Rakowski, H., Popp, R. L. and Martin, R. P.: Diagnosis of left ventricular thrombi by two-dimensional echocardiography. Br. Heart J., 42: 261, 1979. 23) Davis, H. H., Siegel, B. A., Sherman, L. A., Heaton, W. A. and Welch, M. J.: Scintigraphy with In-111-labeled autologous platelets in venous thromboembolism. Radiology, 136: 203, 1980. 22) Ezekowitz, M. D., Eichner, E. R., Scatterday, R. and Elkins, R. C. Diagnosis of a persistent pulmonary embolus by Indium-111 platelet scintigraphy with angiographic and tissu confirmation. Am. J. Cardiol., 72: 839, 1982. 18) Strathy, K. M., Dewanjee, M. K., Kaye, M. P., Rao, S. and Fuster, V.: Quantitation of platelet deposition in Gore-Tex femoral artery implants in the canine model and its reduction with dipyridamole and prostcyclin (abstr) Am. J. Cardiol., 45: 424, 1980. 25) Riba, A. L., Thakur, M. L., Gottschalk, A. and Zaret, B.: Imaging experimental coronary artery thrombosis with Indium-111 platelets. Circulation, 60: 767, 1979. 9) Mikell, F. L., Asinger, R. W., Sharma, B., Francis, G. and Hodges, M.: Serial evaluation of left ventricular thrombi by two-dimensional echocardiography: Effect of anticoagulant therapy (abstr). Circulation, 60: (suppl. II): 11-19, 1979. 16) Dewanjee, M. K., Fuster, V., Kaye, M. P. and Josa, M.: Noninvasive isotopic technique for detection of platelet deposition in coronary artery bypass grafts in dogs and its prevention with platelet-inhibitors (abstr). Circulation, 57 and 58: (suppl. II): 11-6, 1978. 34) Josa, M., Lie, J. T., Bianco, R. L., and Kaye, M. P.: Reduction of thrombosis in canine coronary bypass vein grafts with dipyridamole and aspirin. Am. J. Cardiol., 47: 1248, 1981. 17) Fuster, V., Dewanjee, M. K., Kaye, M. P., Josa, M., Metke, M. P. and Chesebro, J. H.: Noninvasive radioisotopic technique for detection of platelet deposition in coronary artery bypass grafts in dogs and its reduction with platelet inhibitors. Circulation, 60: 1508, 1979. 5) Ports, T. A., Cogan, J., Schiller, N. B. and Rapaport, E.: Echocardiography of left ventricular masses. Circulation, 58: 528, 1978. 27) Fuster, V. and Chesebro, J. H.: Antithrombotic therapy: Role of platelet -inhibitor drugs. Mayo Clin. Proc., 56: 265, 1981. 1) Cheng, TO.: Incidence of ventricular aneurysm in coronary artery disease. An angiografic appraisal. Am. J. Med., 50: 340, 1971. 20) Pumphrey, C. W., Chesebro, J. H., Dewanjee, M. K., Wahner, H. W., Hollier, L. H., Pairolero, P. C. and Fuster, V.: In vivo quantitation of platelet deposition on human peripheral arterial bypass grafts using Indium-111-labeled platelets. Effect of dipyridamole and aspirin. Am. J. Cardiol., 51: 796, 1983. 21) Mcllmoyle, G., Davis, H. H., Welch, M. J., Primeau, J. L., Sherman, L. A. and Siegel, B. A.: Scintigraphic diagnosis of experimental pulmonary embolism with In-111-labeled platelets. J. Nucl. Med., 18: 910, 1977. 30)油井徳雄, 内田立身, 松田 信, 室井秀一, 田中鉄五郎, 斉藤 勝, 刈米重夫: 111In-oxineによる血小板標識の基礎的検討. 核医学, 18: 463, 1981. 31) Bensaid, J., Blanc, P. and Virot, P. Rapid disappearance of left ventricular mass (presumed thrombus) in a patient with cardiomyopathy. Br. Heart J., 47: 301, 1982. 3) Marco, J. D., Kaiser, G. C., Barner, H. E., Codd, J. E. and William, V. L.: Left ventricular aneur- ysmectomy. Arch. Surg., 3: 419, 1976. 26) Passamani, E. R.: Summary of ongoing clinical trials of platelet-active drugs in cardiovascular disease. Circulation, 62: (suppl. V): V-106, 1980. 29) Patrignani, P., Cattani, P., Minuz, P. and Patrono, C.: Low dose aspirin: How low, how often? (abstr) Clin. Research, 29: 343A, 1981. 