64列冠動脈CT検査におけるβ遮断薬静脈投与による心拍数コントロールの効果に関する検討

摘要

The purpose of this study is to clarify the effectiveness of the use of β-blocker in coronary computed tomography angiography (CCTA). In 1783 patients, heart rate was controlled by propranolol injection to patients with heart rates of 61 bpm or more. As a result, the scan heart rate (58.8+6.5 bpm) decreased significantly compared with the initial heart rate (72.7+9.4 bpm). Prospective gating method was used by 61.9% including 64.3% of the intravenous β-blocker injection group. Moreover, daily use of oral (β-blocker had influence on reduction of the scan heart rate (daily use group: 60.1±6.5 bpm vs. unuse group: 58.5+6.3 bpm p<0.01). When we evaluated the image quality of CCTA by the score, the improvement of the score was obviously admitted by 65 bpm or less of the scan heart rate. The ratio of scan heart rate that was controlled by 65 bpm or less was decreased in the initial heart rate groups that were 81 bpm or more. The incidence of adverse reactions by the propranolol injection was few, and these instances only involved slight symptoms. Therefore, heart rate control with the use of β-blocker is useful for the image quality improvement of CCTA. This form of treatment can be safely enforced.%近年，computed tomography(CT)装置のマルチスライス化やガントリ回転速度の高速化，心電同期技術の進歩に伴って，冠動脈CT検査(coronary CT angiography;CCTA)が行われるようになった．特に64列以上のCT装置では，時間分解能の向上や撮影時間の短縮などによって，良好な画像が得られるようになった．