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Sample records for evaluating myocardial anisotropy

  1. Ultrasonic evaluation of local human skin anisotropy

    Czech Academy of Sciences Publication Activity Database

    Tokar, Daniel; Převorovský, Zdeněk; Hradilová, Jana

    2014-01-01

    Roč. 19, č. 12 (2014) ISSN 1435-4934. [European Conference on Non-Destructive Testing (ECNDT 2014) /11./. Praha, 06.10.2014-10.10.2014] Institutional support: RVO:61388998 Keywords : anisotropy * ultrasonic testing * human skin in-vivo * fabric-fiber composite * signal processing Subject RIV: BI - Acoustics http://www.ndt.net/events/ECNDT2014/app/content/Paper/324_Tokar.pdf

  2. Evaluation of electrical resistivity anisotropy in geological mapping ...

    African Journals Online (AJOL)

    user

    Key words: Electrical resistivity anisotropy, radial vertical electrical sounding, anisotropy polygons. INTRODUCTION ... electrical resistivity survey in the geological interpretation ... resistivity and other electrical or electromagnetic based.

  3. Evaluation of myocardial involvement in Duchenne's progressive muscular dystrophy with thallium-201 myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Kawai, Naoki; Sotobata, Iwao; Okada, Mitsuhiro

    1985-01-01

    Myocardial involvement in progressive muscular dystrophy of the Duchenne type was evaluated in 19 patients using thallium-201 myocardial perfusion imaging. A qualitative analysis was performed from five projection images by three experienced physicians. Distinct perfusion defects were shown in 13 patients, especially in the LV posterolateral or posterior wall (11 patients). There was no significant relationship between the presence of perfusion defects and the skeletal muscle involvements or thoracic deformities assessed by transmission computed tomography. Extensive perfusion defects were shown in 2 patients who died of congestive heart failure 1 to 2 years after the scintigraphic study. Progression of the myocardial scintigraphic abnormalities were considered to be minimal in 7 of 9 patients who underwent two serial scintigraphic studies over 2 to 3 years. It was concluded that thallium myocardial perfusion imaging is a useful clinical technique to assess myocardial involvement in Duchenne's progressive muscular dystrophy. (author)

  4. The clinical application value of myocardial perfusion imaging in evaluating coronary artery myocardial bridge patients with symptoms

    International Nuclear Information System (INIS)

    Wang Yuetao; Fu Ning; Ding Xuemei; Lu Cunzhi; Zhu Feng; Wang Guanmin; Huang Yijie; Wang Linguang

    2008-01-01

    Objective: Myocardial bridge is a common inborn coronary artery anomaly, myocardial bridge may be associated with myocardial ischemia. Only a few patients with coronary artery myocardial bridge were evaluated with nuclear medicine techniques. The aim of this study was to investigate the role of nuclear cardiology with myocardial perfusion technique in symptomatic myocardial bridge patients. Methods Nineteen myocardial bridge patients with the symptoms of chest pain and chest distress were analyzed retrospectively. 99 Tc m -methoxyisobutylisonitrile (MIBI) myocardial perfusion images (both exercise and rest) were performed in all. Imaging results were compared with the results of movement electrocardiogram (ECG) and coronary arteriography. The t test or χ 2 test was used to statistically analyze the data with Stata 7.0 software. Results: Of the 19 patients, 18 patients had myocardial bridge locating at the left anterior descending artery, 1 patient at the left anterior descending and left circumflex artery, the mean angiographic systolic occlusion within the myocardial bridge was (65.4 ± 22.1)%. Of these 19 patients, Exercise-rest 99 Tc m -MIBI myocardial perfusion imaging defined positive myocardial ischemia in 10 and negative in 9 patients. Of the 10 patients with 99 Tc m -MIBI myocardial perfusion imaging defined myocardial ischemia, 8 had reversible radioactive defect of partial anterior wall and (or) apex, 1 had reversible defect of post lateral wall and post septal wall, and 1 had reversible defect of inferior wall. The positive predictive value of myocardial perfusion imaging was 52.6% (10/19), which was higher than movement ECG [21.1% (4/19), χ 2 = 4.07, P 99 Tc m -MIBI myocardial periusion imaging defined myocardial ischemia. Six cases with Grade II stenosis, two were 99 Tc m -MIBI myocardial perfusion imaging defined myocardial ischemia. Eight cases with Grade III stenosis, seven were 99 Tc m -MIBI myocardial perfusion imaging defined myocardial

  5. Usefulness of myocardial parametric imaging to evaluate myocardial viability in experimental and in clinical studies.

    Science.gov (United States)

    Korosoglou, G; Hansen, A; Bekeredjian, R; Filusch, A; Hardt, S; Wolf, D; Schellberg, D; Katus, H A; Kuecherer, H

    2006-03-01

    To evaluate whether myocardial parametric imaging (MPI) is superior to visual assessment for the evaluation of myocardial viability. Myocardial contrast echocardiography (MCE) was assessed in 11 pigs before, during, and after left anterior descending coronary artery occlusion and in 32 patients with ischaemic heart disease by using intravenous SonoVue administration. In experimental studies perfusion defect area assessment by MPI was compared with visually guided perfusion defect planimetry. Histological assessment of necrotic tissue was the standard reference. In clinical studies viability was assessed on a segmental level by (1) visual analysis of myocardial opacification; (2) quantitative estimation of myocardial blood flow in regions of interest; and (3) MPI. Functional recovery between three and six months after revascularisation was the standard reference. In experimental studies, compared with visually guided perfusion defect planimetry, planimetric assessment of infarct size by MPI correlated more significantly with histology (r2 = 0.92 versus r2 = 0.56) and had a lower intraobserver variability (4% v 15%, p < 0.05). In clinical studies, MPI had higher specificity (66% v 43%, p < 0.05) than visual MCE and good accuracy (81%) for viability detection. It was less time consuming (3.4 (1.6) v 9.2 (2.4) minutes per image, p < 0.05) than quantitative blood flow estimation by regions of interest and increased the agreement between observers interpreting myocardial perfusion (kappa = 0.87 v kappa = 0.75, p < 0.05). MPI is useful for the evaluation of myocardial viability both in animals and in patients. It is less time consuming than quantification analysis by regions of interest and less observer dependent than visual analysis. Thus, strategies incorporating this technique may be valuable for the evaluation of myocardial viability in clinical routine.

  6. Prognostic usefulness of repeated echocardiographic evaluation after acute myocardial infarction. TRACE Study Group. TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Korup, E; Køber, L; Torp-Pedersen, C

    1999-01-01

    The prognostic value of repeated echocardiographic measurement of left ventricular function after acute myocardial infarction was evaluated. We found that repeated measurements of wall motion index in survivors of acute myocardial infarction, with no reinfarction, provide important prognostic...

  7. Evaluation of myocardial abnormalities in patients with collagen diseases by thallium-201 myocardial scintigram

    Energy Technology Data Exchange (ETDEWEB)

    Yamano, Shigeru (Nara Medical Univ., Kashihara (Japan))

    1992-08-01

    This study was performed to evaluate myocardial lesions in patients with collagen diseases by rest and exercise thallium-201 myocardial scintigraphies. A total of 76 patients without ischemic ECG changes, consisting of 27 cases of systemic lupus erythematosus (SLE), 17 cases of polymyositis or dermatomyositis (PM[center dot]DM), 11 cases of progressive systemic sclerosis (PSS), and 21 cases of Sjoegren's syndrome (SjS), were enrolled in this study. Reversible exercise-induced defects suggesting myocardial ischemia were noted in 12 cases of SLE, 5 cases of PM[center dot]DM, 3 cases of PSS, and 3 cases of SjS. Of the 23 patients who had exercise-induced defects, 9 patients showed normal coronary angiograms by cardiac catheterization. Fixed hypoperfusion areas were observed in 5 cases of SLE, 6 cases of PM[center dot]DM, 4 cases of PSS and 3 cases of SjS. Rest thallium-201 myocardial scintigraphy disclosed hypoperfusion areas, which were not induced by exercise, in 1 case of SLE, 4 cases of PM[center dot]DM, 1 case of PSS and 5 cases of SjS. Endomyocardial biopsy was performed on 20 patients. Myocardial lesions in PM[center dot]DM and PSS were more severe and wide spread than in SLE. Ejection fraction and fractional shortening evaluated by echocardiography had no significant differences between each disease group and the healthy control group. These findings suggest that patients with collagen diseases show the presence of abnormalities of coronary circulation at the level of the intramyocardial vasculature in the stage before impairment of cardiac function, myocardial fibrosis and functional abnormalities of the cell membrane level that were not dependent on myocardial ischemia. (author).

  8. Evaluation of myocardial abnormalities in collagen diseases by thallium-201 myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yamano, Shigeru; Kagoshima, Tadashi; Sugihara, Kiyotaka (Nara Medical Univ., Kashihara (Japan)) (and others)

    1993-12-01

    This study was performed to evaluate myocardial abnormalities in patients with collagen diseases by exercise and rest thallium-201 myocardial scintigrams. A total of 65 patients without ischemic ECG changes, consisting of 18 with systemic lupus erythematosus (SLE), 18 with polymyositis (PM), 8 with progressive systemic sclerosis (PSS), and 21 with Sjoegren's syndrome (SjS), was enrolled in this study. Reversible exercise-induced defects scintigraphically suggesting myocardial ischemia were noted in 8 cases of SLE, 4 cases of PM, 4 cases of PSS, and 3 cases of SjS. Nineteen patients had exercise-induced defects and underwent cardiac catheterization, 8 of whom had normal coronary angiograms. Fixed hypoperfusion areas were observed in one case of SLE, 6 cases of PM and 3 cases of SjS. Rest thallium-201 myocardial scintigram disclosed hypoperfusion areas which were not induced by exercise in 2 cases of SLE, 3 cases of PM, one case of PSS and 5 cases of SjS. Echocardiogram showed no significant differences in ejection fraction and % fractional shortening between the disease groups and healthy control group. These findings suggest that patients with collagen diseases have abnormalities of coronary circulation at the level of the intramural vasculature before cardiac function impairment, myocardial fibrosis and functional abnormalities at the cell membrane. (author).

  9. Evaluation of myocardial damage in Duchenne's muscular dystrophy with thallium-201 myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Takuhisa; Shibuya, Noritoshi (Kawatana National Hospital, Nagasaki (Japan)); Hashiba, Kunitake; Oku, Yasuhiko; Mori, Hideki; Yano, Katsusuke

    1993-01-01

    Myocardial damage and cardiopulmonary functions in patients with Duchenne's muscular dystrophy (DMD) were assessed using thallium-201 myocardial single-photon emission computed tomography (SPECT) and technetium-99m multigated radionuclide angiography. Twenty-five patients with DMD were divided into 4 groups according to percent of perfusion defect (%PD) calculated by the bull's-eye method and age. PD was detected in 24 (96.0%) of 25 patients with DMD, and it spread from the left ventricular lateral wall to the anterior wall and/or interventricular septum. PD was detected even in a 6-year-old DMD boy. Patients in Group I (%PD[>=]10% and age<15 years old) were shown to have a higher risk of left-sided heart failure without respiratory failure. Patients in Group II (%PD[>=]10 and age[>=]15) showed decreased pulmonary function and worsened arterial blood gas values as compared with Group IV (%PD<10 and age[>=]15). There was no significant difference in cardiac function among the 4 groups. It is postulated that myocardial damage in Group II patients is dependent primarily on a deficiency of dystrophin and on chronic respiratory failure, and that some of them are at risk of cardiopulmonary failure. It is concluded that myocardial SPECT is useful for the early diagnosis of myocardial damage and evaluation of cardiopulmonary function in DMD patients. (author).

  10. Evaluation of myocardial damage in Duchenne's muscular dystrophy with thallium-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Tamura, Takuhisa; Shibuya, Noritoshi; Hashiba, Kunitake; Oku, Yasuhiko; Mori, Hideki; Yano, Katsusuke.

    1993-01-01

    Myocardial damage and cardiopulmonary functions in patients with Duchenne's muscular dystrophy (DMD) were assessed using thallium-201 myocardial single-photon emission computed tomography (SPECT) and technetium-99m multigated radionuclide angiography. Twenty-five patients with DMD were divided into 4 groups according to percent of perfusion defect (%PD) calculated by the bull's-eye method and age. PD was detected in 24 (96.0%) of 25 patients with DMD, and it spread from the left ventricular lateral wall to the anterior wall and/or interventricular septum. PD was detected even in a 6-year-old DMD boy. Patients in Group I (%PD≥10% and age<15 years old) were shown to have a higher risk of left-sided heart failure without respiratory failure. Patients in Group II (%PD≥10 and age≥15) showed decreased pulmonary function and worsened arterial blood gas values as compared with Group IV (%PD<10 and age≥15). There was no significant difference in cardiac function among the 4 groups. It is postulated that myocardial damage in Group II patients is dependent primarily on a deficiency of dystrophin and on chronic respiratory failure, and that some of them are at risk of cardiopulmonary failure. It is concluded that myocardial SPECT is useful for the early diagnosis of myocardial damage and evaluation of cardiopulmonary function in DMD patients. (author)

  11. Evaluation of myocardial involvement in Duchenne progressive muscular dystrophy with thallium-201 myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kawai, Naoki; Yamamoto, Shuhei; Okada, Mitsuhiro (Nagoya Univ. (Japan). Faculty of Medicine)

    1983-12-01

    Myocardial involvement in progressive muscular dystrophy of the Duchenne type was evaluated in 19 patients using thallium-201 myocardial perfusion imaging. The qualitative analysis was performed in anterior, 3 left anterior oblique and left lateral projection images by three experienced physicians. Distinct perfusion defects were shown in 13 patients, especially in LV posterolateral or posterior walls (11 patients). There was no significant relationship between the presence of perfusion defects and the skeletal muscle changes or thoracic deformities assessed by transmission computed tomography. Slightly increased thallium-201 activity in RV free wall and lungs was shown in nine and one patient, respectively. The extensive perfusion defects were shown in 2 patients who died of congestive heart failure 1 to 2 years after the scintigraphic study. The myocardial scintigraphic changes were considered to be minimal in 7 of 9 patients who underwent two serial scintigraphic studies in 2 to 3 years. It was concluded that the thallium myocardial perfusion imaging was a useful clinical technique to evaluate the cardiomyopathy in Duchenne progressive muscular dystrophy.

  12. Evaluation of myocardial involvement in Duchenne progressive muscular dystrophy with thallium-201 myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Kawai, Naoki; Yamamoto, Shuhei; Okada, Mitsuhiro

    1983-01-01

    Myocardial involvement in progressive muscular dystrophy of the Duchenne type was evaluated in 19 patients using thallium-201 myocardial perfusion imaging. The qualitative analysis was performed in anterior, 3 left anterior oblique and left lateral projection images by three experienced physicians. Distinct perfusion defects were shown in 13 patients, especially in LV posterolateral or posterior walls (11 patients). There was no significant relationship between the presence of perfusion defects and the skeletal muscle changes or thoracic deformities assessed by transmission computed tomography. Slightly increased thallium-201 activity in RV free wall and lungs was shown in nine and one patient, respectively. The extensive perfusion defects were shown in 2 patients who died of congestive heart failure 1 to 2 years after the scintigraphic study. The myocardial scintigraphic changes were considered to be minimal in 7 of 9 patients who underwent two serial scintigraphic studies in 2 to 3 years. It was concluded that the thallium myocardial perfusion imaging was a useful clinical technique to evaluate the cardiomyopathy in Duchenne progressive muscular dystrophy. (author)

  13. Scintigraphic evaluation of suspected acute myocardial infarction

    International Nuclear Information System (INIS)

    Kan, M.K.; Hopkins, G.B.; Carroll, C.F.X.

    1977-01-01

    Ninety-one patients with chest pain suggestive of acute myocardial infarction were studied by static technetium /sup 99m/Tc stannous pyrophosphate scintigraphy and dynamic sodium pertechnetate /sup 99m/Tc cardioangiography. Twenty-three of 26 patients (88%) with acute transmural infarcts and 12 of 17 patients (71%) with nontransmural infarcts had abnormal static studies. In 45 patients with negative scintigrams, ECG or serum enzyme changes consistent with acute infarction failed to develop. Three false-positive static studies (6%) were recorded. Twenty of 43 (47%) patients with acute infarction had hemodynamic or structural abnormalities identified by cardioangiography. The dynamic study also proved helpful in localizing the site of infarction and in ruling out certain causes of false-positive static scintigrams

  14. Evaluation of myocardial ischemia by multiple detector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Fabio Vieira, E-mail: rccury@me.com [Hospital do Coracao (HCor), Sao Paulo, SP (Brazil); Cury, Roberto Caldeira [Hospital Samaritano, Sao Paulo, SP (Brazil)

    2015-01-15

    For years, cardiovascular diseases have been the leading cause of death worldwide, bringing on important social and economic consequences. Given this scenario, the search for a method capable of diagnosing coronary artery diseases in an early and accurate way is increasingly higher. The coronary computed tomography angiogram is already widely established for the stratification of coronary artery diseases, and, more recently, the computed tomography myocardial perfusion imaging has been providing relevant information by correlating ischemia and the coronary anatomy. The objective of this review is to describe the evaluation of myocardial ischemia by multiple detector computed tomography. This study will resort to controlled clinical trials that show the possibility of a single method to identify the atherosclerotic load, presence of coronary artery luminal narrowing and possible myocardial ischemia, by means of a fast, practical and reliable method validated by a multicenter study. (author)

  15. Myocardial perfusion with multi-detector computed tomography: quantitative evaluation

    International Nuclear Information System (INIS)

    Carrascosa, Patricia M.; Vallejos, J.; Capunay, Carlos M.; Deviggiano, A.; Carrascosa, Jorge M.

    2007-01-01

    The objective of this work is to evaluate the skill of multidetector computer tomography, to quantify the different patterns of intensification during the evaluation of the myocardial perfusion. 45 patients were studied with suspicion of cardiovascular disease. Multi-detector computed tomography was utilized on patients at rest and in effort with pharmacological stress, after the administration of dipyridamole. Also they were evaluated using nuclear medicine [es

  16. Evaluation of the Differences of Myocardial Fibers between Acute and Chronic Myocardial Infarction: Application of Diffusion Tensor Magnetic Resonance Imaging in a Rhesus Monkey Model

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yuqing [Department of Radiology, West China Hospital, Sichuan University, Sichuan 610041 (China); CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of China, Beijing 100190 (China); Cai, Wei [Department of Radiology, West China Hospital, Sichuan University, Sichuan 610041 (China); Department of Radiology, Beijing Jishuitan Hospital, 4th Clinical Medical College of Peking University, Beijing 100035 (China); Wang, Lei [Department of Radiology, West China Hospital, Sichuan University, Sichuan 610041 (China); Xia, Rui [Department of Radiology, West China Hospital, Sichuan University, Sichuan 610041 (China); Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016 (China); Chen, Wei [Department of Radiology, West China Hospital, Sichuan University, Sichuan 610041 (China); Department of Radiology, The First Affiliated Hospital of Kunming Medical University, Yunnan 650032 (China); Zheng, Jie [Mallinckrodt Institute of Radiology, School of Medicine, Washington University, St. Louis, MO 63110 (United States); Gao, Fabao [Department of Radiology, West China Hospital, Sichuan University, Sichuan 610041 (China)

    2016-11-01

    To understand microstructural changes after myocardial infarction (MI), we evaluated myocardial fibers of rhesus monkeys during acute or chronic MI, and identified the differences of myocardial fibers between acute and chronic MI. Six fixed hearts of rhesus monkeys with left anterior descending coronary artery ligation for 1 hour or 84 days were scanned by diffusion tensor magnetic resonance imaging (MRI) to measure apparent diffusion coefficient (ADC), fractional anisotropy (FA) and helix angle (HA). Comparing with acute MI monkeys (FA: 0.59 ± 0.02; ADC: 5.0 ± 0.6 × 10{sup -4} mm{sup 2}/s; HA: 94.5 ± 4.4°), chronic MI monkeys showed remarkably decreased FA value (0.26 ± 0.03), increased ADC value (7.8 ± 0.8 × 10{sup -4}mm{sup 2}/s), decreased HA transmural range (49.5 ± 4.6°) and serious defects on endocardium in infarcted regions. The HA in infarcted regions shifted to more components of negative left-handed helix in chronic MI monkeys (-38.3 ± 5.0°–11.2 ± 4.3°) than in acute MI monkeys (-41.4 ± 5.1°–53.1 ± 3.7°), but the HA in remote regions shifted to more components of positive right-handed helix in chronic MI monkeys (-43.8 ± 2.7°–66.5 ± 4.9°) than in acute MI monkeys (-59.5 ± 3.4°–64.9 ± 4.3°). Diffusion tensor MRI method helps to quantify differences of mechanical microstructure and water diffusion of myocardial fibers between acute and chronic MI monkey's models.

  17. Evaluation of the differences of myocardial fibers between acute and chronic myocardial infarction: Application of diffusion tensor magnetic resonance imaging INA Rhesus monkey model

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yu Qing; Cai, Wei; Wang, Lei; Xia, Rui; Chen, Wei; Zheng, Jie [Dept. of Radiology, West China Hospital, Sichuan University, Sichuan (China); Gao, Fabao [Mallinckrodt Institute of Radiology, School of Medicine, Washington University, St. Louis (United States)

    2016-09-15

    To understand microstructural changes after myocardial infarction (MI), we evaluated myocardial fibers of rhesus monkeys during acute or chronic MI, and identified the differences of myocardial fibers between acute and chronic MI. Six fixed hearts of rhesus monkeys with left anterior descending coronary artery ligation for 1 hour or 84 days were scanned by diffusion tensor magnetic resonance imaging (MRI) to measure apparent diffusion coefficient (ADC), fractional anisotropy (FA) and helix angle (HA). Comparing with acute MI monkeys (FA: 0.59 ± 0.02; ADC: 5.0 ± 0.6 × 10{sup -4} mm{sup 2}/s; HA: 94.5 ± 4.4°), chronic MI monkeys showed remarkably decreased FA value (0.26 ± 0.03), increased ADC value (7.8 ± 0.8 × 10{sup -4} mm{sup 2}/s), decreased HA transmural range (49.5 ± 4.6°) and serious defects on endocardium in infarcted regions. The HA in infarcted regions shifted to more components of negative left-handed helix in chronic MI monkeys (-38.3 ± 5.0°–11.2 ± 4.3°) than in acute MI monkeys (-41.4 ± 5.1°–53.1 ± 3.7°), but the HA in remote regions shifted to more components of positive right-handed helix in chronic MI monkeys (-43.8 ± 2.7°–66.5 ± 4.9°) than in acute MI monkeys (-59.5 ± 3.4°–64.9 ± 4.3°). Diffusion tensor MRI method helps to quantify differences of mechanical microstructure and water diffusion of myocardial fibers between acute and chronic MI monkey's models.

  18. Evaluation of the differences of myocardial fibers between acute and chronic myocardial infarction: Application of diffusion tensor magnetic resonance imaging INA Rhesus monkey model

    International Nuclear Information System (INIS)

    Wang, Yu Qing; Cai, Wei; Wang, Lei; Xia, Rui; Chen, Wei; Zheng, Jie; Gao, Fabao

    2016-01-01

    To understand microstructural changes after myocardial infarction (MI), we evaluated myocardial fibers of rhesus monkeys during acute or chronic MI, and identified the differences of myocardial fibers between acute and chronic MI. Six fixed hearts of rhesus monkeys with left anterior descending coronary artery ligation for 1 hour or 84 days were scanned by diffusion tensor magnetic resonance imaging (MRI) to measure apparent diffusion coefficient (ADC), fractional anisotropy (FA) and helix angle (HA). Comparing with acute MI monkeys (FA: 0.59 ± 0.02; ADC: 5.0 ± 0.6 × 10 -4 mm 2 /s; HA: 94.5 ± 4.4°), chronic MI monkeys showed remarkably decreased FA value (0.26 ± 0.03), increased ADC value (7.8 ± 0.8 × 10 -4 mm 2 /s), decreased HA transmural range (49.5 ± 4.6°) and serious defects on endocardium in infarcted regions. The HA in infarcted regions shifted to more components of negative left-handed helix in chronic MI monkeys (-38.3 ± 5.0°–11.2 ± 4.3°) than in acute MI monkeys (-41.4 ± 5.1°–53.1 ± 3.7°), but the HA in remote regions shifted to more components of positive right-handed helix in chronic MI monkeys (-43.8 ± 2.7°–66.5 ± 4.9°) than in acute MI monkeys (-59.5 ± 3.4°–64.9 ± 4.3°). Diffusion tensor MRI method helps to quantify differences of mechanical microstructure and water diffusion of myocardial fibers between acute and chronic MI monkey's models

  19. Evaluation of left ventricular function in patient with old myocardial infarction by 201-thallium myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Kanji; Shimohara, Yasuaki; Ito, Misao; Okada, Keisei [Kure Kyosai Hospital, Hiroshima (Japan); Kodama, Kazunori

    1984-08-01

    Correlation between the ratio of myocardial defect calculated by 201-thallium myocardial scintigraphy and the left ventricular ejection fraction (LVEF) obtained by gated blood pool scintigraphy and the maximum level of creatine phosphokinase (CPK) was studied in 70 patients with old myocardial infarction. There was a significant correlation between the defect ratio and the LVEF or CPK level in patients with anterior or septal myocardial infarction. In all patients with inferior myocardial infarction in whom no defect was seen, the LVEF was more than 40%. However, no distinct correlation between the defect ratio and the LVEF or CPK level was obtained in cases of inferior myocardial infarction.

  20. Evaluation of myocardial bridging by coronary computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Barros, Marcio Vinicius Lins; Rabelo, Daniel Rocha; Siqueira, Maria Helena Albernaz, E-mail: marciovlbarros@uol.com.br [Hospital Mater Dei, Belo Horizonte, MG (Brazil); Garretto, Luiza Samarane; Paula, Marcela Mascarenhas De; Carvalho, Marina Oliveira; Alves, Marina Rangel Moreira Barros [Faculdade de Saude e Ecologia Humana (FASEH), Vespasiano, MG (Brazil)

    2013-01-15

    The myocardial bridge (MB) is defined as a segment of an epicardial coronary artery that has an intramural course in the myocardium. Although MB is clinically silent in most cases, has been associated with myocardial ischemia, arrhythmias and sudden death. Coronary conventional angiography is the gold standard for detection of MB, but is invasive and cannot be sufficiently sensitive compared to autopsy studies. Recently, multislice computed tomography of coronary arteries (MCTCA) has allowed the detection of coronary artery course, including PM. Objectives: to evaluate MB prevalence in patients with suspected coronary artery disease undergoing MCTCA and to evaluate the predictive value of this method at medium term. Methods: during the period 2008 to 2011, 498 consecutive patients were examined by TMC for the diagnosis of coronary artery disease, being conducted to evaluate the presence of BM and followed for a mean follow-up of 23 months for the occurrence of cardiovascular hard events (death, hospitalization or revascularization). Results: patients mean age was 55.3 ± 14.2, being male 71.1%. Among the patients, 7.6% (38 patients) showed MB. Main findings included angina pectoris in 40% and a positive stress test in 34%. 34.2% had atherosclerotic disease, and one patient had significant coronary stenosis. During follow-up, no patients showed adverse events. Conclusion: MCTCA is a noninvasive technique with high accuracy in anatomical evaluation of the coronary arteries and may be particularly useful to assess the incidence, location and morphology of myocardial bridging in vivo. (author)

  1. Use of myocardial imaging in the evaluation of patients with cardiovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Pitt, B.; Strauss, H.W.; Trhall, J.H.

    1980-01-01

    The role of radioisotope tracer techniques in the evaluation of patients with congenital heart disease, valvular heart disease, suspected myocardial infarction, ischemia or suspected ventricular dysfunction is reviewed. Thallium-201 myocardial imaging and exercise blood pool imaging and Technetium-88m pyrophosphate imaging of myocardial infarction are most commonly used.

  2. Myocardial bridging: evaluation with multislice computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Barros, M.V.L. de; Rabelo, D.R.; Nunes, M.C.P.; Siqueira, M.H.A. [Mater Dei Hospital, Belo Horizonte, MG (Brazil)

    2012-04-15

    Myocardial bridging (MB) is defined as a segment of a major epicardial coronary artery that proceeds intramurally through the myocardium beneath the muscle bridge. Although MB is clinically silent in most cases, it has been associated with myocardial ischemia, myocardial infarction, arrhythmia, and sudden death. Conventional coronary angiography (CCA) is the gold standard for detection, but it is invasive and may not be sensitive enough to detect a thin bridge. Recently, multislice computed tomography coronary angiography (MCTCA) have made possible the clear detection of the entire running courses of coronary arteries and the MB itself. Objective: To evaluate the prevalence MB in patients suspect to coronary artery disease submitted to MCTCA and assessing the predictive value of this method in the midterm. Methods: 498 consecutive patients were examined by MCTCA for the diagnosis of coronary artery disease and followed for a mean follow-up of 17 months for the occurrence of cardiovascular events (death, hospitalization and / or revascularization myocardial). Results: The mean age of patients was 58.4 ± 12.5 years old, 74.3% male. Among the patients, 6,02% (30 patients) showed MB. The major indications were angina pectoris in 45,8% and positive stress testing in 33,3%. 62,5% showed absent atherosclerotic disease and only 1 patient showed moderade descending anterior stenosis. During the follow-up none patient showed hard events. Conclusion: Patients with MB could present with angina pectoris and positive stress testing and showed midterm excellent prognosis. MCTCA is an alternative noninvasive imaging tool that allows for easy and accurate evaluation of MB.

  3. Myocardial contusion in patients with blunt chest trauma as evaluated by thallium 201 myocardial scintigraphy

    International Nuclear Information System (INIS)

    Bodin, L.; Rouby, J.J.; Viars, P.