11) Thakur, M. L., Welch, M. J., Joist, J. H. and Coleman, R. E.: Indium-111 labeled platelets: Studies on preparation and evaluation of in vitro and in vivo functions. Thromb. Res., 9: 345, 1976. 8) Come, P. C., Markis, J. E., Vine, H. S., Sacks, B., McArdle, C. and Ramirez, A.: Echocardiographic diagnosis of left ventricular thrombi. Am. Heart J., 100: 523, 1980. 32) Stratton, J. R., Ritchie, J. L., Hammermeister, K. E., Kennedy, J. W. and Hamilton, G. W.: Detec- tion of left ventricular thrombi with radionuclide angiography. Am. J. Cardiol., 48: 565, 1981. 13) Stratton, J. R., Ritchie, J. L., Hamilton, G. W., Hammermeister, K. E. and Harker, L. A.: Left ventricular thrombi: In vivo detection by Indium-111 platelet imaging and two dimen- sional echocardiography. Am. J. Cardiol., 47: 874, 1981. 12) Ezekowitz, M. D., Leonard, J. C., Smith, E. O., Allen, E. W. and Taylor, F. B.: Identification of left ventricular thrombi in man using Indium-111-labeled autologous platelets. A preliminary report. Circulation, 63: 803, 1981. 28) Patrignani, P., Filabozzi, P. and Patrono, C.: Selective cumulative inhibition of platelet thromboxane production by low-dose aspirin in healthy subjects. J. Clin. Invest., 69: 1366, 1982. 4) Reeder, G. S., Lengyel, M., Tajik, A. J., Smith, H. C., Danielson, G. K. and Seward, J. B.: Incidence of thrombus in left ventricular aneurysm: sensitivity of the angiogram and relation between anticoagulation and embolization (abstr). Am. J. Cardiol., 45: 423, 1980. 10) Reeder, G. S., Tajik, A. J. and Seward, J. B.: Left ventricular mural thrombus. Two-dimensional echocardiographic diagnosis. Mayo Clin. Proc., 56: 82, 1981. 2) Rao, G., Zikria, E. A., Miller, W. H., Samadani, S. R. and Ford, W. B.: Experience with sixty consecutive ventricular aneurysm resection. Circulation, 50: (suppl. II): 11-149, 1974. 24) Fedullo, P. F., Moser, K. M., Moser, K. S., Konopka, R. and Hartman, M. T.: Indium-illlabeled platelets: Effect of heparin on uptake by venous thrombi and relationship to the activated partial thromboplastin time. Circulation, 66: 632, 1982. 15) Ritchie, J. L., Stratton, J. R., Thiele, B., Hamilton, G. W., Warrick, L. N., Huang, T. W. and Harker, L. A.: Indium-111 platelet imag- ing for detection of platelet deposition in abdominal aneurysms and prosthetic arterial grafts. Am. J. Cardiol., 47: 882, 1981. 33) Metke, M. P., Lie, J. T., Fuster, V., Josa, M. and Kaye, M. P.: Reduction of intimal thickening in canine coronary bypass vein grafts with dipyridamole and aspirin. Am. J. Cardiol., 43: 1144, 1979. 14) Ezekowitz, M. D., Smith, E. O., Leonard, J. C., Harrison, L. H., Peyton, M. D., Elkins, R. C., Parker, D. and Taylor, F. B. Indium-111 platelet scintigraphy in the detection of left ventricular thrombi in surgically verified studies. Circulation, 62: (suppl. III): 111-8, 1980. 6) DeMaria, A. N., Bommer, W., Neumann, A., Grehl, T., Weinart, L., DeNardo, S., Amsterdam, E. A. and Mason, D. T.: Left ventricular thrombi identified by cross-sectional echocardiography. Ann. Intern. Med., 90: 14, 1979. 19) Pumphrey, C. W., Fuster, V., Dewanjee, M. K., Chesebro, J. H., Vlietstra, R. E. and Kaye, M. P.: Comparison of the antithrombotic action of calcium antagonist drugs with dipyridamole in dogs. Am. J. Cardiol., 51: 591, 1983. |
