Transcription of 07 シリーズ5-2 大塚 - jcc.gr.jp
1 J Cardiol Jpn Ed Vol. 5 No. 2 2010 116 1,* 2 Yoritaka OTSUKA, MD 1,*, Yutaka TAKE, MD 2 1 2 28 28 2006 6 27 156cm 48kg 108/50mmH 117/ C 18 / SpO2 85% room air ) J Cardiol Jpn Ed 2010; 5: 116 121 1. X 1 43 2. 1 CPK CK-MB Noradrenalin VMA 3. 2 IIIIIaVF V3 6 ST aVR aVL ST 4.
2 3 5. 4 2 22 mmHg 28 mmHg * 565-8565 5-7-1E-mail: 3 peak CPK 480 IU/ 45 163 IU/ peak 1 X Vol. 5 No. 2 2010 J Cardiol Jpn Ed117 creatine kinase-MB 43 IU/ 0 23 IU/ 3 ST QT 5 8 Cardiac magnetic resonance imaging delayed gadolinium enhancement T2-weighted imaging high intensity 5 6 7 Technetium-99m tetrofosmin tomographic 99mTC-TF scintigraphy 9 123I-bmethyliodophenyl pentadecanoic acid 123I-BMIPP scintigraphy 13 23I-metaiodobenzylguanidine 123I-MIBG scintigraphy
3 Norepinephrine 1 106/ 104/ 103/ Cl103mEq/ AST194IU/ ALT100IU/ LD338IU/ CK71IU/ Trop T Peak CK480IU/ Peak CK MB48IU/ Endocrine g/dayDOP372 2 J Cardiol Jpn Ed Vol. 5 No. 2 2010 118 norepinephrine 2,365 pg/ml 100 450 pg/ml norepinephrine g/day g/day vanillylmandelic acid mg/day mg/day computed tomography mass 123I-MIBG scintigraphy 7 8 4 3 4 2 mPCWP=22mmHg PA=32/18/26mmHg mRA=3mmHgAo=82/62mmHg LV=90/~28mmHgCO= /min CI= /min/m2 HR 125/minVol.
4 5 No. 2 2010 J Cardiol Jpn Ed119 1,2 3 4 2000 1 2006 6 5 MRI 6 J Cardiol Jpn Ed Vol. 5 No. 2 2010 120 3 AMI AMI 68 12 vs 70 12 AMI 18% vs 86% variant 17 variant 2006 4 8 physical emotional stress 7 CT MIBG 8 Vol.
5 5 No. 2 2010 J Cardiol Jpn Ed121 9 3,10 variant MRI 3,10 11 12 13 1 Dote K, Sato H, Tateishi H, Uchida T, Ishihara M.
6 Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases. J Cardiol 1991; 21: 203 Kurisu S, Sato H, Kawagoe T, Ishihara M, Shimatani Y, Nishioka K, Kono Y, Umemura T, Nakamura S. Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction. Am Heart J 2002; 143: 448 Tsuchihashi K, Ueshima K, Uchida T, Oh-mura N, Kimura K, Owa M, Yoshiyama M, Miyazaki S, Haze K, Ogawa H, Honda T, Hase M, Kai R, Morii I. Transient left ventricular apical ballooning without coronary ar-tery stenosis: a novel heart syndrome mimicking acute myocardial infarction. Angina Pectoris-Myocardial In-farction Investigations in Japan.
7 J Am Coll Cardiol 2001; 38: 11 Yasu T, Tone K, Kubo N, Saito M. Transient mid-ven-tricular ballooning cardiomyopathy: a new entity of Ta-kotsubo cardiomyopathy. Int J Cardiol 2006;110:100 Sanchez-Recalde A, Costero O, Oliver JM, Iborra C, Ruiz E, Sobrino JA. Images in cardiovascular medicine. Pheochromocytoma-related cardiomyopathy: inverted Takotsubo contractile pattern. Circulation 2006; 113:e738 Takeno Y, Eno S, Hondo T, Matsuda K, Zushi N. Pheo-chromocytoma with reversal of tako-tsubo-like transient left ventricular dysfunction: a case report. J Cardiol 2004; 43: 281 Van de Walle SO, Gevaert SA, Gheeraert PJ, De Pauw M, Gillebert TC. Transient stress-induced cardiomyopa-thy with an "inverted takotsubo" contractile pattern.
8 Mayo Clin Proc 2006; 81: 1499 1502. 8 Ennezat PV, Pesenti-Rossi D, Aubert JM, Rachenne V, Bauchart JJ, Auffray JL, Logeart D, Cohen-Solal A, As-seman P. Transient left ventricular basal dysfunction without coronary stenosis in acute cerebral disorders: a novel heart syndrome (inverted Takotsubo). Echocar-diography 2005; 22: 599 Wittstein IS, Thiemann DR, Lima JA, Baughman KL, Schulman SP, Gerstenblith G, Wu KC, Rade JJ, Bivalac-qua TJ, Champion HC. Neurohumoral features of myo-cardial stunning due to sudden emotional stress. N Engl J Med 2005; 352: 539 Ito K, Sugihara H, Kinoshita N, Azuma A, Matsubara H. Assessment of Takotsubo cardiomyopathy (transient left ventricular apical ballooning) using 99mTc-tetrofos-min, 123I-BMIPP, 123I-MIBG and 99mTc-PYP myo-cardial SPECT.
9 Ann Nucl Med 2005; 19: 435 Otsuka Y, Noguchi T, Goto Y, Nonogi H, Yamada N. Hyperintensity on T2-weighted magnetic resonance im-aging in Takotsubo cardiomyopathy. Int J Cardiol 2008; 130: 113 Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS. Systematic review: transient left ven-tricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med 2004; 141: 858 Kawai S, Kitabatake A, Tomoike H. Takotsubo Cardio-myopathy Group. Guidelines for diagnosis of takotsubo (ampulla) cardiomyopathy. Circ J 2007; 71: 990 992.