    1988-01-01

    Fifty five patients suffering from blunt chest trauma were studied to assess the diagnosis of myocardial contusion using thallium 201 myocardial scintigraphy. Thirty-eight patients had consistent scintigraphic defects and were considered to have a myocardial contusion. All patients with scintigraphic defects had paroxysmal arrhythmias and/or ECG abnormalities. Of 38 patients, 32 had localized ST-T segment abnormalities; 29, ST-T segment abnormalities suggesting involvement of the same cardiac area as scintigraphic defects; 21, echocardiographic abnormalities. Sixteen patients had segmental hypokinesia involving the same cardiac area as the scintigraphic defects. Fifteen patients had clinical signs suggestive of myocardial contusion and scintigraphic defects. Almost 70 percent of patients with blunt chest trauma had scintigraphic defects related to areas of myocardial contusion. When thallium 201 myocardial scintigraphy directly showed myocardial lesion, two-dimensional echocardiography and standard ECG detected related functional consequences of cardiac trauma

  4. Thallium-201 exercise myocardial imaging to evaluate myocardial perfusion after coronary artery bypass surgery

    International Nuclear Information System (INIS)

    Hirzel, H.O.; Nuesch, K.; Sialer, G.; Horst, W.; Krayenbuehl, H.P.

    1980-01-01

    To assess the usefulness of thallium-201 exercise scintigraphy in evaluating myocardial perfusion after coronary artery bypass surgery, imaging was performed after submaximal bicycle ergometry and at rest in 54 patients before and within 24 +- 10 (SD) weeks after operation. Scintigraphy identified 8 out of 20 patients who were symptom free after operation and showed normal exercise electrocardiograms as still having exercise-induced ischaemia and thus as having not truly benefited from the surgical intervention. In contrast, improvement in perfusion was documented in 17 out of 31 patients despite further complaints of chest pain and persistence of a pathological exercise electrocardiogram in 6 of them. Bypass graft patency rate paralleled the scintigraphic findings in the 35 patients who were restudied arteriographically. It was concluded that thallium-201 exercise scintigraphy is a useful technique to document changes in regional perfusion after surgery and is definitely superior to the clinical evaluation of patients including the exercise electrocardiogram. (author)

  5. Usefulness of BMIPP SPECT to evaluate myocardial viability, contractile reserve and coronary stenotic progression after reperfusion in acute myocardial infarction

    International Nuclear Information System (INIS)

    Katsunuma, Eita; Kurokawa, Shingo; Takahashi, Motoi; Fukuda, Naoto; Kurosawa, Toshiro; Izumi, Tohru

    2001-01-01

    Using combined 123 I-BMIPP (BMIPP), 201 Tl (Tl) and 99m Tc-PYP (PYP) myocardial SPECT imaging, risk areas of acute myocardial infarction were documented in the acute stage, and then these images were evaluated for how well they reflected muscle viability, contractile reserve and coronary stenotic progression subsequent to reperfusion therapy. Patients who only experienced a first attack of myocardial infarction were enrolled. In total, 36 cases who had had the occluded artery successfully reperfused were examined during the past year. They had no significant vessel disease except for the culprit single artery. The patients were comprised of 32 men and 4 women. The mean age was 59.5 years. All patients underwent coronary angiography and left ventricular (LV) angiography in the emergency room. BMIPP/Tl and PYP myocardial SPECT were conducted in the acute stage and chronic stage. In the chronic stage LV angiography was repeated to assess the improvement of LV wall motion. The response to postextrasystolic potentiation (PESP) testing was performed to estimate myocardial contractile reserve. The risk area of acute myocardial infarction (AMI) was documented by reduced BMIPP accumulation. The size of reduced BMIPP accumulation was larger than that of PYP accumulation. A BMIPP/Tl discrepancy and PYP accumulation were documented to assess myocardial viability. Both improvement in LV wall motion and augmentation of PESP response were more closely related to a BMIPP/Tl discrepancy in the presence or absence of PYP accumulation. Therefore, it would be possible to evaluate myocardial viability and contractile reserve by the BMIPP/Tl discrepancy. In patients with good viability, it is important to predict whether there is coronary stenotic progression or not. In this study, we demonstrated that most patients with improved BMIPP images had no significant progression at the site of intervention. Serial observation of BMIPP images from the acute stage to the chronic stage might

  6. Evaluation of the severity of anterior myocardial infarction (single-vessel disease) by stress myocardial scanning

    International Nuclear Information System (INIS)

    Kobayashi, Mitsuru; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Hayashi, Makoto; Saito, Muneyasu; Sumiyoshi, Tetsuya

    1986-01-01

    Stress thallium-201 scanning was performed in 57 patients with ≥ 75 % stenosis in the left anterior descending artery. The ratio of lung uptake to heart uptake was defined as lung thallium uptake. For quantitative assessment of infarct size and the severity of ischemia, defect score and ischemic score were derived, respectively, from circumferential profile analysis. Lung thallium uptake at stress tended to increase with an increase in both defect and ischemic scores. The increase in lung thallium uptake also tended to be associated with a decrease in LVEF as determined by cardiac catheterization. The results indicate that stress thallium scanning is of value in the evaluation of the severity of myocardial infarction. (Namekawa, K.)

  7. Quantitative evaluations in planar myocardial scintigraphy using 201-thallium

    International Nuclear Information System (INIS)

    Kaiser, J.W.

    1987-01-01

    The observation that the judgements of myocardial images obtained by 201-thallium scintigraphy tend to vary considerably between investigators has prompted us to develop two versions of a quantitative evaluation technique which - after orthogonal-polar adjustment of the coordinates (with the centre of the left ventricle being the origin of the coordinate system) - would allow the counting rates to be expressed as goniometric functions and shown in graphs. The methods under investigation did, however, not appear to give reasonable approximations to a 'normal range', on the basis of which it would be possible to make clearer distinctions between scintiscans with and without pathological findings. (orig./MG) [de

  8. Methods, qualitative and quantitative evaluations of 201Tl myocardial scintiscans

    International Nuclear Information System (INIS)

    Buell, U.; Kleinhans, E.; Klepzig, M.; Seiderer, M.; Strauer, B.E.

    1981-01-01

    Exercise 201 Tl myocardial scintiscanning is a technique used to supplement exercise electrocardiography. The procedure employed should be identical to the standard procedure of electrocardiography. If the coronary disease has already been established by coronary angiography and kineventriculography, 201 Tl examinations should be carried out before surgery in order to determine the ''regional functional reserve''. Visual evaluations of the 201 Tl scintiscans should be supplemented by quantification methods. Quantification is also required between 201 Tl examination and surgery and to assure constant diagnostic accuracy in case of examination by different examiners. (orig./MG) [de

  9. Evaluation of myocardial sympathetic nerve function in patients with mitral valve prolapse using iodine-123-metaiodobenzylguanidine myocardial scintigraphy

    International Nuclear Information System (INIS)

    Kishi, Fumiko; Nomura, Masahiro; Yukinaka, Michiko

    1996-01-01

    Mitral valve prolapse (MVP) is closely related to myocardial sympathetic nerve function. This study evaluated the presence of impaired myocardial sympathetic nerve function by Iodine-123-metaiodobenzylguanidine (MIBG) scintigraphy in nine patients with MVP. For comparison, 15 healthy subjects without heart disease were investigated (control group). Single photon emission computed tomography (SPECT) and anterior planar myocardial scintigraphy were performed 15 min (initial images) and 3 hours (delayed images) after injection of MIBG (111 MBq). The location and degrees of reduced tracer uptake were evaluated. Myocardial MIBG uptake was quantified by uptake ratio of the heart (H) to upper mediastinum (M) on the anterior planar images (H/M). Percentage washout of MIBG in nine sectors of all oblique slices along the short-axis was calculated. The washout rates were higher at the inferoposterior and septal segments in patients with anterior leaflet prolapse, and at inferoposterior and lateral segments in patients with posterior leaflet prolapse. The bull's eye map showed increased washout rate in the apical and posteroseptal basal segments. There was no significant difference in the H/M ratio between MVP patients and the control group. These results indicate that MIBG can be used to evaluate localized myocardial sympathetic nerve function in MVP. (author)

  10. Evaluation of the specificity of radionuclide myocardial imaging for detecting CAD

    International Nuclear Information System (INIS)

    Liu Xiujie

    1992-01-01

    In order to evaluate the specificity of radionuclide myocardial perfusion imaging for detecting coronary artery disease (CAD), 50 patients with normal coronary arteriography and radionuclide myocardial perfusion scintigraphy were analysed. The results from 201 T1 (20 cases) and 99m Tc-MIBI (30 cases) studies showed that out of 33 patients with no organic cardiovascular disease, 29 had normal myocardial imaging, and the specificity of radionuclide myocardial imaging for detecting CAD was 87.8%. 4 normal young women had false positive myocardial imaging. Out of 17 patients with cardiovascular disease and normal coronary arteriography, 15 patients had abnormal myocardial imaging. The final clinical diagnoses of these 15 patients were: 4 patients with hypertrophic cardiomyopathy, 3 with old myocardial infarction, 2 with myocarditis, 3 with small coronary vessel disease, 1 with congestive cardiomyopathy, and 2 with other cardiac disorder. The points of differentiation between CAD and other cardiovascular disease using radionuclide techniques were discussed

  11. Thallium-201 myocardial imaging for evaluation of pulmonary hypertension

    International Nuclear Information System (INIS)

    Ikuno, Yoshiyasu

    1979-01-01

    Thallium-201 ( 201 Tl) myocardial scintigraphy (TMS) was performed in 54 patients. The images were analysed semi-quantitatively by measuring the extent of radioisotope concentration in the right ventricular free wall and the size of the right ventricular cavity. The extent of radioisotope concentration (four degrees) was expressed as the right ventricular activity score (RVAS) and the size of the right ventricular cavity (three degrees) was expressed as the right ventricular cavity score (RVCS). The scores were added for a right ventricular total score (RVTS). To establish criteria for the diagnosis of pulmonary hypertension (PH) by means of TMS, these scores were compared with the values of pulmonary arterial mean pressure (PAMP). The criteria were evaluated by comparing them with conventional criteria for electrocardiographic diagnosis of right ventricular hypertrophy. Patients with a 2-point RVAS had a significantly higher PAMP than those with a 0 or 1-point RVAS (p 201 Tl myocardial scintigrams is a useful non-invasive method for evaluating PH and its severity. (J.P.N.)

  12. Role of myocardial perfusion imaging in evaluating thrombolytic therapy for acute myocardial infarction

    International Nuclear Information System (INIS)

    Beller, G.A.

    1987-01-01

    Myocardial thallium-201 scintigraphy is being increasingly employed as a method for assessing the efficacy of coronary reperfusion in acute myocardial infarction. New thallium uptake after intracoronary tracer administration after successful recanalization indicates that nutrient blood flow has been successfully restored. One may also presume that some myocardial salvage occurred if thallium administered in this manner is transported intracellularly by myocytes with intact sarcolemmal membranes. However, if one injects thallium by way of the intracoronary route immediately after reperfusion, the initial uptake of thallium in reperfused myocardium may predominantly represent hyperemic flow and regional thallium counts measured may not be proportional to the mass of viable myocytes. When thallium is injected intravenously during the occlusion phase the degree of redistribution after thrombolysis is proportional to the degree of flow restoration and myocardial viability. When thallium is injected for the first time intravenously immediately after reperfusion, an overestimation of myocardial salvage may occur because of excess thallium uptake in the infarct zone consequent to significant hyperemia. Another approach to myocardial thallium scintigraphy in patients undergoing thrombolytic therapy is to administer two separate intravenous injections before and 24 hours or later after treatment. Finally, patients with acute myocardial infarction who receive intravenous thrombolytic therapy are candidates for predischarge exercise thallium-201 scintigraphy for risk stratification and detection of residual ischemia

  13. MR-evaluation of left myocardial function in transplanted hearts

    International Nuclear Information System (INIS)

    Rienmuller, R.K.; Lioret, J.; Kemkes, B.; Erdmann, E.; Gartner, C.; Hacker, H.; Tilling, R.

    1988-01-01

    Of 60 heart transplant recipients, 25 were restudied with magnetic resonance (MR) imaging after 1 year to evaluate the left ventricular myocardial (LVM) function, Seven healthy subjects and 15 patients with dilated cardiomyopathy (DCM) served as controls. EDV, ejection fraction (EF), LVMM, wall stress (T-diastolic, T-systolic), and LVM contraction and relaxation (LVMC, LVMR) were measured over a cardiac cycle and compared with angiocardiographic and clinical data. The results showed that EDV and EF were normal in heart transplant recipients both initially and at follow-up, and in healthy subjects. LVMM was significantly increased in patients with DCM and less so in transplant recipients. T-diastolic wall stress was increased in transplant recipients and patients with DCM. The isovolumetric part of LVMC and the LVMR were reduced in these groups, corresponding to restrictive hemodynamics. In transplant recipients at follow-up, a progressive reduction in LVMR was found. In transplant recipients with global myocardial ischemia, LVMM,LVMC,LVMR, and EF are continuously decreasing, in contrast to acute or subacute rejection, where LVMM was found unchanged or increased. In conclusion, LVMM, LVMR, and LVMC as determined by MR imaging are sensitive quantitative indexes of various causes of altered LVM function that result from (sub) acute, chronic rejection or graft atherosclerosis

  14. Evaluation of initial uptake and redistribution on stress thallium-201 myocardial perfusion images in patients with myocardial infarction

    International Nuclear Information System (INIS)

    Watanabe, Yoshihiko; Tonooka, Ichiroh; Kanaya, Tohru; Tsuiki, Kai; Yasui, Shouji.

    1984-01-01

    Stress thallium-201 myocardial perfusion imaging was performed on 29 patients with previous myocardial infarction and 29 patients with angina pectoris at exercise to evaluate thallium-201 kinetics in ischemic heart disease. Four views of thallium-201 images (right anterior oblique, antero-posterior, left anterior oblique and left lateral views) were obtained at 5 min after treadmill exercise with administration of 2 mCi of thallium-201 chloride (initial image) and at 3 hours later (delayed image). Myocardial images were divided into 6 segments (anterior, lateral, inferior, posterior, apical and septal segments) and initial uptake (IU) and redistribution index (RDI, the ratio of the maximal washout rate to a washout rate in each segment) were calculated in order to assess the relations of thallium-201 kinetics to wall motion abnormality and coronary artery stenosis. In myocardial infarction, IU and RDI were decreased in proportion to the severity of wall motion abnormality and coronary artery stenosis. Contrarily, in angina pectoris, IU was decreased but RDI was increased proportionally to the severity of coronary arterial stenosis. In conclusion, IU and redistribution of thallium-201 were affected essentially by both the grade of coronary arterial stenosis and the amount of residual viable heart muscle in patients with ischemic myocardial disease. (author)

  15. Noninvasive evaluation of myocardial ischemia in patients with heart problems

    Directory of Open Access Journals (Sweden)

    Mehdi Nikseresht

    2018-03-01

    Conclusion: It seems that the higher risk of myocardial ischemia in men aged 60-77 years, as compared to men aged 45-59 years, might be related to aging process and imbalance in the risk factors. Promoting physical activity can favorably affect the risk of myocardial ischemia in the middle-aged or elderly men. It is concluded that physical activity effectively decreased the risk of myocardial ischemia.

  16. Evaluation of BRDF Archetypes for Representing Surface Reflectance Anisotropy Using MODIS BRDF Data

    OpenAIRE

    Zhang, Hu; Jiao, Ziti; Dong, Yadong; Li, Xiaowen

    2015-01-01

    Bidirectional reflectance distribution function (BRDF) archetypes extracted from the Moderate Resolution Imaging Spectroradiometer (MODIS) BRDF/Albedo product over the global Earth Observing System Land Validation Core Sites can be used to simplify BRDF models. The present study attempts to evaluate the representativeness of BRDF archetypes for surface reflectance anisotropy. Five-year forward-modeled MODIS multi-angular reflectance (MCD-ref) and aditional actual MODIS multi-angular observat...

  17. Comparison of myocardial function between post-menopausal and pre-menopausal women: evaluation by gated myocardial SPECT

    International Nuclear Information System (INIS)

    Hwang, K. H.; Choa, Won Sick; Yoon, Min Ki

    2005-01-01

    In addition to inhibiting coronary atherosclerosis, estrogen is expected to have protective effects on cardiac myocytes. We investigated the difference in myocardial functional parameters evaluated by gated myocardial SPECT after adenosine-stress between post-menopausal and pre-menopausal healthy women. This study included 22 healthy post-menopausal women (mean age: 53.0 yr) and 20 pre-menopausal women (mean age: 43.0 yr) who performed Tc-99m tetrofosmin gated myocardial SPECT after adenosine-stress. Measured hemodynamic parameters, EDV, ESV, stroke volume, EF, cardiac output and cardiac index were compared between the two groups. For comparison, similar-aged two male groups with matched numbers were also studied. There was no significant difference in hemodynamic parameters. EDV, ESV, stroke volume, EF, or cardiac output between the post-menopausal and pre-menopausal women. However, post-menopausal women have a smaller cardiac index (mean: 1.95 L/min/m2 vs 2.20 L/min/m2; p=0.045) and adenosine-induced HR increase (mean : 80.5/min vs 89.7/min ; p=0.03), compared to the pre-menopausal women. On the contrary, the two male groups of the same age range and numbers with the women groups showed no significant difference in any myocardial parameters. These results suggest that menopause may be correlated with reduced increase in cardiac index and HR increase after adenosine-stress

  18. Comparison of myocardial function between post-menopausal and pre-menopausal women: evaluation by gated myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, K. H.; Choa, Won Sick; Yoon, Min Ki [Gachon Medical School, Gil Hospital, Incheon (Korea, Republic of)

    2005-07-01

    In addition to inhibiting coronary atherosclerosis, estrogen is expected to have protective effects on cardiac myocytes. We investigated the difference in myocardial functional parameters evaluated by gated myocardial SPECT after adenosine-stress between post-menopausal and pre-menopausal healthy women. This study included 22 healthy post-menopausal women (mean age: 53.0 yr) and 20 pre-menopausal women (mean age: 43.0 yr) who performed Tc-99m tetrofosmin gated myocardial SPECT after adenosine-stress. Measured hemodynamic parameters, EDV, ESV, stroke volume, EF, cardiac output and cardiac index were compared between the two groups. For comparison, similar-aged two male groups with matched numbers were also studied. There was no significant difference in hemodynamic parameters. EDV, ESV, stroke volume, EF, or cardiac output between the post-menopausal and pre-menopausal women. However, post-menopausal women have a smaller cardiac index (mean: 1.95 L/min/m2 vs 2.20 L/min/m2; p=0.045) and adenosine-induced HR increase (mean : 80.5/min vs 89.7/min ; p=0.03), compared to the pre-menopausal women. On the contrary, the two male groups of the same age range and numbers with the women groups showed no significant difference in any myocardial parameters. These results suggest that menopause may be correlated with reduced increase in cardiac index and HR increase after adenosine-stress.

  19. Preoperative evaluation of myocardial viability by thallium-201 imaging in patients with old myocardial infarction who underwent coronary revascularization

    International Nuclear Information System (INIS)

    Naruse, Hitoshi; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Miyamoto, Takashi; Fukuchi, Minoru

    1992-01-01

    The myocardial uptake and redistribution in thallium scintigraphy and the regional wall motion by echocardiography were evaluated by a semi-quantitative method in 42 patients who previously had myocardial infarction (50 target vessels) and underwent coronary revascularization. The aim of this study was to elucidate the significance of the initial image, delayed image and redistribution on thallium-201 scintigraphy for clinical diagnosis of the myocardial viability. As a semi-quantitative analysis, we used a bull's-eye display for thallium image and centerline method for echocardiographic wall motion, and compared the results before and after revascularization. As a result, the thallium grade improved postoperatively in all 17 areas which preoperatively had showed redistribution, and also in 11 of the 32 areas without preoperative redistribution. The sensitivity, specificity and accuracy of preoperative thallium redistribution for predicting myocardial viability were 61%, 100% and 78%, respectively, when the postoperative improvement in the thallium grade was used as the standard. The postoperative probability of improvement in the thallium grade increased in proportion to the preoperative grade (delayed image)(p<0.01). There was no correlation between the preoperative thallium delayed image and postoperative improvement in wall motion. Postoperative improvement in thallium image and wall motion could not be predicted from the preoperative wall motion. Thus, postoperative improvement in thallium images can be anticipated if redistribution is present on the preoperative thallium image, and the preoperative thallium delayed image is useful for predicting myocardial viability. Improvement in wall motion could not be predicted preoperatively by these methods. (author)

  20. Positron imaging in the evaluation of ischemia and myocardial infarction

    International Nuclear Information System (INIS)

    Goldstein, R.A.

    1985-01-01

    Positron emission tomography (PET) is a unique imaging approach since it allows quantification of regional myocardial radioactivity by virtue of its decay characteristics. Studies of regional myocardial metabolism are possible since there are positron emitting isotopes of carbon, oxygen and nitrogen that can be used to synthesize labeled fatty acids, amino acids or carbohydrate. Recent studies from the author's group have focused on Rb-82, a diffusible cation with a short half-life that is obtained from a generator and thus, has the potential for routine clinical use without a cyclotron. In this chapter, the basic principles of positron imaging and their application to imaging of acute myocardial infarction are discussed

  1. Simulation evaluation of quantitative myocardial perfusion assessment from cardiac CT

    Science.gov (United States)

    Bindschadler, Michael; Modgil, Dimple; Branch, Kelley R.; La Riviere, Patrick J.; Alessio, Adam M.

    2014-03-01

    Contrast enhancement on cardiac CT provides valuable information about myocardial perfusion and methods have been proposed to assess perfusion with static and dynamic acquisitions. There is a lack of knowledge and consensus on the appropriate approach to ensure 1) sufficient diagnostic accuracy for clinical decisions and 2) low radiation doses for patient safety. This work developed a thorough dynamic CT simulation and several accepted blood flow estimation techniques to evaluate the performance of perfusion assessment across a range of acquisition and estimation scenarios. Cardiac CT acquisitions were simulated for a range of flow states (Flow = 0.5, 1, 2, 3 ml/g/min, cardiac output = 3,5,8 L/min). CT acquisitions were simulated with a validated CT simulator incorporating polyenergetic data acquisition and realistic x-ray flux levels for dynamic acquisitions with a range of scenarios including 1, 2, 3 sec sampling for 30 sec with 25, 70, 140 mAs. Images were generated using conventional image reconstruction with additional image-based beam hardening correction to account for iodine content. Time attenuation curves were extracted for multiple regions around the myocardium and used to estimate flow. In total, 2,700 independent realizations of dynamic sequences were generated and multiple MBF estimation methods were applied to each of these. Evaluation of quantitative kinetic modeling yielded blood flow estimates with an root mean square error (RMSE) of ~0.6 ml/g/min averaged across multiple scenarios. Semi-quantitative modeling and qualitative static imaging resulted in significantly more error (RMSE = ~1.2 and ~1.2 ml/min/g respectively). For quantitative methods, dose reduction through reduced temporal sampling or reduced tube current had comparable impact on the MBF estimate fidelity. On average, half dose acquisitions increased the RMSE of estimates by only 18% suggesting that substantial dose reductions can be employed in the context of quantitative myocardial

  2. Myocardial bridging as evaluated by 16 row MDCT

    International Nuclear Information System (INIS)

    Canyigit, Murat; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Dagoglu, Merve Gulbiz; Akata, Deniz; Aytemir, Kudret; Oto, Ali; Balkanci, Ferhun; Akpinar, Erhan; Besim, Aytekin

    2009-01-01

    Purpose: The purpose of this study is to find out the prevalence, appearance and clinical symptoms of myocardial bridging (MB) by MDCT coronary angiography (CTA). Materials and methods: A total of 280 (50 females) consecutive patients followed with coronary artery disease or postoperative stent and bypass control, underwent CTA performed by 16-MDCT scanner between January 2006 and April 2006. Short axis multiplanar reformatted images were evaluated. MBs were classified as complete and incomplete bridges with respect to continuity of the myocardium over the tunneled segment of left anterior descending artery (LAD) in interventricular groove and the cut-off value is 1.3 mm. Patients diagnosed with MB on CTA who had prior catheter angiography studies were re-evaluated for the presence of MB. Results: One hundred and twenty MBs [98 (81.6%) on LAD, 2 (1.6%) on diagonal branch, 11 (9.1%) on obtuse marginal, 4 (3.3%) on right coronary artery, 5 (4.1%) on ramus intermedius artery] were detected in 108 (38.5%) patients. Eighty-five (70.8%) of bridged segments in 79 (28.2%) patients were complete and the rest [35 (29.2%) in 34 (12.1%) patients] were incomplete. In 12 patients two MBs (either on different arteries or on the same artery) were detected. The length of bridged segments in patients with complete and incomplete MBs varied between 4-50.9 mm (mean 18 mm) and 4-37.3 mm (mean 13.6 mm), respectively, and the depth of myocardium over the artery ranged between 1-6.4 mm (mean 2.3 mm) and 1-1.2 mm (mean 1 mm), respectively. Thirty (27.7%) out of 108 patients, in whom MB was detected on CTA, were found to have correlative catheter angiography studies, retrospectively and MB was detected only in 4 (13.3%) out of 30 patients. Conclusion: MDCT coronary angiography is a non-invasive, efficient method in the diagnosis of MB avoiding the procedural risks that catheter angiography carries. MDCT coronary angiography allows direct visualization of the bridge itself and may thus give

  3. Spectral analysis for evaluation of myocardial tracers for medical imaging

    International Nuclear Information System (INIS)

    Huesman, Ronald H.; Reutter, Bryan W.; Marshall, Robert C.

    2000-01-01

    Kinetic analysis of dynamic tracer data is performed with the goal of evaluating myocardial radiotracers for cardiac nuclear medicine imaging. Data from experiments utilizing the isolated rabbit heart model are acquired by sampling the venous blood after introduction of a tracer of interest and a reference tracer. We have taken the approach that the kinetics are properly characterized by an impulse response function which describes the difference between the reference molecule (which does not leave the vasculature) and the molecule of interest which is transported across the capillary boundary and is made available to the cell. Using this formalism we can model the appearance of the tracer of interest in the venous output of the heart as a convolution of the appearance of the reference tracer with the impulse response. In this work we parameterize the impulse response function as the sum of a large number of exponential functions whose predetermined decay constants form a spectrum, and each is required only to have a nonnegative coefficient. This approach, called spectral analysis, has the advantage that it allows conventional compartmental analysis without prior knowledge of the number of compartments which the physiology may require or which the data will support

  4. Clinical evaluation of efonidipine hydrochloride in angina pectoris. Evaluation in exercise 201Tl myocardial scintigraphy

    International Nuclear Information System (INIS)

    Hori, Masatsugu; Nishimura, Tsunehiko

    1996-01-01

    Clinical usefulness of once-daily administration of 20 to 60 mg of efonidipine hydrochloride and coronary hemodynamics during exercise 201 Tl myocardial scintigraphy were investigated in patients with angina pectoris. Out of 11 patients enrolled in this study, 9 patients were included in the evaluation of patients' impression, in improvement rating in subjective symptoms, in the analysis of the exercise test, in the improvement rating of images on 201 Tl myocardial scintigraphy, and in the global improvement rating, while 10 patients were included in the overall safety rating. Four patients in improvement rating in subjective symptoms, 2 in improving rating in the exercise test, and 5 in the global improvement rating were rated 'improved' or better. In the improvement rating on the exercise 201 Tl myocardial scintigraphy image, reduction of the image was observed in 5 patients, 3 out of which were evaluated as 'improved' or better. A distinctive reduction of ischemic regions was observed in 2 patients out of the 3. A significant decrease in the number of angina pectoris events and a decreasing tendency in consumption of fast-acting nitrates were observed in spite of the low number of the patients studied. An adverse effect was observed in 1 patient and abnormal laboratory values were observed in 2 patients which were improved promptly after withdrawal of the drug. It was in 7 patients evaluated as 'no problem', while in 4 patients it was evaluated as 'useful' or more. (author)

  5. GATED SPECT TO EVALUATE LEFT VENTRICULAR MYOCARDIAL PERFUSION, FUNCTION AND DYSSYNCHRONY FOR RESYNCHRONIZATION THERAPY

    Directory of Open Access Journals (Sweden)

    E.N. Ostroumov

    2009-01-01

    Full Text Available The study included 15 consecutive patients with heart failure and substantial LV dyssynchrony undergoing CRT. Clinical and phase analysis of gated myocardial perfusion SPECT assessed at baseline, after 2–3 days and after 3–4 months of CRT. The results demonstrated inversely relationship between the response to CRT and the nonviable myocardium. Evaluation of myocardial viability is necessary to considered in the selection process for CRT.

  6. Hypercholesterolemia and Myocardial function evaluated via Tissue Doppler Imaging

    Directory of Open Access Journals (Sweden)

    Kotaru Pavan

    2009-11-01

    Full Text Available Abstract Objective To establish a link between hypercholesterolemia and myocardial dysfunction. Background Heart failure is a complex disease involving changes in systolic and diastolic function. Newer echocardiographic imaging modalities may be able to detect discreet changes in myocardial function associated with hypercholesterolemia. Therefore we sought to establish a link between hypercholesterolemia and myocardial dysfunction with tissue Doppler imaging (TDI. Methods Twenty-seven rabbits were studied: 7 were fed normal chow (group 1 and 20 a high cholesterol diet (10 with ezetimibe, 1 mg/kg/day; group 2 and 10 without, group 3. Echocardiographic images were obtained under general anesthesia. Serum cholesterol levels were obtained at baseline, 3 and 6 months and myocardial cholesterol levels measured following euthanasia. Results Doppler measurements, including E/A, E'/A' and S' were significantly lower in group 3 compared to both groups 1 and 2 but no significant differences were noted in chamber sizes or ejection fraction among the groups. Average serum cholesterol was higher in group 3 compared to groups 1 and 2 respectively (495 ± 305 mg/dl vs. 114 ± 95 mg/dl and 87 ± 37 mg/dl; p 2 = 0.17 p = 0.04, r2 = 0.37 p = 0.001 and r2 = 0.24 p = 0.01. Conclusion Cholesterol load in the serum and myocardium was significantly associated with decreased systolic and diastolic function by TDI. Moreover, lipid lowering was protective.