| References_xml | – reference: 22) Ezekowitz, M. D., Eichner, E. R., Scatterday, R. and Elkins, R. C. Diagnosis of a persistent pulmonary embolus by Indium-111 platelet scintigraphy with angiographic and tissu confirmation. Am. J. Cardiol., 72: 839, 1982. – reference: 31) Bensaid, J., Blanc, P. and Virot, P. Rapid disappearance of left ventricular mass (presumed thrombus) in a patient with cardiomyopathy. Br. Heart J., 47: 301, 1982. – reference: 19) Pumphrey, C. W., Fuster, V., Dewanjee, M. K., Chesebro, J. H., Vlietstra, R. E. and Kaye, M. P.: Comparison of the antithrombotic action of calcium antagonist drugs with dipyridamole in dogs. Am. J. Cardiol., 51: 591, 1983. – reference: 29) Patrignani, P., Cattani, P., Minuz, P. and Patrono, C.: Low dose aspirin: How low, how often? (abstr) Clin. Research, 29: 343A, 1981. – reference: 21) Mcllmoyle, G., Davis, H. H., Welch, M. J., Primeau, J. L., Sherman, L. A. and Siegel, B. A.: Scintigraphic diagnosis of experimental pulmonary embolism with In-111-labeled platelets. J. Nucl. Med., 18: 910, 1977. – reference: 6) DeMaria, A. N., Bommer, W., Neumann, A., Grehl, T., Weinart, L., DeNardo, S., Amsterdam, E. A. and Mason, D. T.: Left ventricular thrombi identified by cross-sectional echocardiography. Ann. Intern. Med., 90: 14, 1979. – reference: 25) Riba, A. L., Thakur, M. L., Gottschalk, A. and Zaret, B.: Imaging experimental coronary artery thrombosis with Indium-111 platelets. Circulation, 60: 767, 1979. – reference: 3) Marco, J. D., Kaiser, G. C., Barner, H. E., Codd, J. E. and William, V. L.: Left ventricular aneur- ysmectomy. Arch. Surg., 3: 419, 1976. – reference: 16) Dewanjee, M. K., Fuster, V., Kaye, M. P. and Josa, M.: Noninvasive isotopic technique for detection of platelet deposition in coronary artery bypass grafts in dogs and its prevention with platelet-inhibitors (abstr). Circulation, 57 and 58: (suppl. II): 11-6, 1978. – reference: 9) Mikell, F. L., Asinger, R. W., Sharma, B., Francis, G. and Hodges, M.: Serial evaluation of left ventricular thrombi by two-dimensional echocardiography: Effect of anticoagulant therapy (abstr). Circulation, 60: (suppl. II): 11-19, 1979. – reference: 23) Davis, H. H., Siegel, B. A., Sherman, L. A., Heaton, W. A. and Welch, M. J.: Scintigraphy with In-111-labeled autologous platelets in venous thromboembolism. Radiology, 136: 203, 1980. – reference: 14) Ezekowitz, M. D., Smith, E. O., Leonard, J. C., Harrison, L. H., Peyton, M. D., Elkins, R. C., Parker, D. and Taylor, F. B. Indium-111 platelet scintigraphy in the detection of left ventricular thrombi in surgically verified studies. Circulation, 62: (suppl. III): 111-8, 1980. – reference: 20) Pumphrey, C. W., Chesebro, J. H., Dewanjee, M. K., Wahner, H. W., Hollier, L. H., Pairolero, P. C. and Fuster, V.: In vivo quantitation of platelet deposition on human peripheral arterial bypass grafts using Indium-111-labeled platelets. Effect of dipyridamole and aspirin. Am. J. Cardiol., 51: 796, 1983. – reference: 17) Fuster, V., Dewanjee, M. K., Kaye, M. P., Josa, M., Metke, M. P. and Chesebro, J. H.: Noninvasive radioisotopic technique for detection of platelet deposition in coronary artery bypass grafts in dogs and its reduction with platelet inhibitors. Circulation, 60: 1508, 1979. – reference: 26) Passamani, E. R.: Summary of ongoing clinical trials of platelet-active drugs in cardiovascular disease. Circulation, 62: (suppl. V): V-106, 1980. – reference: 10) Reeder, G. S., Tajik, A. J. and Seward, J. B.: Left ventricular mural thrombus. Two-dimensional echocardiographic diagnosis. Mayo Clin. Proc., 56: 82, 1981. – reference: 1) Cheng, TO.: Incidence of ventricular aneurysm in coronary artery disease. An angiografic appraisal. Am. J. Med., 50: 340, 1971. – reference: 4) Reeder, G. S., Lengyel, M., Tajik, A. J., Smith, H. C., Danielson, G. K. and Seward, J. B.: Incidence of thrombus in left ventricular aneurysm: sensitivity of the angiogram and relation between anticoagulation and embolization (abstr). Am. J. Cardiol., 45: 423, 1980. – reference: 28) Patrignani, P., Filabozzi, P. and