Оценка состояния метаболизма и перфузии миокарда при некоронарогенных желудочковых нарушениях ритма

Abstract

Objective. To analyze myocardial blood low and metabolism in patients with high gradation nonischemic ventricular arrhythmia (VA). Design and methods. Sixteen patients (9 males, 7 females, average age — 44 ± 99м 6,5 years) were enrolled. One-photon emission computer tomography with Tc-tetraphosmine at rest and at the physical training (veloergometry) were performed for myocardial perfusion examination. Estimation of fatty acids metabolism in myocardium was performed by positron-emission tomography (PET) with С-natrium butyrate. Control groups included age- and sex-matched 10 patients with coronary artery disease (CAD) and VA and 10 99м healthy volunteers. Results. At rest diffused equal distribution of Tc-tetraphosmine was revealed in 93,75 % patients. Reversible diffused stress-induced defects were found at exercise training test, but the changes were not signiicant. There were no changes in myocardial metabolism and no changes in the rate of fatty acids metabolism. Thus, diffused changes of metabolism and perfusion of left ventricle were found in the most patients with VA. Whereas there were no changes in healthy volunteers, and we found reduced extraction and velocity of fatty acids utilization in areas of left ventricle with stress-induced changes of perfusion in the group with CAD and VA. Conclusions. PET is an effective method to conirm nonischemic character of VA, and in most cases of VA it is helpful to ind diffused changes of metabolism and perfusion of left ventricle. These might be important when a treatment approach is to be chosen.