  7. Evaluation of TG-43 recommended 2D-anisotropy function for elongated brachytherapy sources

    International Nuclear Information System (INIS)

    Awan, Shahid B.; Meigooni, Ali S.; Mokhberiosgouei, Ramin; Hussain, Manzoor

    2006-01-01

    The original and updated protocols recommended by Task Group 43 from the American Association of Physicists in Medicine (i.e., TG-43 and TG-43U1, respectively), have been introduced to unify brachytherapy source dosimetry around the world. Both of these protocols are based on experiences with sources less than 1.0 cm in length. TG-43U1 recommends that for 103 Pd sources, 2D anisotropy function F(r,θ), should be tabulated at a minimum for radial distances of 0.5, 1.0, 2.0, 3.0, and 5.0 cm. Anisotropy functions defined in these protocols are only valid when the point of calculation does not fall on the active length of the source. However, for elongated brachytherapy sources (active length >1 cm), some of the calculation points with r 103 Pd source at radial distances of 2.5, 3.0, and 4.0 cm were 2.95, 1.74, and 1.19, respectively, with differences up to about a factor of 3. Therefore, the validity of the linear interpolation technique for an elongated brachytherapy source with such a large variation in F(r,θ) needs to be investigated. In this project, application of the TG-43U1 formalism for dose calculation around an elongated RadioCoil trade mark sign 103 Pd brachytherapy source has been investigated. In addition, the linear interpolation techniques as described in TG-43U1 for seed type sources have been evaluated for a 5.0 cm long RadioCoil trade mark sign 103 Pd brachytherapy source. Application of a polynomial fit to F(r,θ) has also been investigated as an alternate approach to the linear interpolation technique. The results of these investigations indicate that the TG-43U1 formalism can be extended for elongated brachytherapy sources, if the two-dimensional (2D) anisotropy function is tabulated at a minimum for radial distances of 0.2, 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0 cm, L/2, and L/2±0.2 cm. Moreover, with the addition of recommended radial distances for 2D anisotropy functions, the linear interpolation technique more closely replicates

  8. Semi-quantitative evaluation of texture components and anisotropy of the yield strength in 2524 T3 alloy sheets

    International Nuclear Information System (INIS)

    Shen, Fanghua; Yi, Danqing; Wang, Bin; Liu, Huiqun; Jiang, Yong; Tang, Cong; Jiang, Bo

    2016-01-01

    Decreasing the anisotropy of 2524 alloys is a key factor for their use in applications such as high-performance inertial components or space robots. Studying the interaction between sheet textures and anisotropy is a key factor to overcome this problem. In this study, the semi-quantitative approach to estimate the relation between texture and in-plane anisotropy (IPA) of yield strength has been developed. The intensity ratio between Cube and Brass texture components (F CGB ) was used as an effective variable for this purpose. This approach has been tested in 2524 T3 aluminum alloy sheets, which were investigated using X-Ray diffraction, scanning electron microscopy, optical microscopy and tensile tests. The results show that F CGB decreased with an increase in cold reduction. The 2524 T3 sheet, dominated by Cube texture grains, possesses the lowest in-plane anisotropy for the yield strength of all texture components investigated. The alloy sheet dominated by Brass texture exhibits the highest anisotropy, while the Goss texture-led sheets fall in between them. These results agree with the trends seen in the factor F CGB , suggesting that is suited to evaluate the anisotropy of yield strength in 2524 T3 alloy sheets semi-quantitatively.

  9. Semi-quantitative evaluation of texture components and anisotropy of the yield strength in 2524 T3 alloy sheets

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Fanghua [School of Materials Science and Engineering, Central South University, Changsha 410083 (China); Yi, Danqing, E-mail: yioffice@csu.edu.cn [School of Materials Science and Engineering, Central South University, Changsha 410083 (China); Light Alloy Research Institute, Central South University, Changsha, Hunan 410083 (China); National Collaborative Innovation Center of Advanced Nonferrous Structural Materials and Manufacturing, Central South University, Changsha 410083 (China); Wang, Bin; Liu, Huiqun; Jiang, Yong; Tang, Cong; Jiang, Bo [School of Materials Science and Engineering, Central South University, Changsha 410083 (China)

    2016-10-15

    Decreasing the anisotropy of 2524 alloys is a key factor for their use in applications such as high-performance inertial components or space robots. Studying the interaction between sheet textures and anisotropy is a key factor to overcome this problem. In this study, the semi-quantitative approach to estimate the relation between texture and in-plane anisotropy (IPA) of yield strength has been developed. The intensity ratio between Cube and Brass texture components (F{sub CGB}) was used as an effective variable for this purpose. This approach has been tested in 2524 T3 aluminum alloy sheets, which were investigated using X-Ray diffraction, scanning electron microscopy, optical microscopy and tensile tests. The results show that F{sub CGB} decreased with an increase in cold reduction. The 2524 T3 sheet, dominated by Cube texture grains, possesses the lowest in-plane anisotropy for the yield strength of all texture components investigated. The alloy sheet dominated by Brass texture exhibits the highest anisotropy, while the Goss texture-led sheets fall in between them. These results agree with the trends seen in the factor F{sub CGB}, suggesting that is suited to evaluate the anisotropy of yield strength in 2524 T3 alloy sheets semi-quantitatively.

  10. Evaluation of BRDF Archetypes for Representing Surface Reflectance Anisotropy Using MODIS BRDF Data

    Directory of Open Access Journals (Sweden)

    Hu Zhang

    2015-06-01

    Full Text Available Bidirectional reflectance distribution function (BRDF archetypes extracted from the Moderate Resolution Imaging Spectroradiometer (MODIS BRDF/Albedo product over the global Earth Observing System Land Validation Core Sites can be used to simplify BRDF models. The present study attempts to evaluate the representativeness of BRDF archetypes for surface reflectance anisotropy. Five-year forward-modeled MODIS multi-angular reflectance (MCD-ref and aditional actual MODIS multi-angular observations (MCD-obs in four growing periods in 2008 over three tiles were taken as validation data. First, BRDF archetypes in the principal plane were qualitatively compared with the time-series MODIS BRDF product of randomly sampled pixels. Secondly, BRDF archetypes were used to fit MCD-ref, and the average root-mean-squared errors (RMSEs over each tile were examined for these five years. Finally, both BRDF archetypes and the MODIS BRDF were used to fit MCD-obs, and the histograms of the fit-RMSEs were compared. The consistency of the directional reflectance between the BRDF archetypes and MODIS BRDFs in nadir-view, hotspot and entire viewing hemisphere at 30° and 50° solar geometries were also examined. The results confirm that BRDF archetypes are representative of surface reflectance anisotropy for available snow-free MODIS data.

  11. Quantitative evaluation of myocardial perfusion and heart function using a non-invasive double isotope technique

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, W H; Doll, J; Georgi, P [Deutsches Krebsforschungszentrum, Heidelberg (Germany, F.R.). Inst. fuer Nuklearmedizin; Tillmanns, H [Heidelberg Univ. (Germany, F.R.). Innere Medizin 3

    1976-11-01

    This paper describes a non-invasive double nuclide technique for the simultaneous measurement of minimal cardiac transit times (MTT) and regional 'myocardial appearance times' (MAT) using gamma camera and computer. MAT is defined as the time lag between the appearance of an indicator with myocardial affinity in the aortic root and its extraction in the myocardial cells. The extraction can be identified as an increase of the ratio between the count rates of the two nuclides e.g. /sup 201/Tl-chloride and sup(113m)In DTPA. The clinical evaluation of this method allows the following conclusions: 1) MAT, determined over several circumscript myocardial regions permits the qualitative diagnosis of a coronary artery disease with high confidence. 2) Indices of nutritive myocardial blood flow (INF), derived by MAT using several representative areas of myocardium, show a definite correlation to the degree of coronary artery disease. In addition to the localization of infarction and the determination of infarct size, the technique described promises a quantitative evaluation of the regional myocardial perfusion. Simultaneously measured MTT help to assess segmental cardiac performance.

  12. Evaluation of thallium-201 myocardial emission computed tomography based on a comparison with postmortem findings

    International Nuclear Information System (INIS)

    Nagashima, Jun-ichi; Yamada, Hideo; Ohkawa, Shin-ichiro; Yonamine, Shigemichi; Nishino, Hideo; Yamagata, Atsushi; Suzuki, Yasuko; Tanno, Munehiko; Chiba, Kazuo

    1986-01-01

    The correlative study of myocardial perfusion assessed by 201 Tl myocardial ECT with the pathological finding of the heart was performed in 10 autopsied cases with mean age of 77 years old (range: 60 - 90 y). In 6 cases with myocardial infarction (MI) 7 perfusion defects were observed, that was, 3 in anteroseptal wall, 1 in anterolateral wall and 3 in posterior wall on the images of SPECT. Seven MIs were also found in postmortem examination. Six MIs were observed at autopsy corresponding to perfusion defect on SPECT images. In one myocardial perfusion defect at inferoposterior portion on SPECT, a non-transmural MI was found at anteroseptum. In one case with valvular disease a false positive result was obtained at posterior wall where neither myocardial necrosis nor fibrosis was observed at autopsy. This case had aortic stenosis due to bicuspid aortic valve by autopsy. The ventricle was devided into 16 segments in each of 4 short axial images to evaluate extent of MI. SPECT for extent of MI showed sensitivity of 81.9 %, specificity of 96.0 % and diagnostic accuracy of 92.5 %. False negative segment was apt to be observed at the surrounding of non-transmural MI or basal half of left ventricle (LV) with transmural MI, while false positive segment was at posterior portion of basal half of LV. It was concluded that myocardial ECT was useful for evaluation of the site and extent of MI. (author)

  13. Magnetic resonance imaging using paramagnetic contrast agents in the clinical evaluation of myocardial infarction. Chapter 15

    International Nuclear Information System (INIS)

    Dijkman, P.R.M. van; Wall, E.E. van der

    1992-01-01

    MRI is noninvasive and specific method for production of high resolution tomographic images in blocks of 3D information. Apart from scintigraphic techniques and computed tomography for evaluation of myocardial ischemia and infarcts, MRI has emerged as a new diagnostic technique to study the extent of anatomical and functional abnormalities in patients with coronary artery disease. Conventional noncontrast MRI can identify acute-infarcted myocardial areas, although the difficulty in identifying myocardial ischemia and infarct with noncontrast MRI suggests a potential role for contrast enhanced MRI. Use of the paramagnetic contrast agent gadolinium diethylene triamine pentaacetic acid (Gd-DTPA) improves depiction of infarcted myocardium on T1-weighted spin -echo MR images that are obtained soon after acute myocardial infarction. This is of particular interest for the estimation of myocardial infarct size. Furthermore, ultrafast subsecond imaging, in combination with Gd-DTPA, offers the potential to analyze cardiac first pass and myocardial perfusion. The development of nontoxic paramagnetic contrast agents which are selectively taken up by viable myocardium would be helpful in assessing the presence of ischemic/infarcted myocardium salvage by MRI following reperfusion. (author). 58 refs., 6 figs

  14. Radioimmunoassay of myosin heavy beta chains in human serum for the evaluation of the size of myocardial infarction: correlation with myocardial Tl-201 SPECT and cardiac angioscintigraphy

    International Nuclear Information System (INIS)

    Facello, A.; Gries, P.; Demangeat, C.; Brunot, B.; Roul, G.; Demangeat, J.L.; Moulichon, M.; Bareiss, P.; Sacrez, A.; Constantinesco, A.

    1990-01-01

    To determine the relationship between serum levels of myosin heavy beta chains assessed by an IRMA technique and other radionuclide and enzymatic parameters in the evaluation of the size of myocardial infarction, we studied 22 patients with acute myocardial infarction. Blood samples taken daily between 1st to 13th day of evolution allow the determination of peak and integral of myosine release that showed a good correlation (p [fr

  15. Clinical evaluation of sup 123 I-BMIPP myocardial scintigraphy in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Ohtsuki, Katsuichi; Sugihara, Hiroki; Umamoto, Ikuo (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1992-02-01

    {sup 123}I-{beta}-methyl-p-iodophenylpentadecanoic acid ({sup 123}I-BMIPP) myocardial scintigraphy was performed in 13 patients with hypertrophic cardiomyopathy and compared with {sup 201}Tl myocardial scintigraphy performed within 3 months for evaluating the clinical significance of {sup 123}I-BMIPP myocardial scintigraphy. SPECT images were divided into 13 segments and segmental images were visually scored on a 4 (increased tracer uptake) to 0 (severely decreased tracer uptake) scale according to the tracer uptake. In comparison of {sup 123}I-BMIPP early images and {sup 201}Tl perfusion images, mismatches were seen in about 70% of all segments. The number of segments demonstrating lower myocardial uptake of {sup 123}I-BMIPP was larger than that of {sup 201}Tl. In hypertrophic regions, the tracer uptake of {sup 123}I-BMIPP early images was significantly lower than that of {sup 201}Tl images and the lower uptake of {sup 123}I-BMIPP delayed images was more marked. In non-hypertrophic regions, no significant difference was seen between the tracer uptakes of {sup 123}I-BMIPP early images and {sup 201}Tl images but the tracer uptake of {sup 123}I-BMIPP delayed images was significantly lower than that of {sup 201}Tl images. The mismatch between the tracer uptakes of {sup 123}I-BMIPP images and {sup 201}Tl images was thought to be a reflection of disordered myocardial fatty acid metabolism. 'Washout', the difference between the tracer uptakes of {sup 123}I-BMIPP early images and delayed images was also thought to be a reflection of disordered myocardial fatty acid metabolism. These results suggest that {sup 123}I-BMIPP is a promising radiopharmaceutical for evaluating disordered myocardial fatty acid metabolism in patients with HCM. (author).

  16. Clinical evaluation of 123I-BMIPP myocardial scintigraphy in patients with hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Ohtsuki, Katsuichi; Sugihara, Hiroki; Umamoto, Ikuo

    1992-01-01

    123 I-β-methyl-p-iodophenylpentadecanoic acid ( 123 I-BMIPP) myocardial scintigraphy was performed in 13 patients with hypertrophic cardiomyopathy and compared with 201 Tl myocardial scintigraphy performed within 3 months for evaluating the clinical significance of 123 I-BMIPP myocardial scintigraphy. SPECT images were divided into 13 segments and segmental images were visually scored on a 4 (increased tracer uptake) to 0 (severely decreased tracer uptake) scale according to the tracer uptake. In comparison of 123 I-BMIPP early images and 201 Tl perfusion images, mismatches were seen in about 70% of all segments. The number of segments demonstrating lower myocardial uptake of 123 I-BMIPP was larger than that of 201 Tl. In hypertrophic regions, the tracer uptake of 123 I-BMIPP early images was significantly lower than that of 201 Tl images and the lower uptake of 123 I-BMIPP delayed images was more marked. In non-hypertrophic regions, no significant difference was seen between the tracer uptakes of 123 I-BMIPP early images and 201 Tl images but the tracer uptake of 123 I-BMIPP delayed images was significantly lower than that of 201 Tl images. The mismatch between the tracer uptakes of 123 I-BMIPP images and 201 Tl images was thought to be a reflection of disordered myocardial fatty acid metabolism. 'Washout', the difference between the tracer uptakes of 123 I-BMIPP early images and delayed images was also thought to be a reflection of disordered myocardial fatty acid metabolism. These results suggest that 123 I-BMIPP is a promising radiopharmaceutical for evaluating disordered myocardial fatty acid metabolism in patients with HCM. (author)

  17. Clinical evaluation of adenosine and exercise stress 99Tcm-MIBI myocardial imaging in detection of myocardial ischemia in patients with untypical chest pain

    International Nuclear Information System (INIS)

    Tian Yueqin; He Zuoxiang; Wang Qi; Hu Fenghuan; Yang Weixian; Qiao Shubing; Liu Xiujie

    2005-01-01

    Objective: To evaluate the value of adenosine and exercise stress 99 Tc m -methoxyisobutylisonitrile (MIBI) myocardial imaging for the diagnosis of myocardial ischemia in patients with untypical chest pain. Methods: Two groups included. Group 1: 67 cases of adenosine 99 Tc m -MIBI myocardial imaging. Group 2: 81 cases of exercise stress 99 Tc m -MIBI myocardial imaging. All of the patients had coronary angiography (CAG). The results of them were compared. Results: 23 out of 67 patients in group 1 had significant coronary stenosis after CAG, 16 showed reversible perfusion abnormalities in adenosine imaging. 41 of 44 patients with normal CAG showed normal adenosine imaging. The sensitivity, specificity and accuracy of adenosine imaging for coronary artery disease detection were 70%, 93% and 85%, respectively. Group 2: 22 out of 31 patients with significant coronany stenosis after CAG showed reversible perfusion abnormalities, 48 of 50 patients with normal CAG showed normal exercise imaging. The sensitivity, specificity and accuracy of exercise imaging for coronary artery disease detection were 71%, 96% and 86%, respectively. Conclusion: Reversible perfusion abnormalities found both in adenosine and exercise stress 99 Tc m -MIBI myocardial imaging were the key point for diagnosis of myocardial ischemia in patients with untypical chest pain. (authors)

  18. Dipyridamole 201Tl scintigraphy in the evaluation of prognosis after myocardial infarction

    International Nuclear Information System (INIS)

    Okada, R.D.; Glover, D.K.; Leppo, J.A.

    1991-01-01

    Dipyridamole 201Tl imaging has been proposed as an alternative to exercise ECG testing for the prehospital discharge evaluation of patients recovering from myocardial infarction. The rationale is that many postinfarction patients with exercise-induced ischemia experience later cardiac events, and the sensitivity of predischarge exercise ECG testing in patients with multivessel disease ranges from only 45% to 62%. In addition, several groups of investigators have shown the sensitivity of submaximum exercise 201Tl imaging to be less than ideal. This report summarizes the current status of dipyridamole 201Tl imaging in the period of 1-13 days after myocardial infarction. Although the number of studies performed to date is limited, the following conclusions can be drawn: dipyridamole 201Tl imaging after myocardial infarction was associated with no serious side effects, and those present could be quickly reversed with aminophylline; redistribution with dipyridamole 201Tl images definitely correlates with prognosis after uncomplicated myocardial infarction; dipyridamole 201Tl imaging is definitely useful in patients unable to exercise for a variety of reasons; and future studies are definitely indicated to further define the role of dipyridamole 201Tl imaging for assessing prognosis, especially in those patients undergoing interventional therapy after acute myocardial infarction

  19. Objective evaluation of Tl-201 image efficacy for detection of myocardial infarction

    International Nuclear Information System (INIS)

    Nagai, Teruo; Murata, Kazuhiko; Torizuka, Kanji

    1982-01-01

    As the 3rd report of the objective analysis of radioactive 201 Tl scintigraphy of myocardial infarction, detection of infarction and extent of the lesion was discussed. In 114 cases with relatively definite findings, their images were rereaded and evaluated by 2 physicians. Segmental analysis in each direction was employed for localization of perfusion defects. Comparison between the sites of myocardial infarction on ECG and that of perfusion defects by segmental analysis revealed that, in infarction of the anterior wall, many segments showed defects, and that the lesions of the posterior and lateral wall had a few segments showing defects. This standard of correlation was applied to other cases of myocardial infarction, and the result suggested possible improvement in detection of infarction. As regards the extent of the lesion, no significant correlation between number of segments with defect and ECG and/or the serum enzyme levels were seen. (Ueda, J.)

  20. Dynamic CT myocardial perfusion imaging: performance of 3D semi-automated evaluation software

    Energy Technology Data Exchange (ETDEWEB)

    Ebersberger, Ullrich [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); Heart Center Munich-Bogenhausen, Department of Cardiology and Intensive Care Medicine, Munich (Germany); Marcus, Roy P.; Nikolaou, Konstantin; Bamberg, Fabian [University of Munich, Institute of Clinical Radiology, Munich (Germany); Schoepf, U.J.; Gray, J.C.; McQuiston, Andrew D. [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); Lo, Gladys G. [Hong Kong Sanatorium and Hospital, Department of Diagnostic and Interventional Radiology, Hong Kong (China); Wang, Yining [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Department of Radiology, Beijing (China); Blanke, Philipp [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); University Hospital Freiburg, Department of Diagnostic Radiology, Freiburg (Germany); Geyer, Lucas L. [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); University of Munich, Institute of Clinical Radiology, Munich (Germany); Cho, Young Jun [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); Konyang University College of Medicine, Department of Radiology, Daejeon (Korea, Republic of); Scheuering, Michael; Canstein, Christian [Siemens Healthcare, CT Division, Forchheim (Germany); Hoffmann, Ellen [Heart Center Munich-Bogenhausen, Department of Cardiology and Intensive Care Medicine, Munich (Germany)

    2014-01-15

    To evaluate the performance of three-dimensional semi-automated evaluation software for the assessment of myocardial blood flow (MBF) and blood volume (MBV) at dynamic myocardial perfusion computed tomography (CT). Volume-based software relying on marginal space learning and probabilistic boosting tree-based contour fitting was applied to CT myocardial perfusion imaging data of 37 subjects. In addition, all image data were analysed manually and both approaches were compared with SPECT findings. Study endpoints included time of analysis and conventional measures of diagnostic accuracy. Of 592 analysable segments, 42 showed perfusion defects on SPECT. Average analysis times for the manual and software-based approaches were 49.1 ± 11.2 and 16.5 ± 3.7 min respectively (P < 0.01). There was strong agreement between the two measures of interest (MBF, ICC = 0.91, and MBV, ICC = 0.88, both P < 0.01) and no significant difference in MBF/MBV with respect to diagnostic accuracy between the two approaches for both MBF and MBV for manual versus software-based approach; respectively; all comparisons P > 0.05. Three-dimensional semi-automated evaluation of dynamic myocardial perfusion CT data provides similar measures and diagnostic accuracy to manual evaluation, albeit with substantially reduced analysis times. This capability may aid the integration of this test into clinical workflows. (orig.)

  1. Application of myocardial perfusion quantitative imaging for the evaluation of therapeutic effect in canine with myocardial infarction

    International Nuclear Information System (INIS)

    Liang Hong; Chen Ju; Liu Sheng; Zeng Shiquan

    2000-01-01

    Myocardial blood perfusion (MBP) ECT and quantitative analysis were performed in 10 canines with experimental acute myocardial infarct (AMI). The accuracy of main myocardial quantitative index, including defect volume (DV) and defect fraction (DF), was estimated and correlated with histochemical staining (HS) of infarcted area. Other 21/AMI canines were divided into Nd:YAG laser trans-myocardial revascularization treated group LTMR and control group. All canines were performed MBP ECT after experimental AMI. Results found that the infarcted volume (IV) measured by HS has well correlated (r 0.88) with DV estimated by myocardial quantitative analysis. But the DF values calculated by both methods was not significantly different (t = 1.28 P > 0.05). In LTMR group 27.5% +- 3.9%, the DF is smaller than control group 32.1% +- 4.6% (t = 2.49 P 99m Tc-MIBI myocardial perfusion SPECT and quantitative study can accurately predict the myocardial blood flow and magnitude of injured myocardium. Nd:YAG LTMR could improve myocardial blood perfusion of ischemic myocardium and decrease effectively the infarct areas

  2. Diagnostic performance of dark-blood T2-weighted CMR for evaluation of acute myocardial injury.

    Science.gov (United States)

    Srichai, Monvadi B; Lim, Ruth P; Lath, Narayan; Babb, James; Axel, Leon; Kim, Daniel

    2013-01-01

    We compared the image quality and diagnostic performance of 2 fat-suppression methods for black-blood T2-weighted fast spin-echo (FSE), which are as follows: (a) short T1 inversion recovery (STIR; FSE-STIR) and (b) spectral adiabatic inversion recovery (SPAIR; FSE-SPAIR), for detection of acute myocardial injury. Edema-sensitive T2-weighted FSE cardiac magnetic resonance (CMR) imaging is useful in detecting acute myocardial injury but may experience reduced myocardial signal and signal dropout. The SPAIR pulse aims to eliminate artifacts associated with the STIR pulse. A total of 65 consecutive patients referred for CMR evaluation of myocardial structure and function underwent FSE-STIR and FSE-SPAIR, in addition to cine and late gadolinium enhancement (LGE) CMR. T2-weighted FSE images were independently evaluated by 2 readers for image quality and artifacts (Likert scale of 1-5; best-worst) and presence of increased myocardial signal suggestive of edema. In addition, clinical CMR interpretation, incorporating all CMR sequences available, was recorded for comparison. Diagnostic performance of each T2-weighted sequence was measured using recent (T2, and wall motion. There was a statistically significant difference in sensitivity between the clinical interpretation and each of the T2-weighted sequences but not between each T2-weighted sequence. Although FSE-SPAIR demonstrated significantly improved image quality and decreased artifacts, isolated interpretations of each T2-weighted technique demonstrated high specificity but overall low sensitivity for the detection of myocardial injury, with no difference in accuracy between the techniques. However, real-world interpretation in combination with cine and LGE CMR methods significantly improves the overall sensitivity and diagnostic performance.

  3. Evaluation of left ventricular myocardial function in patients with coronary artery disease and myocardial dysfunction before and after coronary artery bypass grafting by cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    Juergens, K.U.; Renger, B.; Reimer, P.; Tombach, B.; Heindel, W.; Wichter, T.; Bruns, H.J.; Vahlhaus, C.; Janssen, F.W.; Breithardt, G.

    2001-01-01

    Purpose: To evaluate left ventricular (LV) myocardial function in ten patients with coronary artery disease (CAD) preoperatively and 6 months after coronary bypass grafting (CABG) by cardiac MRI. Material and methods: Ten patients (mean 65.2±5.9 years) with angiographically proven CAD and an indication for elective CABG underwent prospective evaluation of global LV function and regional wall motion by Cine-MRI at rest using a multiphase FLASH-2D sequence following regions of interest (ROI)-defined diagnostics of regional myocardial wall motion by means of levocardiography. Within the ROIs a total of 613 LV myocardial segments were analyzed preceding and following surgical revascularization. Results were compared with the data of 10 healthy volunteers. Results: Preoperatively, patients showed reduced stroke volume and ejection fraction compared with volunteers (p [de

  4. Evaluation of Parallel and Fan-Beam Data Acquisition Geometries and Strategies for Myocardial SPECT Imaging

    Science.gov (United States)

    Qi, Yujin; Tsui, B. M. W.; Gilland, K. L.; Frey, E. C.; Gullberg, G. T.

    2004-06-01

    This study evaluates myocardial SPECT images obtained from parallel-hole (PH) and fan-beam (FB) collimator geometries using both circular-orbit (CO) and noncircular-orbit (NCO) acquisitions. A newly developed 4-D NURBS-based cardiac-torso (NCAT) phantom was used to simulate the /sup 99m/Tc-sestamibi uptakes in human torso with myocardial defects in the left ventricular (LV) wall. Two phantoms were generated to simulate patients with thick and thin body builds. Projection data including the effects of attenuation, collimator-detector response and scatter were generated using SIMSET Monte Carlo simulations. A large number of photon histories were generated such that the projection data were close to noise free. Poisson noise fluctuations were then added to simulate the count densities found in clinical data. Noise-free and noisy projection data were reconstructed using the iterative OS-EM reconstruction algorithm with attenuation compensation. The reconstructed images from noisy projection data show that the noise levels are lower for the FB as compared to the PH collimator due to increase in detected counts. The NCO acquisition method provides slightly better resolution and small improvement in defect contrast as compared to the CO acquisition method in noise-free reconstructed images. Despite lower projection counts the NCO shows the same noise level as the CO in the attenuation corrected reconstruction images. The results from the channelized Hotelling observer (CHO) study show that FB collimator is superior to PH collimator in myocardial defect detection, but the NCO shows no statistical significant difference from the CO for either PH or FB collimator. In conclusion, our results indicate that data acquisition using NCO makes a very small improvement in the resolution over CO for myocardial SPECT imaging. This small improvement does not make a significant difference on myocardial defect detection. However, an FB collimator provides better defect detection than a

  5. Myocardial perfusion and left ventricular function during exercise evaluated by 201Tl myocardial scintigraphy and 99mTc radionuclide ventriculography in patients treated with PTCA

    International Nuclear Information System (INIS)

    Honda, Toshio; Jo, Tadafumi; Doiuchi, Junji

    1992-01-01

    To evaluate the effects of percutaneous transluminal coronary angioplasty (PTCA), we investigated myocardial ischemia and left ventricular function during exercise before and after successful PTCA in 30 patients. We used extent and severity scores of 201 thallium ( 201 Tl) exercise myocardial scintigraphy to assess myocardial ischemia and determined global and regional left ventricular ejection fraction (EF and REF) of 99m Tc-RBC exercise radionuclide ventriculography to assess left ventricular function. The extent and severity scores of stress images were significantly less after PTCA than before PTCA. The scores of the redistribution images were unchanged before and after PTCA. Global EF during exercise was significantly higher after PTCA than before PTCA. There was no difference in resting global EF between before and after PTCA. Myocardial ischemia induced by exercise was semi-quantitatively analyzed as transient perfusion defect with severity score. Severity score was significantly less after PTCA than before PTCA. ΔEF, which was obtained by subtraction of resting global EF from exercise one, was significantly higher after PTCA than before PTCA. However, the degree of improvement in myocardial ischemia and left ventricular function varied from patient to patient. In 17 patients with one-vessel left anterior descending artery disease, ΔREF, which was determined by subtracting resting regional EF from exercise one, was significantly higher in septal and apical segments after PTCA than before PTCA. Myocardial ischemia and left ventricular function under exercise were alleviated by PTCA. However, the degree of improvement varied from patient to patient and it might have been affected by various factors including coronary dissection, edema, thrombus, restenosis, spasm, side branch stenosis or occlusion, distal thrombus, and myocardial hibernation. (author)

  6. Early diagnosis of interferon-induced myocardial disorder in patients with chronic hepatitis C. Evaluation by myocardial imaging with {sup 123}I-BMIPP

    Energy Technology Data Exchange (ETDEWEB)

    Kondo, Yuki; Yukinaka, Michiko; Nomura, Masahiro; Nakaya, Yutaka; Ito, Susumu [Tokushima Univ. (Japan). School of Medicine

    2000-02-01

    Interferon (IFN) therapy for chronic hepatitis C is sometimes associated with cardiac complications. In the present study, we performed myocardial imaging with {sup 123}I-labeled {beta}-methyl-p-iodophenylpentadecanoic acid ({sup 123}I-BMIPP) in order to evaluate myocardial disorders caused by IFN. We studied 40 healthy subjects (H group) and 25 patients with chronic hepatitis C who had been treated with IFN (IFN group). A Holter electrocardiogram (ECG) was performed and the autonomic nervous function was assessed by analyzing the spectral variability and 1/f fluctuation of heart rate. Myocardial planner imaging with {sup 123}I-BMIPP was performed to obtain the time activity curve for 20 min immediately after administration of {sup 123}I-BMIPP (dynamic study). Early and delayed myocardial single photon emission computed tomography (SPECT) images were expressed as Bull's eyes and the myocardium was divided into four segments to calculate the washout rate for each segment on early and late SPECT images (early and late SPECT study). No significant differences in autonomic nervous function were observed between the two groups in heart rate variability. In a dynamic study, the reduction rate from the time activity curve was significantly higher in the IFN group compared with the H group (reduction rate, IFN group, 5.3{+-}3.7% vs H group, 1.2{+-}3.3%; P<0.05). In the early and delayed myocardial SPECT study, the washout rate for the IFN group was significantly increased in all myocardial areas compared to that in the H group. However, the metabolic disorder of fatty acids caused by IFN was reversed on the second {sup 123}I-BMIPP myocardial scintigraphy examination several months after IFN therapy. These results indicate that metabolic disorders of fatty acids caused by IFN therapy can be detected before abnormalities are observed by Holter-ECG or echocardiography. (author)

  7. Evaluation of cardiomyopathy in Duchenne muscular dystrophy by Tl-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Jinnouchi, Seishi; Asai, Junko; Inoue, Kenjirou; Hoshi, Hiroaki; Watanabe, Katsushi.