Patrono, C.: Selective cumulative inhibition of platelet thromboxane production by low-dose aspirin in healthy subjects. J. Clin. Invest., 69: 1366, 1982. – reference: 12) Ezekowitz, M. D., Leonard, J. C., Smith, E. O., Allen, E. W. and Taylor, F. B.: Identification of left ventricular thrombi in man using Indium-111-labeled autologous platelets. A preliminary report. Circulation, 63: 803, 1981. – reference: 18) Strathy, K. M., Dewanjee, M. K., Kaye, M. P., Rao, S. and Fuster, V.: Quantitation of platelet deposition in Gore-Tex femoral artery implants in the canine model and its reduction with dipyridamole and prostcyclin (abstr) Am. J. Cardiol., 45: 424, 1980. – reference: 8) Come, P. C., Markis, J. E., Vine, H. S., Sacks, B., McArdle, C. and Ramirez, A.: Echocardiographic diagnosis of left ventricular thrombi. Am. Heart J., 100: 523, 1980. – reference: 5) Ports, T. A., Cogan, J., Schiller, N. B. and Rapaport, E.: Echocardiography of left ventricular masses. Circulation, 58: 528, 1978. – reference: 24) Fedullo, P. F., Moser, K. M., Moser, K. S., Konopka, R. and Hartman, M. T.: Indium-illlabeled platelets: Effect of heparin on uptake by venous thrombi and relationship to the activated partial thromboplastin time. Circulation, 66: 632, 1982. – reference: 7) Meltzer, R. S., Guthaner, D., Rakowski, H., Popp, R. L. and Martin, R. P.: Diagnosis of left ventricular thrombi by two-dimensional echocardiography. Br. Heart J., 42: 261, 1979. – reference: 34) Josa, M., Lie, J. T., Bianco, R. L., and Kaye, M. P.: Reduction of thrombosis in canine coronary bypass vein grafts with dipyridamole and aspirin. Am. J. Cardiol., 47: 1248, 1981. – reference: 13) Stratton, J. R., Ritchie, J. L., Hamilton, G. W., Hammermeister, K. E. and Harker, L. A.: Left ventricular thrombi: In vivo detection by Indium-111 platelet imaging and two dimen- sional echocardiography. Am. J. Cardiol., 47: 874, 1981. – reference: 27) Fuster, V. and Chesebro, J. H.: Antithrombotic therapy: Role of platelet -inhibitor drugs. Mayo Clin. Proc., 56: 265, 1981. – reference: 15) Ritchie, J. L., Stratton, J. R., Thiele, B., Hamilton, G. W., Warrick, L. N., Huang, T. W. and Harker, L. A.: Indium-111 platelet imag- ing for detection of platelet deposition in abdominal aneurysms and prosthetic arterial grafts. Am. J. Cardiol., 47: 882, 1981. – reference: 33) Metke, M. P., Lie, J. T., Fuster, V., Josa, M. and Kaye, M. P.: Reduction of intimal thickening in canine coronary bypass vein grafts with dipyridamole and aspirin. Am. J. Cardiol., 43: 1144, 1979. – reference: 2) Rao, G., Zikria, E. A., Miller, W. H., Samadani, S. R. and Ford, W. B.: Experience with sixty consecutive ventricular aneurysm resection. Circulation, 50: (suppl. II): 11-149, 1974. – reference: 32) Stratton, J. R., Ritchie, J. L., Hammermeister, K. E., Kennedy, J. W. and Hamilton, G. W.: Detec- tion of left ventricular thrombi with radionuclide angiography. Am. J. Cardiol., 48: 565, 1981. – reference: 11) Thakur, M. L., Welch, M. J., Joist, J. H. and Coleman, R. E.: Indium-111 labeled platelets: Studies on preparation and evaluation of in vitro and in vivo functions. Thromb. Res., 9: 345, 1976. – reference: 30)油井徳雄, 内田立身, 松田 信, 室井秀一, 田中鉄五郎, 斉藤 勝, 刈米重夫: 111In-oxineによる血小板標識の基礎的検討. 核医学, 18: 463, 1981. |
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| SubjectTerms | Indium-111-oxine アスピリン 左室造影 心腔内血栓 超音波心断層 |
| Subtitle | In-111-oxine標識血小板による血栓シンチグラフィーおよび超音波心断層法,左心室造影法による評価判定 |
| Title | 臨床 心腔内血栓の成長に対するアスピリンの阻止効果 |
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| ispartofPNX | 心臓, 1984/10/15, Vol.16(10), pp.1041-1048 |
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