    1985-01-01

    Clinical evaluation of Tl-201 myocardial SPECT in patients with cardiomyopathy of Duchenne type progressive muscular dystrophy (DMD) was reported. Cases subjected to study were 14 DMD and 8 normal. Using a rotating gamma camera system (ZLC7500 and Scintipac 70A), SPECT data were collected for 16 minutes (32 angles x 30 sec/angle, 180 0 ). The hypoperfusion areas of the left ventricular muscle were observed in 10 patients (71 %), which was in posterior wall (71 %), inferior wall (57 %), lateral and anterior wall (43 %) in the order of frequency. The hypoperfusion area became wider with age and stage, exept for some patients. It was suggested that myocardial degeneration in DMD started in posterior wall and then spread in other areas. For the purpose of quantitative evaluation of myocardial damage, Tl-201 myocardial uptake ratio (MUR) and left ventricular muscle volume (LVMV) were calculated using the results obtained by phantom studies. MUR and LVMV were higher in DMD than those of normal individuals (3.6 +- 1.0 %: 2.7 +- 0.3 %, p < 0.05, 190.2 +- 67.5 ml: 157.8 +- 21.5 ml, n.s., respectively). (author)

  8. Clinical evaluation of the Tl-201 ECG-gated myocardial SPECT

    International Nuclear Information System (INIS)

    Mochizuki, Teruhito

    1989-01-01

    In order to evaluate the clinical usefulness of the Tl-201 ECG-gated myocardial single photon emission computed tomography (SPECT), we compared the wall motion and the grade of the Tl-201 uptake of the ECG-gated myocardial SPECT with the wall motion of the ECG-gated blood pool SPECT. Materials were 87 patients of 50 old myocardial infarctions (OMIs), 19 hypertrophic cardiomyopathies (HCMs), 2 dilated cardiomyopathies (DCMs) and 16 others. After intravenous injection of 111-185 MBq (3-5 mCi) of Tl-201 at rest, the projection data were acquired using a rotating gamma-camera through 180deg, from RAO 45deg in 24 directions, each of which consisted of 80-100 beats. For the reconstruction of ED, ES and non-gated images, R-R interval was divided into about 20 (18-22) fractions. In 348 regions of interest (anterior, septal, lateral and inferior wall) in 87 cases, wall motion and the Tl-201 uptake were evaluated to three grades (normal, hypokinesis and akinesis; normal, low and defect, respectively), which were compared with the wall motion of the ECG-gated blood pool SPECT. The wall motion and the grade of the Tl-201 uptake of the ECG-gated myocardial SPECT correlated well with the wall motion of the ECG-gated blood pool SPECT (96.6% and 87.9%, respectively). In conclusion, the ECG-gated myocardial SPECT can provide clear perfusion images and is a very useful diagnostic strategy to evaluate the regional wall motion and perfusion simultaneously. (author)

  9. Short- and long-term changes in myocardial function, morphology, edema, and infarct mass after ST-segment elevation myocardial infarction evaluated by serial magnetic resonance imaging

    DEFF Research Database (Denmark)

    Ripa, Rasmus Sejersten; Nilsson, Jens Christian; Wang, Yongzhong

    2007-01-01

    undertaken. The aim of this study was to evaluate effects of therapy for STEMI on left ventricular function and perfusion and to test the hypothesis that myocardial perfusion by MRI predicts recovery of left ventricular function. METHODS: Cine MRI, edema, first-pass perfusion, and late enhancement imaging...

  10. Nuclear medicine and coronary artery disease: evaluation of tracers of myocardial perfusion and vulnerable atherosclerotic plaque

    International Nuclear Information System (INIS)

    Broisat, A.

    2005-04-01

    Coronary artery disease is one of the primary cause of mortality worldwide. Nuclear medicine is the major imaging technique for diagnosis and following of this disease. perfusion: nowadays, major radioactive agents used in clinical practice are myocardial perfusion tracers. The reference tracer is thallium-201. However, 201 Tl presents some drawbacks. 99m Tcn-noet has been proposed for its replacement. This study shows that in contrast with previous studies realized in vitro on cardio myocytes, verapamil, an l-type calcium channel inhibitor, does not inhibit myocardial fixation of 99m Tcn-noet in vivo in dog. This data is in agreement with the hypothesis of a non specific endothelial fixation of this tracer. Moreover, this study shows that as a pure tracer of myocardial perfusion, 99m Tcn-noet can also be used to assess myocardial viability on a model of myocardial chronic infarction in rat. atherosclerosis: disruption of vulnerable atherosclerotic plaques is the main event leading to coronary accidents. The second part of this study concerns the evaluation of new potential tracers of the vulnerable atherosclerotic plaque in an experimental model of rabbit with an inheritable hypercholesterolemia. The four tracers evaluated (b2702(r), b2702-I, b2702-Tc and Tc-raft-b2702) are synthetic peptides comprising the residues 75-84 of hla-b2702, a molecule known to link vcam-1, an adhesion molecule expressed in vulnerable atherosclerotic plaque. The autoradiography studies show that all tracers accumulate within atherosclerotic plaque expressing vcam- and that. i-b2702 shows the best plaque/control fixation ratio. (author)

  11. Clinical evaluation of 123I-metaiodobenzylguanidine myocardial scintigram in patients with vascular heart disease

    International Nuclear Information System (INIS)

    Terada, Kouji; Sugihara, Hiroki; Shiga, Koji

    1995-01-01

    Myocardial sympathetic nerve function can be evaluated by 123 I-metaiodobenzylguanidine (MIBG) scintigraphy. Congestive heart failure is closely related to myocardial sympathetic nerve function. This study evaluated the severity of congestive heart failure in 30 patients with valvular heart disease [aortic regurgitation (AR): n=20, mean age=70±13 years; mitral regurgitation (MR): n=10, mean age=61±18 years], who had chronic heart failure by MIBG myocardial scintigraphy. Single photon emission computed tomography (SPECT) and anterior planar myocardial images were obtained 15 minutes (initial images) and 4 hours (delayed images) after injection of MIBG (111 MBq). Defect score was determined by the delayed SPECT images visually as a semi-quantitative index. Myocardial MIBG uptake was quantified by the heart to upper mediastinum uptake ratio on the delayed anterior planar images (H/M) and mean cardiac MIBG washout rate during 4 hours was calculated from the bull's eye display data (clearance). These indices were compared with the NYHA class and echocardiographic findings of the patients. MIBG regional defect in the delayed image was most frequently seen in the inferoposterior wall, and defect score and clearance were significantly higher and the H/M ratio was significantly lower in NYHA class III patients than in class II patients. In patients with AR, clearance significantly correlated with left ventricular end-systolic dimension. In patients with MR, both the H/M ratio and clearance significantly correlated with left atrial dimension. Defect score, H/M, and clearance were closely related to the severity of AR and MR. These results indicate that MIBG scan can be used to assess the severity of valvular heart disease. (author)

  12. Clinical evaluation of {sup 123}I-metaiodobenzylguanidine myocardial scintigram in patients with vascular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Terada, Kouji; Sugihara, Hiroki; Shiga, Koji [Kyoto Prefectural Univ. of Medicine (Japan)] [and others

    1995-05-01

    Myocardial sympathetic nerve function can be evaluated by {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy. Congestive heart failure is closely related to myocardial sympathetic nerve function. This study evaluated the severity of congestive heart failure in 30 patients with valvular heart disease [aortic regurgitation (AR): n=20, mean age=70{+-}13 years; mitral regurgitation (MR): n=10, mean age=61{+-}18 years], who had chronic heart failure by MIBG myocardial scintigraphy. Single photon emission computed tomography (SPECT) and anterior planar myocardial images were obtained 15 minutes (initial images) and 4 hours (delayed images) after injection of MIBG (111 MBq). Defect score was determined by the delayed SPECT images visually as a semi-quantitative index. Myocardial MIBG uptake was quantified by the heart to upper mediastinum uptake ratio on the delayed anterior planar images (H/M) and mean cardiac MIBG washout rate during 4 hours was calculated from the bull`s eye display data (clearance). These indices were compared with the NYHA class and echocardiographic findings of the patients. MIBG regional defect in the delayed image was most frequently seen in the inferoposterior wall, and defect score and clearance were significantly higher and the H/M ratio was significantly lower in NYHA class III patients than in class II patients. In patients with AR, clearance significantly correlated with left ventricular end-systolic dimension. In patients with MR, both the H/M ratio and clearance significantly correlated with left atrial dimension. Defect score, H/M, and clearance were closely related to the severity of AR and MR. These results indicate that MIBG scan can be used to assess the severity of valvular heart disease. (author).

  13. Myocardial involvement in diabetic patients evaluated by exercise thallium-201 scintigraphy and cardiac catheterization

    International Nuclear Information System (INIS)

    Mizuno, Sumio; Genda, Akira; Nakayama, Akira; Igarashi, Yutaka; Takeda, Ryoyu

    1985-01-01

    To evaluate myocardial involvement in diabetes mellitus, we studied 39 patients with negative double-Master's test and without hypertension by exercise thallium-201 (Tl-201) myocardial scintigraphy using a bicycle ergometer. Among the 39 patients, 12 (30.8 %) showed filling defects in the scintigrams (positive cases), including eight with stress-induced defects and four with fixed defects. The positive cases had higher scores of diabetic complications (3.6 +- 2.4 vs 2.1 +- 1.8; p < 0.05) and longer durations of diabetes as compared with those of the negative cases. The frequency of insulin therapy was also greater in the positive cases. Eleven patients (5 positive and 6 negative cases) who underwent cardiac catheterization had no significant stenotic lesions of their coronary arteries. However, all of the positive cases showed abnormal wall motion, mainly hypokinesis, by left ventriculography (LVG). The abnormalities of the LVG corresponded to the findings of the scintigrams (i.e. filling defects and decrease in washout ratios by circumferential profile analysis). These results suggest that in some diabetics myocardial involvement exists in the early stage without overt cardiac disease and exercise Tl-201 scintigraphy is useful in detecting pre-clinical cardiomyopathy. Cardiomyopathy in diabetics seems to be due to disturbances of the myocardial microcirculation. (author)

  14. Evaluation in dogs and humans of three potential technetium-99m myocardial perfusion agents

    International Nuclear Information System (INIS)

    Gerundini, P.; Savi, A.; Gilardi, M.C.

    1986-01-01

    The biodistribution of the three cationic /sup 99m/Tc complexes [/sup 99m/Tc(TMP)6]+, [/sup 99m/Tc(POM-POM)3]+, and [/sup 99m/Tc(TBIN)6]+--where TMP represents trimethylphosphite, POM-POM represents 1,2-bis(dimethyoxyphosphino)ethane, and TBIN represents t-butylisonitrile--have been evaluated in humans and dogs. Each agent was studied in three normal volunteers at rest, while [/sup 99m/Tc(POM-POM)3]+ and [/sup 99m/Tc(TBIN)6]+ were each studied in one normal volunteer at exercise. Even though all three agents yield good myocardial images in dogs, none appear suitable for clinical use as myocardial perfusion imaging radiopharmaceuticals. In humans, [/sup 99m/Tc(TMP)6]+ and [/sup 99m/Tc(POM-POM)3]+ clear very slowly from the blood and provide myocardial images only several hours after injection. [/sup 99m/Tc(TBIN)6]+ clears rapidly from the blood, but accumulation in the lung obscures the myocardial image for the first hour after injection; at later times, activity in the liver and spleen masks the apical wall. These results correlate with the blood-binding properties of the three complexes. [/sup 99m/Tc(TMP)6]+ and [/sup 99m/Tc(POM-POM)3]+ bind tightly to the plasma of human blood, but not to the plasma of dog blood; [/sup 99m/Tc(TBIN)6]+ does not bind tightly to the plasma of either dog or human blood. Among the Tc(I) complexes studied to date in humans, [/sup 99m/Tc(TBIN)6]+ appears to be unique in biodistribution pattern, blood-binding properties, and the fact that exercise improves the ultimate myocardial image. All the Tc(I) complexes appear to undergo myocardial accumulation by a mechanism different from that utilized by Tc(III) complexes. Animal studies alone are not adequate to evaluate the potential utility of /sup 99m/Tc cationic complexes for myocardial perfusion studies

  15. Evaluation of the sickness rate for acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Semenova, Y. V.; Litvinenko, T. M.; Takhanov, R. M.; Karpov, A. B.

    2004-07-01

    Cardiovascular diseases seem to be the main cause of people's death in industrial developed countries. That is why the active study of factors and conditions affecting the sickness and death rate for this group of diseases is being continued at present. Apart from the well-known risk factors, there is a group of technogenic factors the contribution of which to genesis of the examined group of diseases is not clear enough and requires a detailed study. One of such factors appears to be ionizing radiaiton, especially in case of a prolonged effect with the so-called small doses. The sickness rate due to acute myocardial infarction (AMI) in the period 1999-2001 has been studied in the closed population ZATO Seversk. To conduct examinations there was created the towns AMI register to be a structural component of the regional medico-dosimetric register (RMDR) of the Siberian Group of Chemical Enterprises (SGCE) personnel and population of ZATO Seversk. Information on coronary disasters among adult population above 20 is being collected according to the program AMI Register created by WHO in 1968 with our additional results of modern methods of examining patients with ischemic heart disease and prospective observation. The analysis of data obtained testifies to the tendency towards the sickness rate increase in the period under study both among residents of the town (2,011-2,014-2,238 per 1000 people in 1999, 2000 and 2001, respectively) and among SGCE workers (4,354-4,572-5,006 per 1000) that corresponds to general tendencies of AMI sickness rate on the territory of Russian Federation. it is noted that in the group of workers at the main production the AMI sickness rate exceeds similar indices by the plant as a whole (6,205-7, 176-6,518 per 1000). Great prevalence of this AMI form among workers of a large industrial enterprise can be conditioned by a predominance of male contingent high emotional mental load (shift work on complex technological equipment with

  16. Evaluation of the sickness rate for acute myocardial infarction

    International Nuclear Information System (INIS)

    Semenova, Y. V.; Litvinenko, T. M.; Takhanov, R. M.; Karpov, A. B.

    2004-01-01

    Cardiovascular diseases seem to be the main cause of people's death in industrial developed countries. That is why the active study of factors and conditions affecting the sickness and death rate for this group of diseases is being continued at present. Apart from the well-known risk factors, there is a group of technogenic factors the contribution of which to genesis of the examined group of diseases is not clear enough and requires a detailed study. One of such factors appears to be ionizing radiaiton, especially in case of a prolonged effect with the so-called small doses. The sickness rate due to acute myocardial infarction (AMI) in the period 1999-2001 has been studied in the closed population ZATO Seversk. To conduct examinations there was created the towns AMI register to be a structural component of the regional medico-dosimetric register (RMDR) of the Siberian Group of Chemical Enterprises (SGCE) personnel and population of ZATO Seversk. Information on coronary disasters among adult population above 20 is being collected according to the program AMI Register created by WHO in 1968 with our additional results of modern methods of examining patients with ischemic heart disease and prospective observation. The analysis of data obtained testifies to the tendency towards the sickness rate increase in the period under study both among residents of the town (2,011-2,014-2,238 per 1000 people in 1999, 2000 and 2001, respectively) and among SGCE workers (4,354-4,572-5,006 per 1000) that corresponds to general tendencies of AMI sickness rate on the territory of Russian Federation. it is noted that in the group of workers at the main production the AMI sickness rate exceeds similar indices by the plant as a whole (6,205-7, 176-6,518 per 1000). Great prevalence of this AMI form among workers of a large industrial enterprise can be conditioned by a predominance of male contingent high emotional mental load (shift work on complex technological equipment with

  17. Applicability of myocardial perfusion scintigraphy in the evaluation of cardiac synchronization

    Energy Technology Data Exchange (ETDEWEB)

    Reis, Christiane Cigagna Wiefels; Nascimento, Erivelton Alessandro do; Dias, Fernanda Baptista Ribeiro; Ribeiro, Mario Luiz; Wanderley, Annelise Passos Bispo; Batista, Layanara Albino; Nunes, Thais Helena Peixoto; Mesquita, Claudio Tinoco, E-mail: chriswreis@gmail.com [Universidade Federal Fluminense (UFF), Niterói, RJ (Brazil). Hospital Universitário Antônio Pedro

    2017-07-15

    To systematically assess the literature on the applicability of myocardial perfusion scintigraphy with phase analysis in the investigation of cardiac dyssynchrony and in the selection of patients for cardiac resynchronization therapy (CRT), manuscripts published on the PubMed database over the past five years have been reviewed. The following MeSH terms were used: heart failure, left ventricular, dyssynchrony, gated-SPECT, phase analysis and resynchronization therapy. Altogether, 99 manuscripts were included for discussion. Speckle-tracking echocardiography is still widely used in the evaluation of dyssynchrony, but the advent of myocardial perfusion scintigraphy with the phase analysis technique has been gaining ground, as besides being operator independent, it can evaluate myocardial viability in the same test. Its use became more widespread in patients with left bundle branch block, with recommendation of CRT. Phase analysis also allows evaluating, in a highly reproducible way, the last ventricular segment to contract, hence allowing the best positioning of the CRT electrode. Knowing that the presence, location and extent of fibrosis in the left ventricle, associated with dyssynchrony are determinants of response to resynchronization therapy, GATED- SPECT can provide this information in a single test and in a reproducible and accurate way. Phase histogram offers several parameters that provide greater sensitivity and specificity to the method. It seems that the technique is able to add value both in the selection and in the evaluation of response of patients eligible to CRT. Further studies are being conducted to demonstrate its clinical applicability. (author)

  18. Evaluation of 99mTc-nitroimidazole in animal of myocardial necrosis

    International Nuclear Information System (INIS)

    Shimpi, H.H.; Mahapatra, S.; Noronha, O.P.D.

    1998-01-01

    Full text: Extensive studies carried out using 99m Tc-nitroimidazole (BMS 181321) suggested that it is a useful agent to investigate the status of hypoxia in solid tumors and ischemic myocardium. In vitro studies also showed that 99m Tc nitroimidazole is preferentially trapped in and retained by hypoxic, but viable cardiac muscle. We have evaluated the compound in an animal (rat) model of myocardial necrosis. 99m Tc-nitromidazole was labelled with 99m Tc by using cyclan and Sn-glucaric acid. The radiochemical purity was >95%. It was found to be very stable. Experimental (rat) animal of myocardial necrosis or ischemic necrosis was obtained by injecting iso proternol HCl subcutaneously (S.C.) at a dose of 5.25 mg/kg body weight. After 48 h, gross and microscopic necrotic changes were seen in the heart which closely resembled the myocardial infarct of necrotic lesion akin to ischemic necrosis of the myocardium. Animal biodistribution study demonstrated that 99m Tc nitroimidazole cleared very fast from the blood stream of both normal system. Significantly higher uptake was seen in heart of experimental animals compared to normal animals at 60 min. The ratios of heart to blood, liver and kidneys in both normal and experimental animals showed significantly higher ratios in experimental animals. The heart to blood ratio of experimental animal remained same up to 60 min. compared to a sharp decline with time in normal animals. The above results show that 99m Tc-nitroimidazole could be used for detection of myocardial necrosis or myocardial infarct in clinical conditions

  19. Regional left ventricular myocardial contraction abnormalities and asynchrony in patients with hypertrophic cardiomyopathy evaluated by magnetic resonance spatial modulation of magnetization myocardial tagging

    International Nuclear Information System (INIS)

    Mishiro, Yuichiro; Oki, Takashi; Iuchi, Arata

    1999-01-01

    Global left ventricular (LV) pump function is generally preserved in patients with hypertrophic cardiomyopathy (HCM). However, it is unknown whether regional myocardial contractility is impaired, especially in nonhypertrophied regions. The purpose of this study was to evaluate regional LV myocardial contraction in patients with HCM using magnetic resonance (MR) spatial modulation of magnetization (SPAMM) myocardial tagging. The study group comprised 20 patients with asymmetric septal hypertrophy (HCM group) and 16 age-matched normal patients (control group), and data were collected using transthoracic M-mode and 2-dimensional echocardiography, and MR SPAMM myocardial tagging. The systolic strain ratio, maximum systolic strain velocity, and time from end-diastole to maximum systolic strain (ΔT) in the anterior, ventricular septal, inferior and lateral regions for 2 LV short-axis sections at the levels of the chordae tendineae and papillary muscles were measured at 50-ms intervals by MR myocardial tagging. The end-diastolic anterior and ventricular septal wall thicknesses and LV mass index were significantly different between the HCM and control groups. The systolic strain ratio for all 4 walls, particularly the anterior and ventricular septal regions, was significantly lower in the HCM group. In the HCM group, the maximum systolic strain velocity was significantly lower and ΔT was significantly shorter for all 4 walls, particularly the anterior and ventricular septal regions. The standard deviation for the ΔT, calculated from the ΔT for the 8 regions of the 2 LV short-axis sections, was significantly greater in the HCM group. In conclusion, regional LV myocardial contraction is impaired in both hypertrophied and nonhypertrophied regions, and systolic LV wall asynchrony occurs in patients with HCM. (author)

  20. Noninvasive evaluation of regional myocardial perfusion in 112 patients using a mobile scintillation camera and intravenous nitrogen-13 labeled ammonia

    International Nuclear Information System (INIS)

    Walsh, W.F.; Harper, P.V.; Resnekov, L.; Fill, H.

    1976-01-01

    The short half-life positron emitter 13 N, as labeled ammonia ( 13 NH 4 + ), was evaluated as a myocardial imaging agent. Regional myocardial uptake of 13 NH 4 correlated with the distribution of labeled microspheres in experimental myocardial infarction. Using intravenous 13 NH 4 + , myocardial scintigraphy was performed in 85 cardiac patients and 27 normal subjects. Ninety-five scintigrams were suitable for analysis. Eighteen of 24 normal subjects had homogeneous myocardial images; six had inhomogeneous images attributable to early technical problems. Perfusion defects were observed in the scintigrams of 82% (57/65) of patients with coronary artery disease, being most common in patients with myocardial infarction (27/28). Six sequential studies showed changes in perfusion consistent with the clinical course of each patient. Scintigraphic abnormalities were also observed in 4/6 patients with valvular heart disease. 13 NH 4 + myocardial scintigraphy is a valid and sensitive method of assessing regional myocardial perfusion and is especially useful for sequential imaging at short intervals

  1. Noninvasive evaluation of regional myocardial perfusion in 112 patients using a mobile scintillation camera and intravenous nitrogen-13 labeled ammonia

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, W.F.; Harper, P.V.; Resnekov, L.; Fill, H.

    1976-08-01

    The short half-life positron emitter /sup 13/N, as labeled ammonia (/sup 13/NH/sub 4//sup +/), was evaluated as a myocardial imaging agent. Regional myocardial uptake of /sup 13/NH/sub 4/ correlated with the distribution of labeled microspheres in experimental myocardial infarction. Using intravenous /sup 13/NH/sub 4//sup +/, myocardial scintigraphy was performed in 85 cardiac patients and 27 normal subjects. Ninety-five scintigrams were suitable for analysis. Eighteen of 24 normal subjects had homogeneous myocardial images; six had inhomogeneous images attributable to early technical problems. Perfusion defects were observed in the scintigrams of 82% (57/65) of patients with coronary artery disease, being most common in patients with myocardial infarction (27/28). Six sequential studies showed changes in perfusion consistent with the clinical course of each patient. Scintigraphic abnormalities were also observed in 4/6 patients with valvular heart disease. /sup 13/NH/sub 4//sup +/ myocardial scintigraphy is a valid and sensitive method of assessing regional myocardial perfusion and is especially useful for sequential imaging at short intervals.

  2. Evaluation of proportional health impairment due to occupationally related myocardial infarction

    International Nuclear Information System (INIS)

    Szozda, R.; Schneiberg, P.

    1995-01-01

    The authors propose the principles how to calculate a proportional health impairment due to myocardial infarction. The proposals are based on own experience, literature and regulations. It is suggested that the following should be taken into account for the calculation purposes: case history, resting electrocardiogram, postexercise electrocardiogram, results of Holter's examination, chest X-ray including evaluation of the heart silhouette and UCG. (author). 8 refs, 3 tabs

  3. Myocardial thallium scintigraphy after dipyridamole injection. Application to the diagnosis and evaluation of coronary disease

    International Nuclear Information System (INIS)

    Foult, J.M.; Weinmann, P.; Moretti, J.L.; Le Guludec, D.; Faraggi, M.

    1992-01-01

    Myocardial thallium scintigraphy performed after intravenous injection of dipyridamole is a non-invasive method to diagnose and evaluate coronary disease.It be used as an alternative to post-exercise scintigraphy, both methods having similar sensitivity and specificity. The dipyridamole test is contraindicated in patients with a history of bronchospasm and uncontrolled angina pectoris. Close clinical and electrocardiographic monitoring is required. The wide use of tomographic techniques has notably improved this examination

  4. Evaluation of myocardial damage and cardiac residual capacity by Tl-201 myocardial scintigraphy in valvular heart diseases

    International Nuclear Information System (INIS)

    Indo, Shunju

    1992-01-01

    This study was performed to clarify whether the extent-score (Ex-Score) calculated by Tl-201 myocardial scintigraphy is a reliable indicator of the severity of myocardial damage and cardiac residual capacity in valvular heart diseases. The subjects consisted of 38 patients (10 with aortic regurgitation (AR), 4 with aortic stenosis (AS), 13 with mitral regurgitation (MR) and 11 with mitral stenosis (MS)). Ex-Scores were significantly correlated with the severity of myocardial damage found in biopsied specimens obtained intraoperatively (correlation efficiency to Ex-Score with cell diameter in AR, % fibrosis in AR, cell diameter in AS, electron microscopic score in MR and % fibrosis in MS was 0.873, 0.734, 0.970, 0.913 and 0.659, respectively). Ex-Scores were also correlated with cardiac residual capacity determined by radioisotope angiography (correlation efficiency to Ex-Score with %Δ ejection fraction in AR, %Δ end-systolic volume in MR, %Δ end-diastolic volume in MS was -0.764, 0.790 and -0.763, respectively). These results suggest that the severity of myocardial damage and cardiac residual capacity can be estimated by Tl-201 myocardial scintigraphy (Ex-Score) in valvular heart diseases. (author)

  5. The value of gated myocardial perfusion imaging for the evaluation of early treatment effectiveness of ischemic heart disease using Ad-HGF myocardial injection

    International Nuclear Information System (INIS)

    Feng Jianlin; Cheng Xu; Li Jianhua; Xu Zhaoqiang; Li Dianfu; Yuan Biao; Zhang Yourong; Cao Kejiang; Huang Jun

    2008-01-01

    Objective: Hepatocyte growth factor (HGF) has multipotent actions mediated by c- Mesenchymal epithelial transition factor (Met) receptor. Preclinical studies in animal models of myocardial ischemia demonstrated that treatment with HGF could benefit myocardial perfusion, cardiac remodeling, angiogenesis and myocardial function. This study used gated 99 Tc m -methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging (G-MPI) to assess the early treatment effectiveness of adenovirus HGF (Ad-HGF) directly administered in ischemic heart disease (IHD) patients. Methods: Eighteen patients with IHD were divided into 3 groups receiving low dose [5 x 10 8 plaque forming unit (PFU)/site], medium (1.5 x 10 9 PFU/site) and high dose (5 x l0 9 PFU/site) of Ad-HGF. And the Ad-HGF was injected at 10 sites in each patient. Rest G-MPI was performed before and after treatment for myocardial perfusion and left ventricular function measurement. Stata 7.0 was used to analyse the data. Results: (1) After Ad-HGF, myocardial perfusion was improved in 3/6, 5/6 and 6/6 patients in low, medium and high dosage groups. The dosage of AD-HGF was closely correlated with the improvement of myocardial perfusion (χ 2 =4.34, P<0.05). (2) Left ventricular ejection fraction (LVEF) was significantly increased [(50.1 ± 6.4)% vs (58.7 ± 5.6)%, t=6.1, P<0.01], end-diastolic volume [EDV, (137.7 ± 33.2) ml vs (123.7 ± 32.7) ml] and end-systolic volume [ESV, (70.2 ± 22.4) ml vs (51.9 ± 14.9) ml] were significantly reduced. (3) The LVEFs were increased in all groups, and the LVEF improvement in the high dosage group [(8.6 ± 5.9)%] was significantly greater than the other two groups [(4.3 ± l.2)%, (6.8 ± 5.7)%]. The difference of post-treatment improvement on LVEF between the low and medium dosage groups was not significant. The dosage of Ad-HGF was closely correlated with the improvement of LVEF (r=0.67, P< 0.01). Conclusion: G-MPI is a reliable method for evaluating the early effectiveness of

  6. Follow-up of regional myocardial T2 relaxation times in patients with myocardial infarction evaluated with magnetic resonance imaging

    International Nuclear Information System (INIS)

    Krauss, X.H.; Wall, E. van der; Laarse, A. van der; Dijkman, P.R.M. van; Bruschke, A.V.G.; Doornbos, J.; Roos, A. de; Voorthuisen, A.E. van

    1990-01-01

    Multi-echo spin-echo cardiac magnetic resonance imaging studies (echo times 30, 60, 90 and 120 ms) were performed in 19 patients with a 7-14-day (mean 10) old myocardial infarction and were repeated in 13 patients 4-7 months (mean 6) later. Also, 10 normal subjects were studied with magnetic resonance imaging. T2 relaxation times of certain left ventricular segments were calculated from the signal intensities at echo times of 30 and 90 ms. Compared to normal individuals, the mean T2 values on the early magnetic resonance images of the patients with inferior infarction showed significantly prolonged T2 times in the inferiorly localized segments, while on the follow-up magnetic resonance images the T2 times had almost returned to the normal range. Also the patients with anterior infarction showed significantly prolonged T2 times in the anteriorly localized segments on the early nuclear magnetic resonance images, but the T2 times remained prolonged at the follow-up magnetic resonance images. For every patient a myocardial damage score was determined, which was defined as the sum of the segmental T2 values in the patients minus the upper limit of normal T2 values obtained from the normal volunteers (= mean normal+2SD). The damage score on both the early and late magnetic resonance imaging study correlated well with the infarction size determined by myocardial enzyme release. Only the patients with an inferior infarction showed a significant decrease in damage score at follow-up magnetic resonance imaging. It is concluded that the regional T2 relaxation times are increased in infarcted myocardial regions and may remain prolonged for at least up to 7 months after the acute event, particularly in patients with an anterior infarction. These findings demonstrate the clinical potential of T2-weighted magnetic resonance imaging studies for detecting myocardial infarction, and estimating infarct size for an extended period after acute myocardial infarction. (author). 29 refs

  7. Biaxial Mechanical Evaluation of Absorbable and Nonabsorbable Synthetic Surgical Meshes Used for Hernia Repair: Physiological Loads Modify Anisotropy Response.

    Science.gov (United States)

    Cordero, A; Hernández-Gascón, B; Pascual, G; Bellón, J M; Calvo, B; Peña, E

    2016-07-01

    The aim of this study was to obtain information about the mechanical properties of six meshes commonly used for hernia repair (Surgipro(®), Optilene(®), Infinit(®), DynaMesh(®), Ultrapro™ and TIGR(®)) by planar biaxial tests. Stress-stretch behavior and equibiaxial stiffness were evaluated, and the anisotropy was determined by testing. In particular, equibiaxial test (equal simultaneous loading in both directions) and biaxial test (half of the load in one direction following the Laplace law) were selected as a representation of physiologically relevant loads. The majority of the meshes displayed values in the range of 8 and 18 (N/mm) in each direction for equibiaxial stiffness (tangent modulus under equibiaxial load state in both directions), while a few achieved 28 and 50 (N/mm) (Infinit (®) and TIGR (®)). Only the Surgipro (®) mesh exhibited planar isotropy, with similar mechanical properties regardless of the direction of loading, and an anisotropy ratio of 1.18. Optilene (®), DynaMesh (®), Ultrapro (®) and TIGR (®) exhibited moderate anisotropy with ratios of 1.82, 1.84, 2.17 and 1.47, respectively. The Infinit (®) scaffold exhibited very high anisotropy with a ratio of 3.37. These trends in material anisotropic response changed during the physiological state in the human abdominal wall, i.e. T:0.5T test, which the meshes were loaded in one direction with half the load used in the other direction. The Surgipro (®) mesh increased its anisotropic response (Anis[Formula: see text] = 0.478) and the materials that demonstrated moderate and high anisotropic responses during multiaxial testing presented a quasi-isotropic response, especially the Infinit(®) mesh that decreased its anisotropic response from 3.369 to 1.292.

  8. Case of myocardial abscess evaluated by radionuclide techniques: case report

    International Nuclear Information System (INIS)

    Spies, S.M.; Meyers, S.N.; Barresi, V.; Grais, I.M.; DeBoer, A.

    1977-01-01

    A patient with infective endocarditis was evaluated by Ga-67 citrate imaging, Tc-99m pyrophosphate imaging, equilibrium gated blood pool imaging, and Tl-201 imaging of the chest. The diagnosis of ventricular abscess was first suggested by an abnormal gallium scan. At surgery, an abscess was identified in the area where the scan was abnormal, and postoperatively a repeat scan was normal

  9. Iodine-123-labeled meta-iodobenzylguanidine myocardial scintigraphy evaluation of Machado-Joseph disease

    International Nuclear Information System (INIS)

    Kazuta, Toshinari; Hayashi, Michiyuki; Yoshita, Mitsuhiro; Hirai, Shunsaku

    1998-01-01

    Iodine-123-labeled meta-iodobenzylguanidine (( 123 I)MIBG), an analogue of guanetidine, is used as a tracer for evaluation of the function of sympathetic neurons. To investigate cardiac sympathetic function in Machado-Joseph disease (MJD), ( 123 I)MIBG myocardial scintigraphy was performed in 12 patients with MJD and 20 controls. In planar imaging studies, the heart to the mediastinum of the average count ratio (H/M) was calculated for both early and delayed images. The mean values of H/M in delayed images of MJD was lower than those of controls (p 123 I)MIBG myocardial scintigraphy in MJD can be seen earlier than abnormal sudomotor system detected by SSR. (author)

  10. Value of Tl-201 in evaluating myocardial damage and ischemia in transplant patients

    International Nuclear Information System (INIS)

    Jazmati, B.; Tumeh, S.S.; Holman, L.B.

    1989-01-01

    Orthotopic heart transplant recipients suffer from graft rejection and accelerated coronary artery disease. The authors have evaluated 29 recipients of orthotopic heart transplants who had multiple biopsy-proved episodes of rejection and underwent annual T1-201 exercise myocardial scintigraphy and coronary angiography. Of 43 pairs of nuclear scans and coronary angiograms, 39 showed normal radiotracer uptake and coronary arteries. In four scans, there were ischemic changes, and in only one case was there significant two-vessel coronary artery disease. The nuclear scans correlated with the coronary angiograms in 93% of the cases. The authors conclude that T1-201 myocardial scintigraphy is insensitive in the early detection of graft rejection and can reliably rule out significant coronary artery disease in transplant recipients

  11. Evaluation of radiotracers for the detection of atherosclerotic vulnerable plaque and myocardial angiogenesis

    International Nuclear Information System (INIS)

    Dimastromatteo, Julien

    2010-01-01

    Cardiovascular diseases are the leading cause of mortality worldwide. Coronary events are mainly caused by coronary plaque rupture or erosion. However, at present, there is no noninvasive tool available for the detection of vulnerable plaques. The first part of thesis is about evaluation of new radiotracers for the detection of atherosclerotic vulnerable plaques. 99m Tc-B2702p, 20 derivatives, 99m Tc-VP and 99m Tc-VINP28 were evaluated in an experimental model of atherosclerosis (ApoE-/- mice with left carotid artery ligation). 99m Tc- B2702p1 is a potentially useful radiotracer for the in vivo molecular imaging of VCAM-1 expression in atherosclerotic plaques. Myocardial angiogenesis is an important post infarction phenomenon. Angiogenic therapy improves experimentally cardiac parameters. However, clinical trials using the same therapy are more controversial. At present, clinical imaging tools don't allow us to assess angiogenesis therapy. The second part of thesis is about validation of 99m Tc-RAFT-RGD in the detection of myocardial angiogenesis. 99m Tc-RAFT-RGD allow us to perform noninvasive molecular imaging of myocardial angiogenesis in an experimental model. (author)

  12. Evaluation of myocardial involvement in muscular dystrophy with Thallium-201 emission computed tomography

    International Nuclear Information System (INIS)

    Yamamoto, S.; Kawai, N.; Matsushima, H.; Okada, M.; Yamauchi, K.; Yokota, M.; Hayashi, H.; Sotobata, I.; Sakuma, S.

    1985-01-01

    The clinical usefulness of quantitative analysis of thallium-201 emission computed tomography (ECT) for evaluation of left ventricular myocardial fibrosis was assessed on 45 patients with Duchenne(D), facioscapulohumeral(FSH), limbgirdle(LG) and myotonic(M) dystrophy. Trans-,long- and short-axial images were interpreted quantitatively using circumferential profile analysis, and the fibrotic tissue size (%FIB) was estimated by integration of hypoperfused areas in 6 to 8 consecutive short-axial slices. Lung/mediastinum count ratios (L/M ratio) were also assessed. Distinct ECT defects were found in 42 patients (all cases of D, FSH and LG, and 2 of 5 MTs). ECT defects were observed specifically in the posterolateral wall (71%) and apex (58%) in D, and were scattered in all LV walls in FSHG, LG and MT. ECG and VCG underestimated the extent of myocardial fibrosis in 17 patients (40%). Percent FIBs coincided with fibrotic tissue sizes proven by autopsy. Body-surface ECG should be influenced by cardiac position and rotation in the thorax, which were often observed in these disease entities. These factors were also assessed with ECT. The authors conclude; ECT to be useful for non-invasive evaluation of myocardial fibrosis in patients with various types of muscular dystrophy

  13. Evaluation of myocardial involvement in muscular dystrophy with thallium-201 emission computed tomography

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Sotobata, Iwao; Indo, Toshikatsu; Matsuoka, Yukihiko; Kawai, Naoki; Matsushima, Hideo; Suzuki, Akio; Abe, Tetsutaro; Sakuma, Sadayuki

    1986-01-01

    The clinical usefulness of thallium-201 myocardial perfusion scanning with emission computed tomography (ECT) for evaluation of left ventricular myocardial fibrosis was assessed on 47 patients with Duchenne (DMD), facioscapulohumeral (FSH), limb-girdle (LG) and myotonic (MT) dystrophy. Trans-, long- and short-axial images were interpreted quantitatively by circumferential profile analysis, and the fibrotic tissue size (%FIB) was estimated by integration of hypoperfused areas in 6 to 8 consecutive short-axial slices. Lung/mediastinum count ratios (L/M ratio), LV cavity dilatation, aneurysm formation and cardiac malrotations were also assessed with ECT. Distinct ECT perfusion defect was observed in 26 of 29 DMDs, and in 11 of 18 patients with other types. Perfusion defect was demonstrated in 95 of total 235 segments, and was observed specifically in the posterior wall (82 %) and the apex (65 %) in DMD, and was scattered in all LV wall segments in FSH, LG, and MT. Percent FIB correlated significantly with L/M ratio (r = 0.82, p < 0.01), and did not with age or clinical stage score. ECT showed marked LV dilatation in 7, apical aneurysm in 5 and cardiac malrotation in 23 of the 47 patients. In conclusion, ECT was considered to be a useful clinical means of evaluating myocardial involvement in patients with muscular dystrophy. (author)

  14. Evaluation of right ventricular regional wall motion in inferior myocardial infarction by cine MRI

    International Nuclear Information System (INIS)

    Nishino, Masami; Ohnishi, Shusaku; Hasegawa, Shinji

    1991-01-01

    The purpose of this study is to evaluate right ventricular regional wall motion in inferior myocardial infarction by cine MRI. Thirteen patients with inferior myocardial infarction were investigated by cine MRI and were divided into proximal group which consisted of seven patients: >90% stenosis in segment 1 or 2 of right coronary artery and distal group which consisted of six patients: >90% stenosis in segment 3 or 4 of right coronary artery. Cine MRI was performed by 1.5 tesla magnet system (Signa, GE). To depict the regional asynergy, right ventricular wall was divided into 6 segments as follows: Segments 1 and 2 were upper and lower segments in transverse planes, respectively. Segments 3 and 4 were free wall and diaphragmatic segments of outflow tract, and segments 5 and 6 were of inflow tract in sagittal planes. Our results were as follows: (1) In proximal group, right ventricular asynergy was detected in six patients but in distal group it was detected in only one patient; (2) Right ventricular asynergy was detected most frequently at diaphragmatic segments in sagittal planes; (3) All the patients who had shown the hemodynamic deterioration of right ventricle on acute phase of inferior myocardial infarction presented the broad asynergy in right ventricle; (4) Cine MRI is clinically useful in evaluating right ventricular regional wall movement and diagnosing right ventricular infarction. (author)

  15. An evaluation of the resistivity anisotropy of the clays at the Down Ampney fault research site

    International Nuclear Information System (INIS)

    Raines, M.G.; Jackson, P.D.; Evans, C.J.; Meldrun, P.; Rainsbury, M.

    1991-01-01

    The anisotropy of electrical resistivity of the Oxford clay at Down Ampney was examined by a series of measurements of resistivity on the core with current flowing horizontally and vertically. As expected the horizontal resistivity core data was found to agree with the downhole resistivity logs. This observation enabled a methodology to be implemented where both horizontal and vertical resistivities were assessed in the field

  16. Gated single-photon emission tomography imaging protocol to evaluate myocardial stunning after exercise

    International Nuclear Information System (INIS)

    Hashimoto, Jun; Kubo, Atsushi; Iwasaki, Ryuichiro; Iwanaga, Shiro; Mitamura, Hideo; Ogawa, Satoshi; Kosuda, Shigeru

    1999-01-01

    This study was designed to apply ECG-gating to stress myocardial perfusion single-photon emission tomography (SPET) for the evaluation of myocardial stunning after exercise. Technetium-99m sestamibi was selected as the perfusion agent and a rest/exercise 1-day protocol was employed. Fourteen patients without coronary stenosis and 33 patients with coronary stenosis were enrolled in the study. We carried out three data acquisitions with ECG-gating: a 15-min data acquisition starting 30 min after the rest injection (AC1), a 5-min acquisition starting 5 min after the stress injection (AC2) and a 15-min acquisition starting 20 min after the stress injection (AC3). Calculation of left ventricular ejection fraction (LVEF) values was performed by means of automatic determination of the endocardial surface for all gating intervals in the cardiac cycle. Measured global EF values in 14 patients without coronary stenosis were 52.3%±7.6% (AC1), 60.6%±8.9% (AC2) and 55.6%±5.6% (AC3), and those in 11 patients with severe ischaemia were 53.6%±8.0% (AC1), 45.6%±12.1% (AC2) and 49.7%±10.7%. The magnitude of the depression of post-stress LVEF relative to the rest LVEF correlated with the severity of ischaemia (r=0.594, P=0.002), and segments manifesting post-stress functional depression were associated with ischaemic segments showing reversible perfusion defects. Stress myocardial perfusion SPET with ECG-gating is a feasible method for the evaluation of myocardial stunning as well as exercise-induced ischaemia. (orig.)

  17. Evaluation of myocardial disorders in patients with dilated cardiomyopathy and left ventricular eccentric hypertrophy; By sup 201 Tl myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Junichi; Ohsawa, Hidefumi; Uchi, Takashi (Toho Univ., Tokyo (Japan). School of Medicine) (and others)

    1992-03-01

    {sup 201}Tl myocardial SPECT was performed in cases of dilated cardiomyopathy and valvular heart disease with left ventricular eccentric hypertrophy, and the two groups were compared from the standpoint of the mechanism of onset of myocardial disorders. Significant coefficients of correlation were seen between the Tl score and LVDd (r=0.792, r=0.785) and Tl score and LVEF (r=-0.634, r=-0.555) in both dilated cardiomyopathy and valvular heart disease. In cases of valvular heart disease, significant correlation coefficients (r=-0.756, r=-0.720) between LVDd and r-WR (relative-washout rate), and Tl score and r-WR were observed, but no such correlation was seen in dilated cardiomyopathy. In valvular heart disease, a decrease in myocardial perfusion associated with enlargement of the left ventricle appeared, while in dilated cardiomyopathy, there was a marked decrease in LVEF in proportion to the thallium defect. Therefore, it was assumed that left ventricular wall disorders occur due to myocardial metabolic disorders and coronary microcirculation disorders. (author).

  18. Cardiovascular risk evaluation and prevalence of silent myocardial ischemia in subjects with asymptomatic carotid artery disease

    Directory of Open Access Journals (Sweden)

    Ciccone M

    2011-03-01

    Full Text Available Marco Matteo Ciccone1, Artor Niccoli-Asabella2, Pietro Scicchitano1, Michele Gesualdo1, Antonio Notaristefano2, Domenico Chieppa1, Santa Carbonara1, Gabriella Ricci1, Marco Sassara1, Corinna Altini2, Giovanni Quistelli1, Mario Erminio Lepera1, Stefano Favale1, Giuseppe Rubini21Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO, 2Nuclear Medicine Unit, Department of Internal Medicine and of Public Medicine, University of Bari, Bari, ItalyIntroduction: Silent ischemia is an asymptomatic form of myocardial ischemia, not associated with angina or anginal equivalent symptoms, which can be demonstrated by changes in ECG, left ventricular function, myocardial perfusion, and metabolism. The aim of this study was to evaluate the prevalence of silent myocardial ischemia in a group of patients with asymptomatic carotid stenosis.Methods: A total of 37 patients with asymptomatic carotid plaques, without chest pain or dyspnea, was investigated. These patients were studied for age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of cardiac disease, and underwent technetium-99 m sestamibi myocardial stress-rest scintigraphy and echo-color Doppler examination of carotid arteries.Results: A statistically significant relationship (P = 0.023 was shown between positive responders and negative responders to scintigraphy test when both were tested for degree of stenosis. This relationship is surprising in view of the small number of patients in our sample. Individuals who had a positive scintigraphy test had a mean stenosis degree of 35% ± 7% compared with a mean of 44% ± 13% for those with a negative test. Specificity of our detection was 81%, with positive and negative predictive values of 60% and 63%, respectively.Conclusion: The present study confirms that carotid atherosclerosis is associated with coronary atherosclerosis and highlights the importance of screening for ischemic heart disease in

  19. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

    International Nuclear Information System (INIS)

    Miranda, Matheus; Hossne, Nelson Américo Jr.; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Fonseca, José Honório de Almeida Palma da; Pestana, José Osmar Medina de Abreu; Juliano, Yara; Buffolo, Enio

    2014-01-01

    Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions

  20. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Miranda, Matheus, E-mail: matheus10miranda@gmail.com; Hossne, Nelson Américo Jr.; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Fonseca, José Honório de Almeida Palma da; Pestana, José Osmar Medina de Abreu [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Juliano, Yara [Universidade de Santo Amaro, São Paulo, SP (Brazil); Buffolo, Enio [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil)

    2014-02-15

    Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions.

  1. Early diagnosis of interferon-induced myocardial disorder in patients with chronic hepatitis C. Evaluation by myocardial imaging with 123I-BMIPP

    International Nuclear Information System (INIS)

    Kondo, Yuki; Yukinaka, Michiko; Nomura, Masahiro; Nakaya, Yutaka; Ito, Susumu

    2000-01-01

    Interferon (IFN) therapy for chronic hepatitis C is sometimes associated with cardiac complications. In the present study, we performed myocardial imaging with 123 I-labeled β-methyl-p-iodophenylpentadecanoic acid ( 123 I-BMIPP) in order to evaluate myocardial disorders caused by IFN. We studied 40 healthy subjects (H group) and 25 patients with chronic hepatitis C who had been treated with IFN (IFN group). A Holter electrocardiogram (ECG) was performed and the autonomic nervous function was assessed by analyzing the spectral variability and 1/f fluctuation of heart rate. Myocardial planner imaging with 123 I-BMIPP was performed to obtain the time activity curve for 20 min immediately after administration of 123 I-BMIPP (dynamic study). Early and delayed myocardial single photon emission computed tomography (SPECT) images were expressed as Bull's eyes and the myocardium was divided into four segments to calculate the washout rate for each segment on early and late SPECT images (early and late SPECT study). No significant differences in autonomic nervous function were observed between the two groups in heart rate variability. In a dynamic study, the reduction rate from the time activity curve was significantly higher in the IFN group compared with the H group (reduction rate, IFN group, 5.3±3.7% vs H group, 1.2±3.3%; P 123 I-BMIPP myocardial scintigraphy examination several months after IFN therapy. These results indicate that metabolic disorders of fatty acids caused by IFN therapy can be detected before abnormalities are observed by Holter-ECG or echocardiography. (author)

  2. Early diagnosis of interferon-induced myocardial disorder in patients with chronic hepatitis C: evaluation by myocardial imaging with 123I-BMIPP.

    Science.gov (United States)

    Kondo, Y; Yukinaka, M; Nomura, M; Nakaya, Y; Ito, S

    2000-01-01

    Interferon (IFN) therapy for chronic hepatitis C is sometimes associated with cardiac complications. In the present study, we performed myocardial imaging with 123I-labeled beta-methyl-p-iodophenylpentadecanoic acid (123I-BMIPP) in order to evaluate myocardial disorders caused by IFN. We studied 40 healthy subjects (H group) and 25 patients with chronic hepatitis C who had been treated with IFN (IFN group). A Holter electrocardiogram (ECG) was performed and the autonomic nervous function was assessed by analyzing the spectral variability and 1/f fluctuation of heart rate. Myocardial planner imaging with 123I-BMIPP was performed to obtain the time activity curve for 20min immediately after administration of 123I-BMIPP (dynamic study). Early and delayed myocardial single photon emission computed tomography (SPECT) images were expressed as Bull's eyes and the myocardium was divided into four segments to calculate the washout rate for each segment on early and late SPECT images (early and late SPECT study). No significant differences in autonomic nervous function were observed between the two groups in heart rate variability. In a dynamic study, the reduction rate from the time activity curve was significantly higher in the IFN group compared with the H group (reduction rate, IFN group, 5.3 +/- 3.7% vs H group, 1.2 +/- 3.3%; P acids caused by IFN was reversed on the second 123I-BMIPP myocardial scintigraphy examination several months after IFN therapy. These results indicate that metabolic disorders of fatty acids caused by IFN therapy can be detected before abnormalities are observed by Holter-ECG or echocardiography.

  3. Frequency of myocardial injury after blunt chest trauma as evaluated by radionuclide angiography

    International Nuclear Information System (INIS)

    Sutherland, G.R.; Driedger, A.A.; Holliday, R.L.; Cheung, H.W.; Sibbald, W.J.

    1983-01-01

    Seventy-seven patients who had sustained multisystem trauma, including severe blunt chest injury, were prospectively evaluated to assess the frequency of associated traumatic myocardial injury. Traumatic injury to either the right or left ventricle was defined by the presence of discrete abnormalities of wall motion on electrocardiographically gated cardiac scintigraphy in patients without a clinical history of heart disease. Forty-two patients (55%) (Group 1) had focal abnormalities of wall motion; 27 involved the right ventricle, 7 the left ventricle, 7 were biventricular, and 1 involved only the septum. Both the right and left ventricular ejection fractions were significantly lower (31 +/- 11% and 47 +/- 14%, respectively) than those in the 35 traumatized patients without wall motion abnormalities on scintigraphy (Group 2) (49 +/- 8% and 58 +/- 11%, respectively). Repeat scintigraphic examination in 32 Group 1 patients at a time remote from initial injury showed improvement or resolution of previously defined focal wall motion abnormalities in 27 of 32 patients (84%). The electrocardiogram and serum enzyme tests were insensitive indexes of traumatic myocardial injury when defined by the scintigraphic abnormalities. Thus, severe blunt chest trauma results in a higher frequency of traumatic myocardial injury than heretofore recognized, and frequently involves the anteriorly situated right ventricle

  4. The usefulness of myocardial SPECT for the preoperative cardiac risk evaluation in noncardiac surgery

    International Nuclear Information System (INIS)

    Lim, Seok Tae; Lee, Dong Soo; Kang, Won Jon; Chung, June Key; Lee, Myung Chul

    1999-01-01

    We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. 118 patients ( M: F=66: 52, 62.7±10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest Tl-201/ stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heat failure and unstable angina) were surveyed through perioperative periods (14.6±5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery

  5. Thallium-201 myocardial imaging for evaluation of right-ventricular overloading

    International Nuclear Information System (INIS)

    Kondo, M.; Kubo, A.; Yamazaki, H.; Ohsuzu, F.; Handa, S.; Tsugu, T.; Masaki, H.; Kinoshita, F.; Hashimoto, S.

    1978-01-01

    This study evaluated the specificity and sensitivity of Tl-201 myocardial imaging in the detection of right-ventricular (RV) overloading. Right-ventricular visualization (RVV) after administration of Tl-201 chloride was studied on 99 patients with various heart diseases. Tracer uptake in the free wall of the RV was graded in four degrees. The degree of RVV was compared with the findings of cardiac catheterization. The comparisons indicated that the uptake increased in step with the inreases in RV systolic pressure, RV end-diastolic pressure, mean pulmonary arterial pressure, total pulmonary vascular resistance, and stroke-work index of the right ventricle (P < 0.05--P < 0.001). Of the patients with visible RV, all but three had RV overloading, and all but three of those without RVV had normal RV systolic pressure. Myocardial images also reflect the type of RV overloading. In patients with RV pressure overloading, the septum showed a tendency to appear straight. In patients with atrial septal defect leading to RV volume overloading, the RV cavity was dilated, the LV image small, and the septum convex toward the RV cavity. These results indicate that Tl-201 myocardial imaging is a sensitive and specific method for the study of RV overloading

  6. Myocardial imaging in the noninvasive evaluation of patients with suspected ischemic heart disease

    International Nuclear Information System (INIS)

    Pitt, B.; Strauss, H.W.

    1976-01-01

    Three noninvasive radioactive tracer techniques for evaluating patients with ischemic heart disease are described: (1) myocardial perfusion imaging, (2) acute infarct imaging, and (3) the gated blood pool scan. Myocardial perfusion imaging with tracers that distribute in the myocardium in relation to regional blood flow allows detection of patients with transmural and nontransmural infarction by the finding of decreased tracer concentration in the affected region of the myocardium. If these tracers are injected at the time of maximal stress to patients with significant coronary arterial stenosis but without infarction, areas of transient ischemia can be identified as zones of decreased tracer concentration not found when an examination is performed at rest. Acute infarct imaging with tracers that localize in acutely damaged tissue permits separation of patients with acute myocardial necrosis from those without infarction and those with more chronic damage. The gated blood pool scan permits assessment of left ventricular function and regional wall motion. The measurement of ventricular volumes, ejection fraction and regional wall motion adds significantly to the determination of hemodynamic variables in assessing patients with acute infarction. The technique also permits detection of right ventricular dysfunction. Performance of a combination of these radioactive tracer techniques is often advantageous, particularly in patients with suspected infarction. The techniques can establish whether infarction is present, whether it is acute, where the damage is located and how extensive it is; they can also provide a measure of the effect of this damage on left ventricular function

  7. Myocardial scintigraphy

    International Nuclear Information System (INIS)

    Bunko, Hisashi; Hisada, Kinichi

    1982-01-01

    Among the various methods of image diagnosis of the cardiovascular disorder, nuclear cardiology provides noninvasive means for evaluation of myocardial perfusion as well as morphological and functional informations. In this article, clinical application and image diagnosis of myocardial scintigraphy including Tl-201 myocardial perfusion scintigraphy, single photon emission computed tomography with Tl-201, acute myocardial infarction scintigraphy with Tc-99m-pyrophosphate and Ga-67 imaging of the heart, were discussed. Multiplanar imaging of the heart with Tl-201 after stress and at redistribution was the accepted method for detection and evaluation of the ischemic heart disease. Although it achieved high sensitivity and specificity for ischemic heart disease, detection of the small ischemia and quantation of the regional Tl-201 accumulation were difficult with conventional multiplanar imaging. Application of emission computed tomography improved detectability and quantitativity of the ischemia. However, 7-pinhole tomography did not increase the diagnostic accuracy significantly. It had limited clinical applicability due to poor quantitativity in spite of improved image contrast and its tomographic nature. Advantage and limitation of these tomographic imaging and multiplanar imaging were discussed. Problems and prognostic significance of pyrophosphate imaging of the acute myocardial infarction were also discussed. Visualization of the heart with Ga-67 was helpful for identification of the tumor or inflammation of the heart as well as evaluation of the effect of the therapy. (author)

  8. Application of Anisotropy of Magnetic Susceptibility to large-scale fault kinematics: an evaluation

    Science.gov (United States)

    Casas, Antonio M.; Roman-Berdiel, Teresa; Marcén, Marcos; Oliva-Urcia, Belen; Soto, Ruth; Garcia-Lasanta, Cristina; Calvin, Pablo; Pocovi, Andres; Gil-Imaz, Andres; Pueyo-Anchuela, Oscar; Izquierdo-Llavall, Esther; Vernet, Eva; Santolaria, Pablo; Osacar, Cinta; Santanach, Pere; Corrado, Sveva; Invernizzi, Chiara; Aldega, Luca; Caricchi, Chiara; Villalain, Juan Jose

    2017-04-01

    Major discontinuities in the Earth's crust are expressed by faults that often cut across its whole thickness favoring, for example, the emplacement of magmas of mantelic origin. These long-lived faults are common in intra-plate environments and show multi-episodic activity that spans for hundred of million years and constitute first-order controls on plate evolution, favoring basin formation and inversion, rotations and the accommodation of deformation in large segments of plates. Since the post-Paleozoic evolution of these large-scale faults has taken place (and can only be observed) at shallow crustal levels, the accurate determination of fault kinematics is hampered by scarcely developed fault rocks, lack of classical structural indicators and the brittle deformation accompanying fault zones. These drawbacks are also found when thick clayey or evaporite levels, with or without diapiric movements, are the main detachment levels that facilitate large displacements in the upper crust. Anisotropy of Magnetic Susceptibility (AMS) provides a useful tool for the analysis of fault zones lacking fully developed kinematic indicators. However, its meaning in terms of deformational fabrics must be carefully checked by means of outcrop and thin section analysis in order to establish the relationship between the orientation of magnetic ellipsoid axes and the transport directions, as well as the representativity of scalar parameters regarding deformation mechanisms. Timing of faulting, P-T conditions and magnetic mineralogy are also major constraints for the interpretation of magnetic fabrics and therefore, separating ferro- and para-magnetic fabric components may be necessary in complex cases. AMS results indicate that the magnetic lineation can be parallel (when projected onto the shear plane) or perpendicular (i.e. parallel to the intersection lineation) to the transport direction depending mainly on the degree of shear deformation. Changes between the two end-members can

  9. Evaluation of anisotropy of J c in silver-sheathed Bi-2223 tape

    International Nuclear Information System (INIS)

    Himeda, Y.; Kiuchi, M.; Otabe, E.S.; Matsushita, T.

    2005-01-01

    The magnetic field angle dependence of J c was measured by four probe method and DC magnetization method. The latter measurement was used for the specimen before and after bending to break the intergrain current in order to investigate only the intragrain current. It was found that the intragrain critical current density could be increased by a factor 2.7 in a parallel magnetic field when the c-axis misorientation could be improved. From the field angle dependence of the intragrain critical current density, the anisotropy parameter was estimated as 20.4

  10. Evaluation of myocardial and skeletal muscular involvement with thallium-201 myocardial emission computed tomography and whole body scintigraphy

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Matsushima, Hideo; Sotobata, Iwao; Suzuki, Akio; Indo, Toshikatsu; Matsuoka, Yukihiko

    1986-01-01

    Thallium-201 (Tl-201) myocardial emission computed tomography and whole body scintigraphy were performed using a rotating gamma camera in 64 patients with neurologic disease and 14 normal subjects. Thallium-201 myocardial perfusion defects were seen in 40 % of the muscular involvement in 47 patients with muscular dystrophy (MD), in whom morphological abnormality of the heart was common. There was strong relationship between the degree of left ventricular perfusion defects and the degree of pulmonary uptake of Tl-201. Thallium-201 whole body scintigraphy showed homogeneous distribution of Tl-201 in the extremities in normal subjects, and perfusion defects in 73 % of the muscular lesions in MD patients. Muscular and skeletal lesions for MD appear to progress independently. Thallium-201 imaging seems to be of clinical value in assessing the muscular and skeletal lesions. (Namekawa, K.)

  11. Time course evaluation of myocardial perfusion after reperfusion therapy by 99mTc-tetrofosmin SPECT in patients with acute myocardial infarction.

    Science.gov (United States)

    Tanaka, R; Nakamura, T

    2001-09-01

    Myocardial perfusion imaging with 99mTc-labeled agents immediately after reperfusion therapy can underestimate myocardial salvage. It is also conceivable that delayed imaging is useful for assessing the risk area. However, to our knowledge, very few studies have sequentially evaluated these image changes. We conducted 99mTc-tetrofosmin (TF) and 123I-beta-methyl-p-iodophenylpentadecanoic acid (BMIPP) SPECT before and after reperfusion to treat acute myocardial infarction and quantified changes in TF myocardial accumulation and reverse redistribution. Seventeen patients with a first myocardial infarction underwent successful reperfusion. We examined SPECT images obtained at the onset (preimage), those acquired 30 min (early image) and 6 h (delayed image) after TF injection, and images acquired 1, 4, 7, and 20 d after reperfusion (post-1-d, post-4-d, post-7-d, and post-20-d image, respectively). We also examined BMIPP SPECT images after 7 +/- 1.8 d (BMIPP image). Polar maps were divided into 48 segments to calculate percentage uptake, and time course changes in segment numbers below 60% were observed as abnormal area. Moreover, cardiac function was analyzed by gated TF SPECT on 1 and 20 d after reperfusion. In reference to the abnormal area on the early images, the post-1-d image was significantly improved compared with the preimage (P < 0.01) as was the post-7-d image compared with the post-1-d and post-4-d images (P < 0.05, respectively). However, post-20-d and post-7-d images did not significantly differ. Therefore, the improvement in myocardial accumulation reached a plateau 7 d after reperfusion. On the other hand, the abnormal area on the delayed images was significantly greater (P < 0.01) compared with that on the early images from 4 to 20 d after reperfusion, as the value was essentially constant. The correlations of the abnormal area between the preimage and the post-7-d delayed image, the preimage and the BMIPP image, and the post-7-d delayed image and the

  12. Evaluation of a method to determine the myocardial uptake from 123I-BMIPP myocardial SPECT and its significance

    International Nuclear Information System (INIS)

    Iwase, Mikio; Toriyama, Takayuki; Itou, Masato; Shimao, Ryuichiro; Ikeda, Koshiro; Suzuki, Takeshi; Nobuta, Takaaki; Iida, Akihiko.

    1996-01-01

    We examined methods of calculating myocardial uptake (TU) of 123 I-BMIPP by SPECT, and compared TU to heart function (ejection fraction (EF), cardiac output (CO), cardiac index (CI)) calculated by left ventriculography. Forty-two patients with acute myocardial infarction were classified into 5 groups; within 1 week (I), from 1 to 2 weeks (II), from 2 weeks to 1.5 months (III), from 1.5 to 3 months (IV) and more than 3 months (V) after percutaneous transluminal coronary angioplasty (PTCA). Chest depth (Tw) was calculated by measuring the thoracic absorption rate of 123 I. In calculating TU, the myocardial count was calculated from short-axis tomograms, and then absorption was corrected using Tw to calculate each value on early-phase image (E) and delay-phase image (D). The influence of lung uptake on myocardial count was only 1.76%. When TU was compared to heart function, there were correlations between group I and group V. Especially in group VD-TU was a significantly correlated with heart function. In heart function CI, but not EF nor CO, was significantly correlated with TU. It was suggested that the correlation between TU and heart function reflected the infarct condition before PTCA in group I, and that the individual difference in recovery of fatty acid metabolism in group V. The significant correlation between D-TU and CI suggests that D-TU reflects heart function and fatty acid metabolism, although TU is influenced by differences in physical status. (author)

  13. [Evaluation of myocardial uptake of beta-methyl-(123I)-iodophenylpentadecanoic acid (123I-BMIPP)].

    Science.gov (United States)

    Momose, M; Kobayashi, H; Saito, K; Matsumoto, N; Maki, M; Hosoda, S; Kusakabe, K

    1994-12-01

    To evaluate the myocardial uptake of beta-methyl-(123I)-iodophenylpentadecanoic acid (123I-BMIPP), nineteen patients with ischemic heart disease including left ventricular hypertrophy (mean age 63 +/- 7.8, 14 males and 5 females) underwent BMIPP myocardial scintigraphy. Myocardial uptake (MU) of BMIPP to the total injected dose was calculated from anterior view of the planar image in all subjects, and was compared with plasma glucose (BS), triglyceride (TG), and free fatty acid (FFA). It was also compared with left ventricular mass (LVM) calculated with echocardiography. MU was not related to BS, TG, and FFA, however had the positive correlation with LVM (r = 0.676, p < 0.01). Myocardial uptake per left ventricular mass (MU/LVM) had the negative correlation with LVM (r = -0.671, p < 0.01). Further studies for the significance of MU/LVM will be required.

  14. Evaluation of myocardial uptake of {beta}-methyl-({sup 123}I)-iodophenylpentadecanoic acid ({sup 123}II-BMIPP)

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Mitsuru; Kobayashi, Hideki; Matsumoto, Nobusuke; Maki, Masako; Kusakabe, Kiyoko [Tokyo Women`s Medical Coll. (Japan); Saito, Katsumi; Hosoda, Saichi

    1994-12-01

    To evaluate the myocardial uptake of {beta}-methyl-({sup 123}I)-iodophenylpentadecanoic acid ({sup 123}I-BMIPP), nineteen patients with ischemic heart disease including left ventricular hypertrophy (mean age 63{+-}7.8, 14 males and 5 females) underwent BMIPP myocardial scintigraphy. Myocardial uptake (MU) of BMIPP to the total injected dose was calculated from anterior veiw of the planar image in all subjects, and was compared with plasma glucose (BS), triglyceride (TG), and free fatty acid (FFA). It was also compared with left ventricular mass (LVM) calculated with echocardiography. MU was not related to BS, TG, and FFA, however had the positive correlation with LVM (r=0.676, p<0.01). Myocardial uptake per left ventricular mass (MU/LVM) had the negative correlation with LVM (r=-0.671, p<0.01). Further studies for the significance of MU/LVM will be required. (author).

  15. Evaluation of myocardial uptake of β-methyl-(123I)-iodophenylpentadecanoic acid (123II-BMIPP)

    International Nuclear Information System (INIS)

    Momose, Mitsuru; Kobayashi, Hideki; Matsumoto, Nobusuke; Maki, Masako; Kusakabe, Kiyoko; Saito, Katsumi; Hosoda, Saichi.

    1994-01-01

    To evaluate the myocardial uptake of β-methyl-( 123 I)-iodophenylpentadecanoic acid ( 123 I-BMIPP), nineteen patients with ischemic heart disease including left ventricular hypertrophy (mean age 63±7.8, 14 males and 5 females) underwent BMIPP myocardial scintigraphy. Myocardial uptake (MU) of BMIPP to the total injected dose was calculated from anterior veiw of the planar image in all subjects, and was compared with plasma glucose (BS), triglyceride (TG), and free fatty acid (FFA). It was also compared with left ventricular mass (LVM) calculated with echocardiography. MU was not related to BS, TG, and FFA, however had the positive correlation with LVM (r=0.676, p<0.01). Myocardial uptake per left ventricular mass (MU/LVM) had the negative correlation with LVM (r=-0.671, p<0.01). Further studies for the significance of MU/LVM will be required. (author)

  16. 201Tl myocard scintigraphy - a specialized non-invasive method in evaluating myocardial function

    International Nuclear Information System (INIS)

    Birke, S.; Deckart, H.; Mischke, W.; Schulz, J.; Koblitz, E.

    1985-01-01

    In 216 patients with ischemic heart disease (IHK) or with angina pectoris symptoms and suspected IHK the results of resting electrocardiograms were compared with those of 201 Tl scintigraphy under conditions of rest and exercise, resp. 201 Tl scintigraphy proved to be superior in sensitivity and specifity to the electrocardiograms of rest and under exercise as to the detection of coronary heart disease, the localization and assessment of the severity of coronary heart disease, and the evidence of load ischemia. Conclusions are drawn for a program of consecutive diagnostic steps in suspected IHK as well as for the evaluation of myocardial function in known IHK. (author)

  17. Effect of post-myocardial infarction streptokinase (sk) therapy, on myocardial viability - evaluation with thallium-201 single photon emission computed tomography (TL-201 SPECT)

    International Nuclear Information System (INIS)

    Shaikh, M.S.; Raza, M.; Kayani, A.M.; Fazal, I.

    2011-01-01

    To evaluate the effect of post-myocardial infarction Streptokinase therapy on myocardial viability, employing Thallium-201 single photon emission computed tomography (TL-201 SPECT). Design: Retrospective, experimental study. Place and duration of study: The Nuclear Cardiology Department, Armed Forces Institute of Cardiology / National Institute of Heart Diseases, Rawalpindi, from 1 April, 2009 to 31 October, 2009. Patients and Methods: Male patients, who had suffered from acute myocardial infarction (AMI), in an area supplied by the left anterior descending (LAD) artery, had infarct-related electrocardiogram (ECG) changes and received or did not receive Streptokinase therapy, were included. Those with a normal ECG, or history of revascularisation, or non-ST elevation MI, or more than one MIs, were excluded. The patients were divided into groups 1 (who received Streptokinase) and 2 (who did not receive Streptokinase). Each group contained 42 patients and all underwent scintigraphic viability study through intravenous injection of 3.0 mCi (123 MBq) of TL-201, followed by rest-redistribution SPECT imaging on a dual head, dedicated cardiac gamma camera system (Philips Cardio MD). Emory's cardiac toolbox and AutoQUANT were used for data processing and quantitative estimation of viable myocardium. Empirical scores from 0 to 2 were assigned to each of the scans, in the order of increasing viability, and these were compared across the two groups. Result: Group 1 contained 42 patients (age range = 38 to 80 years, mean = 53.98 +- 11.26 years), in whom empirical viability scoring was done. Score 0 was seen in 2 patients, score 1 was seen in 15 patients and score 2 was seen in 25 patients form this group. Group 2 also contained 42 patients (age range = 38 to 80 years, mean = 56.71 +- 9.05 years), in whom viability score of 0 was seen in 3 patients, score 1 was seen in 11 patients and score 2 was seen in 28 patients form this group. Age difference between the two groups was

  18. Myocardial Bridge

    Science.gov (United States)

    ... Center > Myocardial Bridge Menu Topics Topics FAQs Myocardial Bridge En español Your heart is made of muscle, ... surface of the heart. What is a myocardial bridge? A myocardial bridge is a band of heart ...

  19. The quantitative evaluation of 201Tl myocardial scintigraphy using reinjection method

    International Nuclear Information System (INIS)

    Naruse, Hitoshi; Itano, Midoriko; Yamamoto, Juro; Morita, Masato; Fukutake, Naoshige; Kawamoto, Hideo; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Fukuchi, Minoru

    1993-01-01

    This study was designed to determine whether Tl-201 myocardial scintigraphy using reinjection method would improve the rate of redistribution (RD) and, if improved, which would contribute to RD improvement, extent or severity of ischemia shown by the bolls-eye view method. In 17 patients with ischemic heart disease, exercise Tl-201 myocardial images were acquired at 10 min (early images) and 180 min (delayed images) after intravenous injection of 74 MBq of TlCl. In addition, 37 MBq of TlCl was injected again after delayed imaging and then images were acquired (RI images). Among the 17 patients, 7 were judged as RD(+), 8 as RD(-), and 2 as undefined. In 8 RD(-) patients and 2 undefined patients, RD became (+) on RI images. Visual changes in extent and severity of ischemia from early to delayed images were 68±42 for RD(+) cases vs. 3±20 for RD(-) cases and 0.4±0.8 for RD(+) cases vs. 0.1±0.3 for RD(-) cases, respectively. The corresponding figures from delayed to RI images for extent and score of ischemia were 50±46 for RD(+) cases vs. 13±22 for RD(-) cases and 0.4±30.3 for RD(+) cases vs. 0.1±0.5 for RD(-) cases, respectively. For 5 patients undergoing coronary revascularization, extent was improved in all cases, but severity was improved in only some cases. In conclusion, when RD became (+) on RI images, myocardial viability seemed to have been underestimated. Quantitative evaluation revealed that RD improved from early to delayed images depended on extent and that RD improved from delayed to RI images depended on both extent and severity. In postoperative improvement of RD, extent of ischemia was mainly involved. RI imaging was found to compensate for the underestimation of RD. Quantitative evaluation was also useful in the observation of subtle changes of ischemia. (N.K.)

  20. Evaluation of effects of early intravenous thrombolytic therapy in acute myocardial infarction with 99mTc-MIBI tomography imaging

    International Nuclear Information System (INIS)

    Zhang Zhongzheng; Xue Zheng; Qin Fuzhong

    1997-01-01

    PURPOSE: To evaluate the effects of early intravenous thrombolytic therapy in acute myocardial infarction (AMI) with 99m Tc-MIBI tomography imaging. METHODS: 22 patients with AMI were observed using 99m Tc-MIBI rest myocardial tomography imaging. The semiquantitative score of myocardial 99m Tc-MIBI uptake was expressed with a four point scoring system. RESULTS: The findings showed in patients in whom reperfusion was achieved, mean scores decreased from 9.1 +- 3.3 before thrombolytic therapy to 3.7 +- 2.2 (t 4.085, P 99m Tc-MIBI perfusion defect segments correlated with that of the ECG-determined infarct site. The comparison between the first and the second myocardial imaging in the non-thrombolytic-treatment group was statistically insignificant. CONCLUSION: The potential advantages of rest myocardial imaging in AMI before and after thrombolytic therapy not only provide an information for assessing the extent of improvement of myocardial ischemia but also provide an imaging basis for determining coronary artery reperfusion

  1. Evaluation of hemodynamic significance of coronary fistulae. Diagnostic integration between coronary angiography and stress/rest myocardial scintigraphy

    International Nuclear Information System (INIS)

    Rubini, G.; Sebastiani, M.

    2000-01-01

    It is here reported on the importance of the integration of data obtained from digital coronary angiography and stress/rest 99m Tc sestamibi myocardial perfusion single photon emission tomography in evaluationing the hemodynamic significance of coronary arteriovenous fistulae. Coronary fistulae were detected with coronary angiography in 9 patients. All patients underwent clinical examination, trans thoracic echocardiography, stress electrocardiogram and stress/rest 99m Tc sestamibi myocardial perfusion single photon emission tomography. Stress/rest 99m Tc sestamibi myocardial perfusion single photon tomography and stress electrocardiogram showed stress-induced myocardial ischemia in 2 patients. The first patient with familial predisposition and risk factors for ischemic heart disease presented a mesocardic heart murmur on clinical examination. At stress ECG (125 Watt, 153 b/m max frequency 93%, arterial pressure 230 mmHg, max frequency pressure product 35200) ischemic alterations were recorded at the first minute of the second stage of the Bruce protocol. Coronary angiography detected a circumflex artery fistula in the coronary sinus. Stress/rest 99m Tc sestamibi myocardial perfusion single photon emission tomography for the evaluation of stress/rest perfusion detected a reversible perfusion defect of the proximal portion of the posterolateral and lateral walls, thus confirming the hemodynamic importance of the flow through the fistula during stress cycloergometric testing. In the second patient familial predisposition to ischemic heart disease and previous inferior wall myocardial infarction and non-significant stress ECG, coronary angiography identified a seclusive stenosis of the right coronary artery and anomaly between the anterior interventricular artery and the left pulmonary artery. The presence of the contrast medium in the left pulmonary artery identified a flow from the left ventricle to the left pulmonary artery. Good angiographic results were obtained

  2. Operative characteristics of rest myocardial perfusion in emergency thoracic pain evaluation

    International Nuclear Information System (INIS)

    Merlano G, Sonia; Murgueitio C, Ramon; Rodriguez F, Edgard; Carvajal C, Andres; Suarez R, Martin

    2000-01-01

    Study objective: Conventional emergency department testing strategies for patients with chest pain often provide equivocal diagnosis of coronary artery disease. This study was conducted to determine the sensibility, specificity , positive predictive value (PPV), negative predictive value (NPV) and Likelihood ratio LR(-) of the myocardial perfusion imaging with single photon emission computed tomography (SPECT) imaging at rest. Methods: We design a diagnostic imaging protocol to evaluate clinical usefulness of SPECT Technetium sestamibi imaging at rest in patients with typical and atypical chest pain and normal or non diagnostic electrocardiogram. Coronary angiogram was the gold standard for positive studies and six month follow up after completing the exercise test for negatives. Nuclear Medicine physicians were unaware of the angiograms results. The inter observers variability was measure with a Kappa coefficient. Results: We enrolled 107 patients 78 males (72.8%) and 29 females (27.2%). We found sensitivity 95.45% (IC 95% 95.41-95.48), specificity 92.94%(IC 95% 92.9- 92.98) Negative predictive value 98.75% LR(-) 0.092 . The study adequately classified 93% of the patients. Kappa coefficient for concordance between observer was 0.95 Conclusion: Myocardial perfusion imaging with SPECT at rest, has a high negative predictive value and a very good ability to classify normal patients as such and therefore may be use for the assessment of patients with chest pain and normal or non diagnostic electrocardiograms at the emergency room (Au)

  3. Prospective evaluation of stress myocardial perfusion imaging for pre-operative cardiac risk assessment

    International Nuclear Information System (INIS)

    Byrne, A.J.; Rowe, C.C.; Flannery, G.

    2002-01-01

    Full text: A prospective evaluation of patients who underwent stress myocardial perfusion imaging (MPI) to assess preoperative cardiac risk was undertaken. At the time of the scan patients were classified into 4 Clinical Risk groups (CR) based on known clinical data. On completion of the scan, the patient was then categorised into 4 Scan based Risk groups (SR), incorporating size of perfusion deficit, single versus multi-vessel disease and ejection fraction. Surgery at Austin and Repatriation Medical Centre within 6 months of scan and complications were identified using the hospital medical database. Major early cardiac events coded were death (cardiac related), myocardial infarction, unstable angina, acute pulmonary oedema, cardiac arrest, and urgent revascularisation. 208 patients have reached 6 months post-MPI scan. Of these 119 (57%) were identified as having surgery. Of the Scan Risk groups, 63% of normal, 57% of increased, and 47% of high and very high groups have had surgery. An abnormal scan is associated with a three-fold risk of cardiac complication (3.5% vs 11.3%). This is lower than most previous reports and may be due to higher representation of low risk surgical procedures (14% in this series), improved peri-operative care and/or the test result influence on management (suggested by decreasing surgical rate as SR estimate rose). Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  4. [Establishment of myocardial targeted nanoparticles and preliminary evaluation of its effects on prevention and treatment of myocardial injury].

    Science.gov (United States)

    Liu, Y Y; Wang, C; Luo, P F; Xia, Z F

    2017-11-20

    Objective: To establish 3-{4-[2-hydroxyl-(1-methylethylamino) propoxy] phenyl} propionic acid cetylesters (PAC) modified nanoparticles, and preliminarily explore its cardiomyocyte-targeting function and protection effects on myocardium. Methods: (1) HL-1 myocardial cells were divided into cyanidin-3 (Cy3) marked non-targeted small interference RNA (Cy3-siNC) group and Cy3 marked small interference RNA designed for the nuclear factor kappa B (NF-κB)-p65 gene (Cy3-si435) group according to the random number table, with 3 wells in each group. Cells in Cy3-siNC group were transfected with Cy3-siNC, while cells in Cy3-si435 group were transfected with Cy3-si435. At transfection hour 24, the mRNA expression of NF-κB-p65 of cells was determined by real-time fluorescent quantitative polymerase chain reaction. (2) Multiple emulsificating solvent evaporating method was adopted to prepare PAC modified nanoparticles carried with Cy3-siNC (Cy3-siNC-PAC) and PAC modified nanoparticles carried with Cy3-si435 (Cy3-si435-PAC). The morphology of Cy3-si435-PAC nanoparticles was observed with scanning electron microscope, and the size and potential of Cy3-si435-PAC nanoparticles were detected by nanometer particle size and zeta potential analyzer. The entrapment efficiency and drug loadings of Cy3-si435-PAC nanoparticle were determined with ultraviolet spectrophotometer. The release of Cy3-si435 of Cy3-si435-PAC nanoparticles was determined by dialysis method. (3) Another batch of HL-1 cells were divided into 4 groups according to the random number table, with 9 wells in each group. Cells in negative control group were added with 5 μL phosphate buffer. Cells in 25, 50, and 100 mg/mL Cy3-si435-PAC nanoparticles groups were added with 5 μL 25, 50, and 100 mg/mL Cy3-si435-PAC nanoparticles, respectively. At transfection hour 6, 12, and 24, proliferation activity of cells in 3 wells of each group was detected by methyl thiazolyl tetrazolium method, respectively. (4) Another batch of

  5. The research on biodistribution of 131I-iodosennoside A in normal mice and to evaluate myocardial activity

    International Nuclear Information System (INIS)

    Wang Junhu; Yin Zhiqi; Jiang Cuihua; Jiang Xiao; Li Yue; Zhang Jian; Sun Ziping; Ni Yicheng

    2013-01-01

    Purpose: The objective of this project is to evaluate biodistribution of [ 131 I]-Iodosennoside A in normal mice and explore the feasibility on the diagnosis of myocardial infarction. Methods: Iodogen method was used to radioiodinate sennoside A with 131 I. [ 131 I] Iodosennoside A was intravenously injected into mice. Three groups of mice were killed at 4 h, 24 h and 48 h post injection respectively and the radioactive uptake in major organs were calculated. Rats were subjected to left anterior descending (LAD) coronary artery ligation to induce acute myocardial infarction. Rat models of myocardial infarction were intravenously injected [ 131 I] iodosennoside A. 24 h after injection of [ 131 I] iodosennoside A, the regional distribution of radioiodinated sennoside A was determined by radioactivity counting technique. 2, 3, 5-triphenyl tetrazolium chloride (TTC) staining and autoradiography were per- formed with 2 mm thick sections of hearts for postmortem verifications. Results: The study showed high uptake of [ 131 I] iodosennoside A in kidneys and fast blood clearance. At 24 h post injection, radioactivity concentration in infarcted myocardium was over 11.9 times higher than in normal myocardium. Preferential uptake of the [ 131 I] iodosennoside A in necrotic tissue was confirmed by perfect match of images from TTC staining and autoradiography. Conclusion: The result proved that [ 131 I] iodosennoside A has myocardial necrosis affinity and may serve as a marker on the diagnosis of myocardial infarction. (authors)

  6. Clinical evaluation of myocardial perfusion imaging with 99mTc-CPI

    International Nuclear Information System (INIS)

    Liu Xiujie

    1988-01-01

    10 normal subjects and 55 cases of patients with heart diseases were studied with 99m Tc-CPI myocardial perfusion imaging. The 99m Tc-CPI myocarbial imaging is superior to 99m Tc-TBI, because the uptake of 99m Tc-CPI in both lung and liver is lower. The imaging quality of 99m Tc-CPI is nearly as good as that of 201 Tl. 16 patients had both 99m Tc-CPI myocardial imaging and coronary artery angiography. The sensitivity of 99m Tc-CPI myocardial imaging for detecting coronary artery disease (CAD) was 92%, whereas the sensitivity of ECG was 84.6%. 99m Tc-CPI myocardial tomography was obtained in 17 patients using Toshiba 90B SPECT system. The imaging quality of myocardial tomography using 99m Tc-CPI is very good and superior to planar imaging for detecting myocardial infarction

  7. Thallium-201 myocardial imaging in evaluation of asymptomatic individuals with ischaemic ST segment depression on exercise electrocardiogram

    International Nuclear Information System (INIS)

    Caralis, D.G.; Bailey, I.; Kennedy, H.L.; Pitt, B.

    1979-01-01

    This study showed that asymptomatic adults with normal physical examination, normal resting electrocardiogram, and normal routine laboratory evaluation who had a positive exercise electrocardiogram and abnormal exercise thallium-201 myocardial image had a very high probability of angiographically significant coronary artery disease. If, on the other hand, the exercise electrocardiogram was positive for 'ischaemic' ST segment changes, but the exercise thallium image was normal, the probability for coronary disease was low. The exercise electrocardiogram combined with thallium-201 myocardial image are safe non-invasive methods which can be performed on an out-patient basis. (author)

  8. Evaluation of myocardial glucose metabolism in hypertrophic cardiomyopathy using 18F-fluorodeoxyglucose positron emission tomography.

    Directory of Open Access Journals (Sweden)

    Rie Aoyama

    Full Text Available The purposes of this study were to assess the usefulness of myocardial 18F-fluorodeoxyglucose (18F-FDG positron emission tomography (PET/computed tomography (CT for evaluating myocardial metabolic status in hypertrophic cardiomyopathy (HCM and the therapeutic efficacy of alcohol septal ablation (ASA in hypertrophic obstructive cardiomyopathy (HOCM.Thirty HCM patients (64.4±10.5 years, 14 male, 12 hypertrophic non-obstructive cardiomyopathy [HNCM], 16 HOCM, and 2 dilated phase of HCM underwent 18F-FDG-PET/CT. 18F-FDG uptake was semi-quantitatively evaluated using an uptake score in each 17 segment and the entire LV or regional standardized uptake value (SUV.18F-FDG uptake was observed mostly in a hypertrophied myocardium in HNCM patients, whereas 18F-FDG was extensively accumulated beyond the hypertrophied myocardium in HOCM patients. There was a positive correlation between the summed uptake score of 18F-FDG and high-sensitive troponin T level in HNCM patients (r = 0.603, p = 0.049, whereas the score was positively correlated with brain natriuretic peptide level (r = 0.614, p = 0.011 in HOCM patients. In 10 patients who received ASA, the maximum SUV of the entire LV was significantly reduced from 5.6±2.6 to 3.2±2.1 (p = 0.040 after ASA. Reduction of that maximum SUV was particularly significant in the lateral region (from 5.5±2.6 to 2.9 ±2.2, p = 0.024 but not significant in the anteroseptal region (from 4.5±2.6 to 2.9±1.6, p = 0.12.Extensive 18F-FDG uptake beyond the hypertrophied myocardium was observed in HOCM. ASA attenuates 18F-FDG uptake in a remote lateral myocardium.

  9. Evaluation of the return to work and its duration after myocardial infarction

    Directory of Open Access Journals (Sweden)

    Seyyed Jalil Mirmohammadi

    2014-05-01

    Full Text Available BACKGROUND: The evaluation of the ability for return to work among patients after myocardial infarction (MI is subject to controversy. Understanding various factors, which may affect return to work process, will help in promoting effective communication between physicians and patients. Return to work is dependent on such factors as patients’ functional capacity, MI expansion, cardiac muscle function, some psychiatric variables, job satisfaction, economic status, and age. In this study, we aimed to assess the frequency of return to work after first MI attack, and factors affecting it. METHODS: This was a follow-up study performed in Yazd, Iran from September 2007 until September 2010 on 200 patients suffering from their first MI attack. Patients were assessed 6 months and 1-year after MI regarding their cardiac function. Job satisfaction was evaluated by Direct Support Professional job satisfaction questionnaire. RESULTS: Seventy-seven percent of MI patients returned to work after 1-year. Mean time for return to work was 46.00 ± 4.12 days. Sixty percent of patients returned to work during the first 50 days after MI and 50% of them during 40 days after MI. The most common reason for not returning to work was patient’s decision. CONCLUSION: This study showed that a considerable numbers of patients returned to work after 1-year. The only factors which affected the rate of return to work were left ventricular function after MI and job satisfaction.   Keywords: Myocardial Infarction, Return to Work, Left Ventricular Function, Job Satisfaction 

  10. Myocardial involvement in muscular dystrophy evaluated by thallium-201 emission computed tomography

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Matsushima, Hideo; Kawai, Naoki; Sotobata, Iwao

    1986-01-01

    The clinical usefulness of thallium-201 myocardial emission computed tomography (ECT) for evaluating left ventricular myocardial fibrosis was assessed in 47 patients with Duchenne (MD), facio-scapulo-humeral (FSH), limb-girdle (LG) and myotonic (MT) dystrophy. 1. Trans-, long- and short-axial images were interpreted quantitatively by circumferential profile analysis, and the extent of fibrotic tissue (%FIB) was estimated by integrating hypoperfused areas in six to eight consecutive short-axial slices. Lung/mediastinum count ratio (L/M ratio), LV cavity dilatation, aneurysm formation and cardiac malrotation were also assessed with ECT. 2. Distinct ECT defects were demonstrated in 95 of a total of 235 LV segments (40 %) and in 37 of 47 cases (85 % of DMD, 71 % of FSH, 50 % of MT and 60 % of LG). They were observed specifically in the posterior wall (82 %) and the apex (65 %) in DMD, and were scattered in all LV wall segments in FSH, LG, and MT. 3. There was a significant correlation between %FIB and the L/M ratio (r = 0.79, p < 0.001), and the L/M ratio was significantly higher in DMD than in MT (0.67 ± 0.36 vs 0.34 ± 0.25, p < 0.05). 4. ECT showed marked LV dilatation in seven (15 %), apical aneurysm in five (11 %) and vertical heart in 12 (26 %) of the 47 patients. 5. There were no significant correlations between age or clinical stage scores and numbers of defect segments or %FIB in each group. 6. During the one-year follow-up period of these patients, a DMD boy with the largest %FIB (54 %) and the highest L/M ratio (1.4) together with LV dilatation had complications of refractory heart failure and he died eight months following the ECT examination. 7. Thallium-201 planar imaging and standard 12-lead ECG underestimated the perfusion defects which were evaluated with ECT. (author)

  11. Ventricular Repolarization Evaluation From Surface ECG for Identification of the Patients With Increased Myocardial Electrical Instability

    National Research Council Canada - National Science Library

    Lass, Jaanus

    2001-01-01

    In order to reveal the possible correlation between the level of myocardial electrical instability assessed at Holter monitoring and certain ECG parameters characterizing ventricular repolarization...

  12. Evaluating the effect of PTCA by exercise stress myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Lin Jinghui

    1992-01-01

    In this study, 44 patients after successful percutaneous transluminal coronary angioplasty (PTCA) were followed up by exercise stress myocardial perfusion imaging. In 28 patients with myocardial ischemia after PTCA, myocardial imaging of 75.0% patients reverted to normal or approximately normal. In 16 patients of myocardial infarction with ischemia after PTCA, myocardial imaging of only 37.5% patients reverted to normal or approximately normal, significantly less than myocardial ischemia. But the general efficacious incidence was similar in both groups. Most of 77 myocardial segments with complete or obvious redistribution returned to normal imaging after PTCA. During the follow-up coronary artery restenosis occurred in 6 cases, 5 of which were confirmed by coronary arteriography. Restenosis may be discovered as soon as possible, if a patient was reexamined by myocardial imaging 2-6 months after PTCA. The results of this study indicated that myocardial imaging is a noninvasive and reliable method for the assessment of PTCA therapeutic effect and follow up studies

  13. Prognostic risk stratification of myocardial ischaemia evaluated by gated myocardial perfusion SPECT in patients with chronic kidney disease

    International Nuclear Information System (INIS)

    Hatta, Tsuguru; Nishimura, Shigeyuki; Nishimura, Tsunehiko

    2009-01-01

    The aim of this study was to identify useful predictors of cardiac events in patients with chronic kidney disease (CKD). Among 4,031 patients identified from the Japanese Assessment of Cardiac Events and Survival Study (J-ACCESS) database with suspected or known ischaemic heart disease, we selected 820 with an estimated glomerular filtration rate (eGFR) of 2 . A total of 75 cardiac events developed among these 820 patients. The incidence of cardiac events was higher in the group with a lower eGFR. Multivariate Cox analysis indicated that age, diabetes mellitus, end-systolic volume, summed stress score (SSS) and eGFR were predictors of cardiac events. Event rates of patients with SSS ≥ 9 were significantly higher in groups with lower eGFR values (< 40 and 40-49 ml/min). The SSS value (≥ 9) is a reliable predictor of cardiac events and myocardial single photon emission computed tomography has incremental value for predicting cardiac events and survival in CKD. (orig.)

  14. The usefulness of treatment evaluation of severe heart failure by ECG-gated myocardial SPECT

    International Nuclear Information System (INIS)

    Ohkoshi, Nobuyuki; Watanabe, Shingo; Matsumoto, Tooru

    2011-01-01

    Our purpose of study was to investigate the usefulness of treatment evaluation of severe heart failure by Electrocardiogram (ECG)-gated myocardial single photon emission computed tomography (SPECT). We evaluated the cardiac function in the case of severe heart failure by gated SPECT and compared it with the cardiac function obtained by left ventriculography (LVG), echocardiography, cardiac MRI, and B-type natriuretic peptide (BNP) values. We investigated the correlation of ejection fraction (EF), time lag of wall motion between the septal and lateral walls of the left ventricle for cardiac resynchronization therapy (CRT) and wall thickening (WT). We classified the left ventricular (LV) into basal, middle and apical areas for comparison of WT. We investigated the effect of a perfusion defect score in these comparisons. The gated SPECT results were correlated with comparative subjects in EF. The results were correlated with MRI on the middle area of the LV in the comparison of WT. We thought it was possible that there was an effect from a perfusion defect score in a time lag comparison of wall motion. Treatment evaluation of severe heart failure by gated SPECT is useful, because it is able to obtain three-dimensional cardiac function analysis, and it offers objectivity and reproducible quantitative evaluation. At the same time, perfusion SPECT is helpful for CRT and LV-plasty. (author)

  15. Quantitative evaluation of right ventricular overload in cor pulmonale using sup 201 Tl myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Hiroshi; Misawa, Toshihiro; Kutsumi, Yasunori [Fukui Medical School, Matsuoka (Japan); and others

    1991-01-01

    To determine quantitatively the discriminant and characteristics of cor pulmonale, {sup 201}Tl myocardial perfusion SPECT was performed in 16 patients with chronic obstructive pulmonary disease (COPD) and 7 with restrictive pulmonary disease (RPD). One section of the short-axis SPECT image in which the right ventricle was most clearly visualized was selected. Tl-score was defined as the ratio of the sum of counts in the region of interest (ROI) at the anterior, mid, and posterior regions of the right ventricular free wall to the sum of counts in ROI at the posterior, lateral, and anterior walls of the left ventricle, and the anterior and posterior regions of the interventricular septum. In the group of COPD patients, Tl-score was positively correlated with mean pulmonary arterial pressure (mPAP), total pulmonary vascular resistance (TPR), and arterial carbon dioxide tension (PaCO{sub 2}), while it was inversely correlated with arterial oxygen tension (PaO{sub 2}). However, there was no significant correlation between Tl-score and mPAP, TPR, PaCO{sub 2}, and PaO{sub 2} in the group of RPD patients. In assessing pulmonary hypertension as defined by mPAP over 20 mmHg, a Tl-score greater than 0.25 was useful with a sensitivity of 69% and a specificity of 90%. The occurrence of cor pulmonale is a major factor in determining the prognosis of COPD patients. It was concluded that {sup 201}Tl myocardial SPECT is useful for evaluating right ventricular overload quantitatively, as well as for assessing core pulmonale, especially in COPD patients, since the ratio of Tl counts in the right and left ventricles was significantly correlated with right cardiopulmonary hemodynamic parameters. (N.K.).

  16. Quantitative evaluation of right ventricular overload in cor pulmonale using 201Tl myocardial SPECT

    International Nuclear Information System (INIS)

    Kato, Hiroshi; Misawa, Toshihiro; Kutsumi, Yasunori

    1991-01-01

    To determine quantitatively the discriminant and characteristics of cor pulmonale, 201 Tl myocardial perfusion SPECT was performed in 16 patients with chronic obstructive pulmonary disease (COPD) and 7 with restrictive pulmonary disease (RPD). One section of the short-axis SPECT image in which the right ventricle was most clearly visualized was selected. Tl-score was defined as the ratio of the sum of counts in the region of interest (ROI) at the anterior, mid, and posterior regions of the right ventricular free wall to the sum of counts in ROI at the posterior, lateral, and anterior walls of the left ventricle, and the anterior and posterior regions of the interventricular septum. In the group of COPD patients, Tl-score was positively correlated with mean pulmonary arterial pressure (mPAP), total pulmonary vascular resistance (TPR), and arterial carbon dioxide tension (PaCO 2 ), while it was inversely correlated with arterial oxygen tension (PaO 2 ). However, there was no significant correlation between Tl-score and mPAP, TPR, PaCO 2 , and PaO 2 in the group of RPD patients. In assessing pulmonary hypertension as defined by mPAP over 20 mmHg, a Tl-score greater than 0.25 was useful with a sensitivity of 69% and a specificity of 90%. The occurrence of cor pulmonale is a major factor in determining the prognosis of COPD patients. It was concluded that 201 Tl myocardial SPECT is useful for evaluating right ventricular overload quantitatively, as well as for assessing core pulmonale, especially in COPD patients, since the ratio of Tl counts in the right and left ventricles was significantly correlated with right cardiopulmonary hemodynamic parameters. (N.K.)

  17. Evaluation of radioactive potassium and its analogues for imaging myocardial infarcts

    International Nuclear Information System (INIS)

    Gorten, R.J.

    1977-01-01

    An extensive clinical evaluation was undertaken to assess the value of myocardial infarct imaging with radioactive potassium and analogues. Of 130 patients so examined, 80 were diagnosed as having suffered infarcts in the recent or distant past on the basis of all information other than the scan. The radionuclide imaging results were abnormal in 87.5 percent overall, 97 percent in acute transmural infarcts, and 83 percent in lesions over 3 weeks old. In 50 patients not considered to have had myocardial infarcts or contusions, apparently false abnormal results were obtained in 15 percent. These were all patients in whom additional diagnostic help was desired after the ordinary laboratory tests and electrocardiograms. Excellent agreement of infarct location was discovered on comparing radionuclide scans with radiographic contrast ventriculography. On comparing electrocardiograms with scans for infarct location, 85 percent complete or partial correlation was revealed. Agreement between scan abnormalities and significant-appearing coronary arteriographic lesions was rather poor, causing one to realize that 43 K scan abnormalities indicate regions of poor blood extraction by old or recent infarcts, rather than just poor regional arterial perfusion. While costly, radionuclide scans often provide worthwhile information about presence or absence of infarcts as well as about their location and size. Electrocardiograms and blood enzyme levels each cost less, but are almost always performed in serial fashion. This makes them actually more expensive than a single scan. Furthermore, a normal scan in a patient being considered for acute coronary care may be used as potent argument against the presence of an infarct, thereby saving costly intensive care and monitoring

  18. Radionuclide ventriculography for evaluation of left ventricular function in patients after myocardial infarction

    International Nuclear Information System (INIS)

    Sledzevskaya, I.K.; Stroganova, N.P.; Il'yash, M.G.

    1989-01-01

    The use of an expanded set of parameters of radionuclide ventriculography with 99m Tc-prtechnetate, characterizing myocardial function, made it possible to specify radionuclide semiotics of myocardial infarction, to identify 4 cardiodynamic types, and to establish correlation between a degree of cardiodynamic changes and a site of lesion, and the relationship with exercise tolerance

  19. Basic and advanced echocardiographic evaluation of myocardial dysfunction in sepsis and septic shock.

    Science.gov (United States)

    Vallabhajosyula, S; Pruthi, S; Shah, S; Wiley, B M; Mankad, S V; Jentzer, J C

    2018-01-01

    Sepsis continues to be a leading cause of mortality and morbidity in the intensive care unit. Cardiovascular dysfunction in sepsis is associated with worse short- and long-term outcomes. Sepsis-related myocardial dysfunction is noted in 20%-65% of these patients and manifests as isolated or combined left or right ventricular systolic or diastolic dysfunction. Echocardiography is the most commonly used modality for the diagnosis of sepsis-related myocardial dysfunction. With the increasing use of ultrasonography in the intensive care unit, there is a renewed interest in sepsis-related myocardial dysfunction. This review summarises the current scope of literature focused on sepsis-related myocardial dysfunction and highlights the use of basic and advanced echocardiographic techniques for the diagnosis of sepsis-related myocardial dysfunction and the management of sepsis and septic shock.

  20. Clinical evaluation of myocardial involvement in acute myopericarditis in young adults.

    Science.gov (United States)

    Saricam, Ersin; Saglam, Yasemin; Hazirolan, Tuncay

    2017-05-22

    Myocardial involvement in young adults has various causes. Acute myopericarditis is one of the myocardial involvements in young adults. It is easy to confuse with acute ST-elevation myocardial infarction because of the electrocardiographic features. This study aims to investigate a number of imaging techniques and clinical features for acute myopericarditis in young adults (defined as myocardial brightness in the left ventricle regions, especially in posterior and lateral wall. Focal echobright was observed in the 75 of 77 cases of acute myopericarditis in transthoracic echocardiogram. This sign was confirmed by cardiac magnetic resonance imaging. Focal echobright sensitivity was 95%; its specificity was 93%; its predictive was 95.2%. Pericardial effusion (83%) was observed in group I behind posterior wall. Its specificity was 81%; its sensitivity was 65%; predictivity was 73%. Pericardial effusion and myocardial focal echobright in echocardiography can be quite sensitive indicators for acute myopericarditis in young adults.

  1. The role of ECToolbox software in evaluating bio-therapeutic effect on acute myocardial infarct of pig modal

    International Nuclear Information System (INIS)

    Zou Renjian; Meng Shu; Fu Hongliang; Wu Jingchuan; Wang Hui

    2009-01-01

    Objective: The aim of this study was to estimate the role of ECToolbox software in evaluating the bio-therapeutic effect on acute myocardial infarction of pig model by angiopoietin-related protein 2 (Ad. ARP2). Methods: Sixteen acute myocardial infarction pigs were divided into groups A and B. Group A was intra-myocardial injected with Ad. ARP2 gene and group B was control with intra-myocardial injected of saline. Gated myocardial perfusion imaging was performed one and four weeks after the injection. To evaluate the bio-therapeutic effect, data was acquired and analyzed qualitatively and quantitatively with ECToolbox to observe the territory, extent and severity of myocardial defect. SPSS 10.0 was used for the statistical analysis. By applying the scoring system for each segment of the 20-segments model to the myocardial perfusion images, a mean score could be derived. Comparisons for the data of one and four weeks after the injection in the same group were made with the paired t-test, and for the data of different groups were made with t-test. Results: (1) The mean score of ischemic lateral wall was 1.99±0.85 and 1.71±0.85 respectively at one and four weeks after the injection. The mean score of ischemic inferior wall was 1.86±0.67 and 1.65±0.73 respectively. (2) The radioactivity ratios of defect area to the whole left ventricle in the first week and the fourth week were 25.75±7.16 and 31.57±5.64 on the short axis (t=3.83, P<0.01), 30.55±4.80 and 36.03± 6.27 on the vertical long axis (t=3.71, P<0.01), 25.03±2.65 and 27.42±3.48 on horizontal long axis (t= 2.88, P<0.01). (3) Polar maps showed myocardial defect extent of the fourth week was smaller than that of the first week. The percentage of defect area to the whole left ventricle in the first and fourth week was (16.58±5.78)% and (12.66±4.90)%. (4) Mean left ventricular eject fraction (LVEF) of group A was (43.99±5.96)% and (61.03±8.74)% respectively after one and four weeks. Conclusions: Bio

  2. Evaluation of viability of infarcted myocardium by low dose dobutamine stress echocardiography. Comparison with exercise stress 201Tl myocardial scintigraphy

    International Nuclear Information System (INIS)

    Nagahara, Toshihiro; Sakamoto, Kazunori; Sofue, Akira; Horiuchi, Toshimitsu; Yamazaki, Shigeki; Kuwako, Kenji

    1999-01-01

    Exercise stress 201 Tl myocardial single-photon emission computed tomography (SPECT) is recognized to be a excellent method for identifying viability after myocardial infarction, but it is expensive and needs a longer time for data acquisition than echocardiography. We therefore performed this study to evaluate the effectiveness of low dose (5-10 μg/kg/min) dobutamine stress echocardiography (DSE) in 30 patients (61±8 years old: 24 men and 6 women) within 4 weeks after myocardial infarction in identifying viable myocardium, compared to results obtained by SPECT. Defining an akinetic or dyskinetic segment obtained by rest echocardiography as a definite infarct area, altogether 96 segments out of 716 segments were shown to be infarct areas. Of these, 75 (78%) segments were identified as viable by DSE, and 77 (80%) by SPECT. Only 2 segments were shown to be discrepant on DSE and SPECT. Subsequently, the sensitivity, specificity and accuracy rates for DSE were 96%, 100% and 96%, respectively. In conclusion, DSE is as effective and useful as SPECT in the evaluation of viability after myocardial infarction. (author)

  3. Evaluation of Soft Tissue Sarcoma Tumors Electrical Conductivity Anisotropy Using Diffusion Tensor Imaging for Numerical Modeling on Electroporation

    Directory of Open Access Journals (Sweden)

    Ghazikhanlou-sani K.

    2016-06-01

    Full Text Available Introduction: There is many ways to assessing the electrical conductivity anisotropy of a tumor. Applying the values of tissue electrical conductivity anisotropy is crucial in numerical modeling of the electric and thermal field distribution in electroporation treatments. This study aims to calculate the tissues electrical conductivity anisotropy in patients with sarcoma tumors using diffusion tensor imaging technique. Materials and Method: A total of 3 subjects were involved in this study. All of patients had clinically apparent sarcoma tumors at the extremities. The T1, T2 and DTI images were performed using a 3-Tesla multi-coil, multi-channel MRI system. The fractional anisotropy (FA maps were performed using the FSL (FMRI software library software regarding the DTI images. The 3D matrix of the FA maps of each area (tumor, normal soft tissue and bone/s was reconstructed and the anisotropy matrix was calculated regarding to the FA values. Result: The mean FA values in direction of main axis in sarcoma tumors were ranged between 0.475–0.690. With assumption of isotropy of the electrical conductivity, the FA value of electrical conductivity at each X, Y and Z coordinate axes would be equal to 0.577. The gathered results showed that there is a mean error band of 20% in electrical conductivity, if the electrical conductivity anisotropy not concluded at the calculations. The comparison of FA values showed that there is a significant statistical difference between the mean FA value of tumor and normal soft tissues (P<0.05. Conclusion: DTI is a feasible technique for the assessment of electrical conductivity anisotropy of tissues. It is crucial to quantify the electrical conductivity anisotropy data of tissues for numerical modeling of electroporation treatments.

  4. Evaluation of regional wall motion in myocardial infarction using animation ECG gated cardiac computed tomography

    International Nuclear Information System (INIS)

    Shimizu, Takahiko; Hyodo, Haruo; Hayashi, Terumi; Yamamoto, Hideo; Yagi, Shigeru

    1984-01-01

    Regional wall motion of the left ventricle was evaluated in 21 patients with myocardial infarction using an animation system of gated cardiac computed tomographic (CT) images (animation gated CCT). The results obtained were compared with data by two-dimensional echocardiography (2-DE). 1. Evaluation of the asynergic area by animation gated CCT and 2-DE: Animation gated CCT detected the following specific regions with asynergy established by 2-DE; 10/10 cases (100%) at the anterior wall of the left ventricle, 14/14 cases (100%) at the interventricular septum, and 9/11 cases (81.8%) at the infero-posterior wall. In addition, one false positive case and one negative case were observed at the lateral wall and the apex, respectively. Of 37 instances with asynergic areas established by 2-DE, 21 cases or 89.2% were detected by animation gated CCT; the sensitivity was 91.9%. 2. Evaluation of severity of asynergy by animation gated CCT and 2-DE: The degree of asynergy evaluated by both methods was compared with each other, and the agreement was as follows: 10/10 cases (100%) at the left-ventricular anterior wall, 13/13 cases (100%) at the interventricular septum, and 7/9 cases (77.8%) at the infero-posterior wall. 3. Evaluation of the asynergic area by nonanimation gated CCT and 2-DE: Nonanimation gated CCT detected asynergic areas ascertained by 2-DE at the following areas; 8/10 cases (80%) at the left-ventricular anterior wall, 12/14 cases (85.7%) at the interventricular septum, and 4/11 cases (36.4%) at the infero-posterior wall. The difference between animation and nonanimation gated CCT was statistically significant (p<0.05). The severity of asynergy could not be evaluated by nonanimation gated CCT. (J.P.N.)

  5. Evaluation of carbohydrate cardiac metabolism by the 18FDG and positron emission tomography in the myocardial infarction with healthy coronaries

    International Nuclear Information System (INIS)

    Agostini, D.; Quennelle, F.; Babatasi, G.; Grollier, G.; Potier, J.C.; Bouvard, G.

    1997-01-01

    The aim of this study was to evaluate the regional myocardial metabolism of glucose (RMMG) by positron emission tomography (PET) with fluoro-de-oxy-glucose ( 18 FDG) in patients having myocardial infarction with healthy coronaries (MIHC). Four patients (4M, age: 41 ± 12 years) have presented: MI with a coronarography showing no significant lesions on the epicardial arteries, an irreversible anterior hypo-perfusion, moderated at 201 Tl scintigraphy and an isotopic FEVG 18 FDG. The dynamical images allow measuring RMMG and the static image to define the regions of interest on ventricular transaxial cross sections. A myocardial region embodying the totality of VG, including the septal, anterior and lateral regions and an intracavitary region are handy delimited. A model with 3 compartments is applied to the time-activity curves measured in the VG (input function) and in the myocardium (Patlak's method) and allows measuring the RMMG. The mean value of RMMG, measured along the VG, is significantly diminished as compared with that measured in healthy subjects. In conclusion, the PET based on 18 FDG shows that the myocardial carbohydrate metabolism is altered in patients afflicted with MIHC

  6. Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

    Directory of Open Access Journals (Sweden)

    Paola Emanuela Poggio Smanio

    2015-01-01

    Full Text Available Background: Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined. Objective: To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea that underwent myocardial scintigraphy (MS, over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group. Methods: This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05. Results: Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5% had non-fatal myocardial infarction and six individuals (0.7% died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036 and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0

  7. Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Smanio, Paola Emanuela Poggio, E-mail: pgmsmanio@gmail.com; Silva, Juliana Horie; Holtz, João Vitor; Ueda, Leandro; Abreu, Marilia; Marques, Carlindo; Machado, Leonardo [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil Mailing (Brazil)

    2015-08-15

    Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined. To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea) that underwent myocardial scintigraphy (MS), over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group. This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05. Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5%) had non-fatal myocardial infarction and six individuals (0.7%) died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036) and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0.043). The occurrence of major cardiac events in 8 years

  8. [Association between collateral circulation and myocardial viability evaluated by cardiac magnetic resonance imaging in patients with coronary artery chronic total occlusion].

    Science.gov (United States)

    Li, J N; Zhang, L J; He, Y; Chen, Y L; Huang, R C; Lyu, S Z; Song, X T

    2017-07-24

    Objective: Late gadolinium enhancement(LGE) cardiac magnetic resonance imaging(CMR) was used to evaluate the myocardial viability of chronic total occlusion(CTO) in patients with coronary heart disease and to observe the relationship between collateral circulation and myocardium viability in these patients. Methods: This retrospective study included 40 patients with CTO diagnosed by invasive coronary angiography (CAG) from September 2015 to June 2016 in our department, all patients performed CMR examination within one week after CAG.The collateral circulation of CTO was graded with Rentrop classification as follows: poor or no collateral circulation group, moderate collateral circulation group and good collateral circulation group.According to CMR images, the delayed enhancement transmural extent of myocardial segments were scored, the ventricular wall motion of the myocardial segment were graded, and the wall motion score index (WMSI) was calculated.Spearman correlation analysis was used to analyze the relationship between the delayed enhancement transmural extent of myocardial segments and WMSI. Results: In the no or poor collateral group of 6 myocardial regions, 1 myocardial region had viable myocardium and 3 myocardial regions had no viable myocardium; in the moderate collateral group of 16 myocardial regions, 11 myocardial regions had viable myocardium and 5 myocardial regions had no viable myocardium; in the good collateral group of 24 myocardial regions, 21 myocardial regions had viable myocardium and 3 myocardial regions had no viable myocardium, there was significant difference between the groups ( P =0.002). The WMSI of poor or no collateral circulation group, moderate collateral circulation group and good collateral circulation group were 1.54±0.50, 1.21±0.34 and 1.26±0.40, respectively, there was no significant difference between the groups ( P =0.063). Spearman correlation analysis showed that the extent of delayed enhancement transmural extent of

  9. Evaluation of attenuation correction, scatter correction and resolution recovery in myocardial Tc-99m MIBI SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Larcos, G.; Hutton, B.F.; Farlow, D.C.; Campbell- Rodgers, N.; Gruenewald, S.M.; Lau, Y.H. [Westmead Hospital, Westmead, Sydney, NSW (Australia). Departments of Nuclear Medicine and Ultrasound and Medical Physics

    1998-06-01

    Full text: The introduction of transmission based attenuation correction (AC) has increased the diagnostic accuracy of Tc-99m MIBI myocardial perfusion SPECT. The aim of this study is to evaluate recent developments, including scatter correction (SC) and resolution recovery (RR). We reviewed 13 patients who underwent Tc-99m MIBI SPECT (two day protocol) and coronary angiography and 4 manufacturer supplied studies assigned a low pretest likelihood of coronary artery disease (CAD). Patients had a mean age of 59 years (range: 41-78). Data were reconstructed using filtered backprojection (FBP; method 1), maximum likelihood (ML) incorporating AC (method 2), ADAC software using sinogram based SC+RR followed by ML with AC (method 3) and ordered subset ML incorporating AC,SC and RR (method 4). Images were reported by two of three blinded experienced physicians using a standard semiquantitative scoring scheme. Fixed or reversible perfusion defects were considered abnormal; CAD was considered present with stenoses > 50%. Patients had normal coronary anatomy (n=9), single (n=4) or two vessel CAD (n=4) (four in each of LAD, RCA and LCX). There were no statistically significant differences for any combination. Normalcy rate = 100% for all methods. Physicians graded 3/17 (methods 2,4) and 1/17 (method 3) images as fair or poor in quality. Thus, AC or AC+SC+RR produce good quality images in most patients; there is potential for improvement in sensitivity over standard FBP with no significant change in normalcy or specificity

  10. Evaluation of occupational radiation dose in nuclear medicine: radiopharmaceutical administration to scintiscanning exams of myocardial perfusion

    International Nuclear Information System (INIS)

    Komatsu, Cassio V.; Michelin, Charlie A.; Jakubiak, Rosangela R.; Lemes, Alyne O.; Silva, Juliana L.M.

    2013-01-01

    In nuclear medicine, workers directly involved in exams are constantly exposed to ionizing radiation. The procedure for administration of the radiopharmaceutical to the patient is one of the most critical times of exposure. In tests of myocardial perfusion scintigraphy (MPS) administration of radiopharmaceutical repeats the steps of rest and cardiac stress. In this study, we used a Geiger -Mueller detector for measuring occupational radiation doses for during the administration of technetium- 99m - sestamibi in MPS tests. In the evaluation, discriminated the stages of examination and related professional experience time to doses measures at home. It were followed 110 procedures at home (55 conducted by professionals with over 5 years experience and 55 conducted by professionals with less than 1 year of experience) and 55 effort procedures. The results showed that the rest of the procedure time and dose are related to the experience of the worker. More experienced workers were faster (mean: 43 ± 16 vs 67 ± 25 seconds / procedure), and therefore received lower doses (mean 0.57 ± 0.16 versus 0.80 ± 0.24 μSv / procedure), both with statistical significance (p <0.001). In step effort, there were procedures lasting longer (mean: 19 ± 2 minutes / procedure), which resulted in higher doses (mean 3.0 ± 0.6 μSv / procedure)

  11. Comparison of different computer-assisted evaluation procedures of thallium-201 myocardial scintigrammes in the diagnosis of coronary diseases

    International Nuclear Information System (INIS)

    Traurig, G.D.

    1981-01-01

    The aim of this investigation was to compare five different methods of evaluation of myocardial scintiscanning with each other as to their value in the diagnosis of coronary diseases, and to work out recommendations for routine diagnostics. Coronary angiography and ventriculography were used as methods of reference. In two evaluation procedures the scintigrammes, upon computer processing, were judged by the investigator according to optical criteria, three further evaluation methods were predominantly computer-oriented and were to provide semiquantitative results less influenced by the investigator's subjectivity. A further aim of the investigation consisted in verifying the author's own results and comparing them with the literature. (orig.) [de

  12. Clinical evaluation of segmental wall motion by radionuclide cardioangiography in the patients with myocardial infarction

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Uehara, Toshiisa; Kozuka, Takahiro

    1980-01-01

    To detect segmental wall motion of left ventricle is useful to identify the size and location of infarcted area in coronary arteries diseases. In this study, segmental wall motion by radionuclide cardioangiography were evaluated to compare with contrast left ventriculography in fifty patients of myocardial infarction. Segmental wall motion in RAO position by first pass method, in LAO position by multi-gated method were evaluated using an Anger camera and on-line minicomputer system by following methods; ED, ES images, sequential images, edge display, regional ejection fraction and movie imaging system (MIS). The percent agreements of segmental wall motion by RI and LVG were 84% in 350 segments of 50 cases. In all segments, segments 4, 6, 7 were better agreements than other segments. For the degree of wall motion, skinesis and dyskinesis were good agreements in both methods, while hypokinesia was slightly poor agreement (62%). On the other hand, the size of infarction, that is, percent thallium defect area was good correlated with radionuclide left ventricular ejection fraction (r = -0.855 in anterior infarction, r = -0.646 in inferior infarction). From these data, wall motion was thought to be closely related with left ventricular function, therefore, regional ejection fraction in seven areas in left ventricular image was developed and compared with segmental wall motion in left ventriculogram according to the classification of A.H.A. Comittee Report. The value of regional ejection fraction is 0.29, 0.40, 0.60 in akinesis, hypokinesis and normal. In conclusion, radionuclide cardioangiography is useful in the detection of abnormal segmental wall motion as noninvasive methods. (author)

  13. Evaluation of thallium redistribution in infarcted area in accordance with time interval from the onset of myocardial infarction

    International Nuclear Information System (INIS)

    Shimonagata, Tsuyoshi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Sumiyoshi, Tetsuya; Nonogi, Hiroshi; Hase, Kazuo

    1991-01-01

    This study evaluated the relationship between the time after onset of myocardial infarction and thallium redistribution in infarcted areas in a total of 123 patients with anterior infarction who underwent exercise thallium scintiscanning. Complete or incomplete redistribution of thallium was visually evaluated for transient perfusion defect by three physicians. Ischemic and defect scores were quantitatively determined by using circumferential profile analysis. The patients were divided into three groups: 64 patients receiving thallium scintiscanning within 3 months after onset of myocardial infarction (Group A), 25 patients receiving it at 3 months to one year after that (Group B), and 34 patients receiving it one year or later (Group C). Complete and incomplete redistributions were seen in 4% and 96%, respectively, for Group A, 38% and 62% for Group B, and 53% and 47% for Group C; and the rate of incomplete redistribution was significantly higher in Group A than the other two groups. Ischemic score was 50±32 for Group A, 46±29 for Group B, and 37±19 for Group C; and defect scores for these groups were 25±16, 24±16, and 20±18, respectively. Both ischemic and defect scores tended to be lower as the time after onset of myocardial infarction was longer. Eighteen patients, comprising 7 in Group A, 4 in Group B, and 7 in Group C, were also reinjected with thallium 201 and then reimaged at rest. These scans for Group A showed a significantly lower defect scores than the conventional thallium scans. Conventional exercise thallium scintiscanning seemed to underestimate thallium redistribution when performed early after onset of myocardial infarction. (N.K.)

  14. Evaluation of left ventricular function using electrocardiographically gated myocardial SPECT with (123)I-labeled fatty acid analog.

    Science.gov (United States)

    Nanasato, M; Ando, A; Isobe, S; Nonokawa, M; Hirayama, H; Tsuboi, N; Ito, T; Hirai, M; Yokota, M; Saito, H

    2001-12-01

    Electrocardiographically (ECG) gated myocardial SPECT with (99m)Tc-tetrofosmin has been used widely to assess left ventricular (LV) function. However, the accuracy of variables using ECG gated myocardial SPECT with beta-methyl-p-(123)I-iodophenylpentadecanoic acid (BMIPP) has not been well defined. Thirty-six patients (29 men, 7 women; mean age, 61.6 +/- 15.6 y) with ischemic heart disease underwent ECG gated myocardial SPECT with (123)I-BMIPP and with (99m)Tc-tetrofosmin and left ventriculography (LVG) within 1 wk. LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV) were determined on gated SPECT using commercially available software for automatic data analysis. These volume-related items on LVG were calculated with an area-length method and were estimated by 2 independent observers to evaluate interobserver validity. The regional wall motion with these methods was assessed visually. LVEF was 41.1% +/- 12.5% on gated SPECT with (123)I-BMIPP, 44.5% +/- 13.1% on gated SPECT with (99m)Tc-tetrofosmin, and 46.0% +/- 12.7% on LVG. Global LV function and regional wall motion between both gated SPECT procedures had excellent correlation (LVEF, r = 0.943; LVEDV, r = 0.934; LVESV, r = 0.952; regional wall motion, kappa = 0.92). However, the correlations of global LV function and regional wall motion between each gated SPECT and LVG were significantly lower. Gated SPECT with (123)I-BMIPP showed the same interobserver validity as gated SPECT with (99m)Tc-tetrofosmin. Gated SPECT with (123)I-BMIPP provides high accuracy with regard to LV function and is sufficiently applicable for use in clinical SPECT. This technique can simultaneously reveal myocardial fatty acid metabolism and LV function, which may be useful to evaluate various cardiac diseases.

  15. Evaluation of multi-gated myocardial perfusion imaging in various heart diseases

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Uehara, Toshitake; Kozuka, Takahiro

    1980-01-01

    Multi-gated myocardial perfusion imaging were studied in a hundred cases of various heart diseases. In normal cases, ED ES images showed thinning and thickening of wall motion respectively to compare with static images. In the myocardial infarction cases, the dynamic changes of wall motion was decreased at infarcted areas in all cases. In congestive cardiomyopathy, the change of wall motion is smaller than normal cases in all cases, while in hypertrophic cardiomyopathy, the change is not so hyperdynamic to compare with normal cases and by multi-gated images, asymmetric hypertrophy was clearly detected in HCM than static images. In conclusion, these methods were useful to detect the myocardial contraction stage in various heart diseases. (author)

  16. Thallium myocardial scanning in the emergency department evaluation of chest pain

    International Nuclear Information System (INIS)

    Mace, S.E.

    1989-01-01

    Chest pain is a common complaint of patients seen in the emergency department. The causes are legion, and range from the non-life threatening to the potentially catastrophic. Thallium heart scanning was done prospectively in 20 patients with a ''classic'' history for myocardial infarction (eight patients) or atypical chest pain and/or associated symptoms plus an abnormal ECG (12 patients) to discern a subset of patients from whom thallium scintography may be indicated in the emergency department. Although further investigation is needed, our preliminary study suggests that myocardial scanning with thallium can be a safe, fairly rapid, and useful objective parameter in the emergency department detection of suspected myocardial infarction, and in differential diagnosis of chest pain when other data such as the history, physical examination, ECG, or enzymes are inconclusive

  17. Evaluation of the Efficacy of Treatment of Newborns with Transient Myocardial Ischemia

    Directory of Open Access Journals (Sweden)

    Yulia N. Dovnar

    2018-01-01

    Full Text Available The purpose of the study: a comprehensive assessment of the effectiveness of the treatment of newborns with transient myocardial ischemia in the intensive care unit.Materials and methods. 102 newborns with transient myocardial ischemia, with a history of ante- and/or intranatal hypoxia, at the age of 1 to 7 days, with a gestational age from 29 to 42 weeks, underwent a clinical and instrumental examination of the heart before and during the treatment. The Group 1 consisted of 30 infants with 1 degree circulatory failure (CF; the Group 2 was comprised of 39 infants with 2A degree of CF, and the Group 3 included 33 infants with the 2B degree of CF. All children received cardiotropic drugs; infants from Groups 2 and 3 received cardiotonic drugs.Results. The study demonstrated an increase in biochemical parameters of blood (myocardial CPK, lactate dehydrogenase, aspartate aminotransferase, de Ritis ratio, manifestations of subendocardial ischemia in the electrocardiogram (depression of ST segment in one or more leads in combination with a T-wave defect, changes in systolic cardiac function during echocardiography (stroke volume, ejection and shortening factions, left ventricular TEI index, cardiac output, and cardiac index that correlated with the severity of myocardial ischemia and circulatory failure and their reverse development during the treatment. Various correlative links between parameters of left ventricular systolic function and blood biochemistry before and during the treatment reflecting the myocardial dysfunction with a gradual reverse development have been found.Conclusion. Infants with transient myocardial ischemia suffered from disorders of the clinical and functional state of the heart depending on the degree of ischemia and circulatory failure. Most infants exebited gradual reverse development during a complex intensive therapy. 

  18. Evaluation of myocardial function with the 201 Thallium scintimetry in various diseases of the heart. A correlative study based on 100 patients

    Energy Technology Data Exchange (ETDEWEB)

    Buell, U; Niendorf, H P; Strauer, B E; Hast, B

    1976-08-12

    To assess the validity of the quantitative /sup 201/Tl scintimetry in various diseases of the heart (coronary heart disease with and without myocardial infarction, non-coronary cardiomyopathy, scleroderma heart disease and asymmetric septal hypertrophy with IHSS), the /sup 201/Tl myocardial uptake values for five standardized projections (a) were correlated with the grade of LAD stenosis, (b) the pattern of myocardial wall motion and (c) were compared with the /sup 201/Tl uptake values derived from normal patients. Significant reduction (c) of /sup 201/Tl myocardial uptake could in individual cases be evaluated in acute myocardial infarction (95%), in dys- and akinesia (90%), in hypokinesia (71%), in scleroderma heart disease (50%), in non-coronary cardiomyopathy (50%) as well as in normokinesia (28%) when associated with LAD stenosis. The mean values (b) of /sup 201/Tl uptake in normo- and hypokinesia significantly differed between these two groups and from those evaluated in dys- and akinesia. The latter group showed the lowest /sup 201/Tl uptake values computed which in some cases were very close to the mean mediastinal /sup 201/Tl uptake. The correlation (a) of individual /sup 201/Tl values demonstrated that /sup 201/Tl distribution in the myocardium is not only equivalent to myocardial ''perfusion'' but is corresponding with the myocardial function. In non-coronary cardiomyopathy reduced /sup 201/Tl values sometimes could not be separated from values in coronary heart disease (and myocardial infarction). A regional increase of myocardial mass as in septal hypertrophy correlated well with an augmented /sup 201/Tl uptake when referred to the /sup 201/Tl storage in the mediastinum.

  19. Evaluation of myocardial function with the 201 Thallium scintimetry in various diseases of the heart. A correlative study based on 100 patients

    Energy Technology Data Exchange (ETDEWEB)

    Buell, U.; Niendorf, H.P.; Strauer, B.E.; Hast, B.

    1976-08-12

    To assess the validity of the quantitative /sup 201/Tl scintimetry in various diseases of the heart (coronary heart disease with and without myocardial infarction, non-coronary cardiomyopathy, scleroderma heart disease and asymmetric septal hypertrophy with IHSS), the /sup 201/Tl myocardial uptake values for five standardized projections (a) were correlated with the grade of LAD stenosis, (b) the pattern of myocardial wall motion and (c) were compared with the /sup 201/Tl uptake values derived from normal patients. Significant reduction (c) of /sup 201/Tl myocardial uptake could in individual cases be evaluated in acute myocardial infarction (95%), in dys- and akinesia (90%), in hypokinesia (71%), in scleroderma heart disease (50%), in non-coronary cardiomyopathy (50%) as well as in normokinesia (28%) when associated with LAD stenosis. The mean values (b) of /sup 201/Tl uptake in normo- and hypokinesia significantly differed between these two groups and from those evaluated in dys- and akinesia. The latter group showed the lowest /sup 201/Tl uptake values computed which in some cases were very close to the mean mediastinal /sup 201/Tl uptake. The correlation (a) of individual /sup 201/Tl values demonstrated that /sup 201/Tl distribution in the myocardium is not only equivalent to myocardial ''perfusion'' but is corresponding with the myocardial function. In non-coronary cardiomyopathy reduced /sup 201/Tl values sometimes could not be separated from values in coronary heart disease (and myocardial infarction). A regional increase of myocardial mass as in septal hypertrophy correlated well with an augmented /sup 201/Tl uptake when referred to the /sup 201/Tl storage in the mediastinum.

  20. Aerobic Training after Myocardial Infarction: Remodeling Evaluated by Cardiac Magnetic Resonance

    International Nuclear Information System (INIS)

    Izeli, Nataly Lino; Santos, Aurélia Juliana dos; Crescêncio, Júlio César; Gonçalves, Ana Clara Campagnolo Real; Papa, Valéria; Marques, Fabiana; Pazin-Filho, Antônio; Gallo-Júnior, Lourenço; Schmidt, André

    2016-01-01

    Numerous studies show the benefits of exercise training after myocardial infarction (MI). Nevertheless, the effects on function and remodeling are still controversial. To evaluate, in patients after (MI), the effects of aerobic exercise of moderate intensity on ventricular remodeling by cardiac magnetic resonance imaging (CMR). 26 male patients, 52.9 ± 7.9 years, after a first MI, were assigned to groups: trained group (TG), 18; and control group (CG), 8. The TG performed supervised aerobic exercise on treadmill twice a week, and unsupervised sessions on 2 additional days per week, for at least 3 months. Laboratory tests, anthropometric measurements, resting heart rate (HR), exercise test, and CMR were conducted at baseline and follow-up. The TG showed a 10.8% reduction in fasting blood glucose (p = 0.01), and a 7.3-bpm reduction in resting HR in both sitting and supine positions (p < 0.0001). There was an increase in oxygen uptake only in the TG (35.4 ± 8.1 to 49.1 ± 9.6 mL/kg/min, p < 0.0001). There was a statistically significant decrease in the TG left ventricular mass (LVmass) (128.7 ± 38.9 to 117.2 ± 27.2 g, p = 0.0032). There were no statistically significant changes in the values of left ventricular end-diastolic volume (LVEDV) and ejection fraction in the groups. The LVmass/EDV ratio demonstrated a statistically significant positive remodeling in the TG (p = 0.015). Aerobic exercise of moderate intensity improved physical capacity and other cardiovascular variables. A positive remodeling was identified in the TG, where a left ventricular diastolic dimension increase was associated with LVmass reduction

  1. Aerobic Training after Myocardial Infarction: Remodeling Evaluated by Cardiac Magnetic Resonance

    Energy Technology Data Exchange (ETDEWEB)

    Izeli, Nataly Lino; Santos, Aurélia Juliana dos; Crescêncio, Júlio César; Gonçalves, Ana Clara Campagnolo Real; Papa, Valéria; Marques, Fabiana [Divisão de Cardiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP, Ribeirão Preto, SP (Brazil); Pazin-Filho, Antônio [Divisão de Emergência da Faculdade de Medicina de Ribeirão Preto - USP, Ribeirão Preto, SP (Brazil); Gallo-Júnior, Lourenço; Schmidt, André, E-mail: aschmidt@fmrp.usp.br [Divisão de Cardiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP, Ribeirão Preto, SP (Brazil)

    2016-04-15

    Numerous studies show the benefits of exercise training after myocardial infarction (MI). Nevertheless, the effects on function and remodeling are still controversial. To evaluate, in patients after (MI), the effects of aerobic exercise of moderate intensity on ventricular remodeling by cardiac magnetic resonance imaging (CMR). 26 male patients, 52.9 ± 7.9 years, after a first MI, were assigned to groups: trained group (TG), 18; and control group (CG), 8. The TG performed supervised aerobic exercise on treadmill twice a week, and unsupervised sessions on 2 additional days per week, for at least 3 months. Laboratory tests, anthropometric measurements, resting heart rate (HR), exercise test, and CMR were conducted at baseline and follow-up. The TG showed a 10.8% reduction in fasting blood glucose (p = 0.01), and a 7.3-bpm reduction in resting HR in both sitting and supine positions (p < 0.0001). There was an increase in oxygen uptake only in the TG (35.4 ± 8.1 to 49.1 ± 9.6 mL/kg/min, p < 0.0001). There was a statistically significant decrease in the TG left ventricular mass (LVmass) (128.7 ± 38.9 to 117.2 ± 27.2 g, p = 0.0032). There were no statistically significant changes in the values of left ventricular end-diastolic volume (LVEDV) and ejection fraction in the groups. The LVmass/EDV ratio demonstrated a statistically significant positive remodeling in the TG (p = 0.015). Aerobic exercise of moderate intensity improved physical capacity and other cardiovascular variables. A positive remodeling was identified in the TG, where a left ventricular diastolic dimension increase was associated with LVmass reduction.

  2. Quantitative evaluation of right ventricular overload with thallium-201 myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Watanabe, Toshiya; Miyakoda, Hiroyuki; Koike, Yoshihiro; Itatsu, Hidetaka; Kawai, Naoki; Sotobata, Iwao.

    1983-01-01

    Thallium-201 myocardial perfusion scintigraphy and right-heart catheterization were performed on patients with right ventricular pressure overload (RVPO) or right ventricular volume overload (RVVO). In 18 patients with RVPO, right ventricular systolic pressure correlated significantly both with the RV/LV wall thallium-201 uptake ratios (r=0.54, p<0.02) and the RV wall/background thallium-201 uptake ratios (r=0.70, p<0.01). RV/LV work ratios also significantly correlated with RV/LV wall thallium-201 uptake ratios (r=0.57, p<0.02). In 19 patients with RVVO, Qp/Qs and RV/LV work ratios both significantly correlated with RV/LV wall thallium-201 uptake ratios (r=0.78 and 0.87, respectively; p<0.001 for both) and RV wall/background thallium-201 uptake ratios (r=0.69, p<0.01 for both parameters). Right ventricular systolic pressure also correlated with RV/LV wall thallium-201 uptake ratios (r=0.57, p<0.02). Feasibility of the differentiation between RVPO and RVVO was suggested with use of ''transitional view angle'' and RV/LV diameter ratios obtained from the scintigram. In patients who underwent cardiac surgery, post-operative alleviations of the right ventricular overload were evaluated. There was a significant decrease in RV/LV wall thallium-201 uptake ratios, but no significant decrease in RV wall/background thallium-201 uptake ratios in patients with RVPO. On the other hand, there was a significant decrease both in RV/LV wall thallium-201 uptake ratios and RV wall/background thallium-201 uptake ratios in patients with RVVO. No significant changes were observed between the scintigraphic measurements obtained 1 month and 1 year after the surgery, irrespective of the type of right ventricular overloading. (J.P.N.)

  3. Evaluation of right and left ventricular function in the patients with myocardial infarction using quantitative radionuclide cardioangiography

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Ohmine, Hiromi; Kozuka, Takahiro

    1984-01-01

    We evaluated right and left ventricular function in the case of myocardial infarction (MI) by radionuclide cardioangiography. The right and left ventricular ejection fraction (RVEF, LVEF) and ventricular volume (RVEDV, LVEDV) were calculated. And, phase and amplitude images were also obtained from gated blood pool scan. There were 60 cases of MI (35 anterior MI, 17 inferior MI and 8 right ventricular MI) and 10 normal cases. The LVEF was depressed in anterior MI (36 +- 14%) and RVEF was depressed in right ventricular MI (37 +- 5%). In addition, LVEDV was increased in anterior MI (163 +- 47 ml) and RVEDV increased in right ventricular MI (208 +- 33 ml), respectively. The amplitude of infarcted area was decreased. And the phase angle of LV was delayed in anterior MI and that of RV was delayed in right ventricular MI. Therefore, in the case of right ventricular MI, the depression of LVEF and RVEF was caused by the biventricular myocardial damage. And the cross talk phenomenon of biventricle was rarely observed, since the lung acts as the buffer between RV and LV. In conclusion, these noninvasive, methods provide useful information on the biventricular function in the case of myocardial infarction. (author)

  4. Evaluation of Survival Rate and Effective Factors in Acute Myocardial Infarction Patients in Emam Hospital (Year 2000

    Directory of Open Access Journals (Sweden)

    M Maghsoodloo

    2002-09-01

    Full Text Available Introduction: For the time being we have considered that the myocardial infarction is an increasing event in Islamic Republic of Iran and there are many procedures and methods which can help us to diminish the number of death from this ongoing event. The main aim of this research is to determine the survival rate in those patients who have had acute myocardial infarction and the association of it with different variables. Methods and Materials: The present research is a descriptive case-series study which evaluates the 100 cases of acute myocardial infarction who had been admitted in Tehran Emam Khomeini Hospital during the year 1999. Results: The mean age of patients was 57 years. The peak of attack rates was in spring and autumn. Investigating of the past history of these patients reviled that 41 percent had been smokers, 63.5 percent have had the history of previous ischemic heart disease, 41 percent have had hyper cholestrolemia, 34 percent had hypertension, 18 percent had diabetes mellitus, 9 percent had mitral rigurgitation and 9 percent had heart block. The Survival rate in our study has been calculated 68 percent in first 28 days of disease. Conclusion: In our study we concluded that there is significant correlation between survival rate and past history of hypertension, ischemic heart disease, tobacco smoking and clip classification.

  5. Synthesis and evaluation of radioiodinated (E)-18-iodo-17-octadecenoic acid as a model iodoalkenyl fatty acid for myocardial imaging

    International Nuclear Information System (INIS)

    Knapp, F.F. Jr.; Goodman, M.M.; Kabalka, G.W.; Sastry, K.A.

    1984-01-01

    125 I-labeled (E)-18-iodo-17-octadecenoic acid (13) has been prepared and evaluated in rats to determine the myocardial uptake and retention and degree of in vivo deiodination of this model iodovinyl-substituted fatty acid, which contains no structural perturbation to inhibit metabolism. This new agent was prepared by NaI-chloramine-T treatment of (17-carbomethoxyheptadec-1-en-1-yl)boronic acid (11) prepared by catecholborane treatment of methyl 17-octadecynoate (10), followed by basic hydrolysis to the free acid (13). The pivotal substrate, 17-octadecynoic acid (9), was prepared by two new routes. The 125 I-labeled acid 13 showed high myocardial uptake (1 h, 1.90-2.28% dose/g) with 45% washout after 2 h but lower heart/blood ratios in comparison to analogues containing the tellurium heteroatom. Deiodination was low for the first 2 h after injection (2 h, 61% dose/g). Excellent myocardial images were obtained in a dog with the 123 I-labeled agent

  6. Can the inflammatory response be evaluated using 18F-FDG within zones of microvascular obstruction after myocardial infarction?

    Science.gov (United States)

    Prato, Frank S; Butler, John; Sykes, Jane; Keenliside, Lynn; Blackwood, Kimberley J; Thompson, R Terry; White, James A; Mikami, Yoko; Thiessen, Jonathan D; Wisenberg, Gerald

    2015-02-01

    Inflammation that occurs after acute myocardial infarction plays a pivotal role in healing by facilitating the creation of a supportive scar. (18)F-FDG, which is taken up avidly by macrophages, has been proposed as a marker of cell-based inflammation. However, its reliability as an accurate indicator of inflammation has not been established, particularly in the early postinfarction period when regional myocardial perfusion is often severely compromised. Nine adult dogs underwent left anterior descending coronary occlusion with or without reperfusion. Animals were imaged between 7 and 21 d after infarction with PET/MR imaging after bolus injection of gadolinium-diethylenetriaminepentaacetic acid (DTPA), bolus injection of (18)F-FDG, bolus injection of (99)Tc-DTPA to simulate the distribution of gadolinium-DTPA (which represents its partition coefficient in well-perfused tissue), and injection of (111)In-labeled white blood cells 24 h earlier. After sacrifice, myocardial tissue concentrations of (18)F, (111)In, and (99)Tc were determined in a well counter. Linear regression analysis evaluated the relationships between the concentrations of (111)In and (18)F and the dependence of the ratio of (111)In/(18)F to the apparent distribution volume of (99m)Tc-DTPA. In 7 of 9 animals, (111)In increased as (18)F increased with the other 2 animals, showing weak negative slopes. With respect to the dependence of (111)In/(18)F with partition coefficient, 4 animals showed no dependence and 4 showed a weak positive slope, with 1 animal showing a negative slope. Further, in regions of extensive microvascular obstruction, (18)F significantly underestimated the extent of the presence of (111)In. In the early post-myocardial infarction period, (18)F-FDG PET imaging after a single bolus administration may underestimate the extent and degree of inflammation within regions of microvascular obstruction. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  7. Evaluation of myocardial disorders in patients with dilated cardiomyopathy and left ventricular eccentric hypertrophy

    International Nuclear Information System (INIS)

    Yamazaki, Junichi; Ohsawa, Hidefumi; Uchi, Takashi

    1992-01-01

    201 Tl myocardial SPECT was performed in cases of dilated cardiomyopathy and valvular heart disease with left ventricular eccentric hypertrophy, and the two groups were compared from the standpoint of the mechanism of onset of myocardial disorders. Significant coefficients of correlation were seen between the Tl score and LVDd (r=0.792, r=0.785) and Tl score and LVEF (r=-0.634, r=-0.555) in both dilated cardiomyopathy and valvular heart disease. In cases of valvular heart disease, significant correlation coefficients (r=-0.756, r=-0.720) between LVDd and r-WR (relative-washout rate), and Tl score and r-WR were observed, but no such correlation was seen in dilated cardiomyopathy. In valvular heart disease, a decrease in myocardial perfusion associated with enlargement of the left ventricle appeared, while in dilated cardiomyopathy, there was a marked decrease in LVEF in proportion to the thallium defect. Therefore, it was assumed that left ventricular wall disorders occur due to myocardial metabolic disorders and coronary microcirculation disorders. (author)

  8. Depolarization changes during acute myocardial ischemia by evaluation of QRS slopes: standard lead and vectorial approach.

    Science.gov (United States)

    Romero, Daniel; Ringborn, Michael; Laguna, Pablo; Pahlm, Olle; Pueyo, Esther

    2011-01-01

    Diagnosis and risk stratification of patients with acute coronary syndromes can be improved by adding information from the depolarization phase (QRS complex) to the conventionally used ST-T segment changes. In this study, ischemia-induced changes in the main three slopes of the QRS complex, upward ( ℑ(US)) and downward ( ℑ(DS) ) slopes of the R wave as well as the upward ( ℑ(TS)) slope of the terminal S wave, were evaluated as to represent a robust measure of pathological changes within the depolarization phase. From ECG recordings both in a resting state (control recordings) and during percutaneous coronary intervention (PCI)-induced transmural ischemia, we developed a method for quantification of ℑ(US), ℑ(DS), and ℑ(TS) that incorporates dynamic ECG normalization so as to improve the sensitivity in the detection of ischemia-induced changes. The same method was also applied on leads obtained by projection of QRS loops onto their dominant directions. We show that ℑ(US), ℑ(DS), and ℑ(TS) present high stability in the resting state, thus providing a stable reference for ischemia characterization. Maximum relative factors of change ( ℜ(ℑ)) during PCI were found in leads derived from the QRS loop, reaching 10.5 and 13.7 times their normal variations in the control for ℑ(US) and ℑ(DS), respectively. For standard leads, the relative factors of change were 6.01 and 9.31. The ℑ(TS) index presented a similar behavior to that of ℑ(DS). The timing for the occurrence of significant changes in ℑ(US) and ℑ(DS) varied with lead, ranging from 30 s to 2 min after initiation of coronary occlusion. In the present ischemia model, relative ℑ(DS) changes were smaller than ST changes in most leads, however with only modest correlation between the two indices, suggesting they present different information about the ischemic process. We conclude that QRS slopes offer a robust tool for evaluating depolarization changes during myocardial ischemia.

  9. ROC evaluation of SPECT myocardial lesion detectability with and without single iteration non-uniform Chang attenuation compensation using an anthropomorphic female phantom

    International Nuclear Information System (INIS)

    Jang, S.; Jaszczak, R.J.; Duke Univ. Medical Center, Durham, NC; Gilland, D.R.; Turkington, T.G.; Coleman, R.E.; Tsui, B.M.W.; Metz, C.E.

    1998-01-01

    The purpose of this work was to evaluate lesion detectability with and without nonuniform attenuation compensation (AC) in myocardial perfusion SPECT imaging in women using an anthropomorphic phantom and receiver operating characteristics (ROC) methodology. Breast attenuation causes artifacts in reconstructed images and may increase the difficulty of diagnosis of myocardial perfusion imaging in women. The null hypothesis tested using the ROC study was that nonuniform AC does not change the lesion detectability in myocardial perfusion SPECT imaging in women. The authors used a filtered backprojection (FBP) reconstruction algorithm and Chang's single iteration method for AC. In conclusion, with the proposed myocardial defect model nuclear medicine physicians demonstrated no significant difference for the detection of the anterior wall defect; however, a greater accuracy for the detection of the inferior wall defect was observed without nonuniform AC than with it. Medical physicists did not demonstrate any statistically significant difference in defect detection accuracy with or without nonuniform AC in the female phantom

  10. Elastic anisotropy of crystals

    Directory of Open Access Journals (Sweden)

    Christopher M. Kube

    2016-09-01

    Full Text Available An anisotropy index seeks to quantify how directionally dependent the properties of a system are. In this article, the focus is on quantifying the elastic anisotropy of crystalline materials. Previous elastic anisotropy indices are reviewed and their shortcomings discussed. A new scalar log-Euclidean anisotropy measure AL is proposed, which overcomes these deficiencies. It is based on a distance measure in a log-Euclidean space applied to fourth-rank elastic tensors. AL is an absolute measure of anisotropy where the limiting case of perfect isotropy yields zero. It is a universal measure of anisotropy applicable to all crystalline materials. Specific examples of strong anisotropy are highlighted. A supplementary material provides an anisotropy table giving the values of AL for 2,176 crystallite compounds.

  11. Evaluation of branched chain fatty acid, BMIPP [β-methyl-ω-(p-iodophenyl)-pentadecanoic acid] for the myocardial imaging

    International Nuclear Information System (INIS)

    Kawamura, Yasuaki; Morishita, Takeshi; Yamazaki, Junichi

    1988-01-01

    Iodine-123 labeled branched chain fatty acid BMIPP [ β -methyl-ω-(p-iodophenyl)-pentadecanoic acid] was evaluated for the myocardial imaging experimentally. 123 I-BMIPP was accumulated in the heart at 2 - 4 minutes after injection and retention in the heart was remarkable at 30 minutes. In the acute canine infarction model, infarcted area was recognized as a defect. Furthermore, in comparison between 123 I-BMIPP and 201 Tl-Cl, discrepancy between these images was recognized in the ischemic and infarcted area. BMIPP is of use in not only cardiomyopathy and hypertension, but ischemic heart desease. (author)

  12. Exercise electrocardiography and myocardial scintigraphy in the serial evaluation of the results of percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    Schall, J.M.; Chaitman, B.R.; David, P.R.; Dupras, G.; Brevers, G; Val, P.G.; Crepeau, J.; Lesperance, J.; Bourassa, M.G.

    1982-01-01

    The diagnostic value of exercise electrocardiography using 14 leads and thallium-201 scintigraphy were evaluated in 54 of 70 patients who underwent percutaneous transluminal coronary angioplasty (PTCA), both in the initial assessment and serial follow-up of patients after PTCA. Of the 45 patients who had successful PTCA, 36 had complete noninvasive studies performed before and 1 month after PTCA. The use of clinical symptoms in conjunction with the physiologic data, ECG and myocardial scintigram acquired during exercise provide important short-term data on the angiographic evolution of PTCA results. The noninvasive tests may be useful in determining guidelines for repeat angiography in patients who have had PTCA

  13. A history of a prior myocardial infarct does not negate the utility of myocardial perfusion imaging in the evaluation of acute chest pain syndromes

    International Nuclear Information System (INIS)

    Zhou Danbing; Jonathan Knott; Leeanne Grigg; Meir Lichtenstein; Nathan Better

    2004-01-01

    Purpose: Acute myocardial perfusion imaging (MPI) for evaluation of patients with acute chest pain and a non-diagnostic electrocardiogram (ECG) has a high sensitivity and moderate specificity to detect acute ischaemia and predict cardiac events. However, previous studies excluded patients with a history of prior myocardial infarction (MI). The purpose of our study was to assess the utility of acute MPI for evaluating patients with acute chest pain and a non-diagnostic ECG. We aim to study patients both with and without a history of prior MI, including normal and abnormal studies, as well as to assess the independent predictive value of a prior MI history in determining patient outcome. Methods: We studied 367 consecutive patients with (group 1, n--107) and without. (group 2, n=260) a history of prior MI. 800 MBq Tc99m sestamibi was injected while chest pain was present ('HOT' MIBI). SPECT imaging was performed 1-6 hours post injection. Scan results were reported as,normal, ischaemia, infarct or equivocal. For patients with a defect, a 24-hour painfree study ( C OLD' MIBI) was offered to differentiate ischaemia from infarct. Follow-up was at 1 year by review of the patient's medical record. Outcomes were (1) Hard cardiac events (HE), defined as cardiac death and non-fatal MI, and (2) Total cardiac events (TE), defined as HE or revascularisation. Results: For the total study population, 206 had a normal study, with a HE rate 0.97% (2/206), while 161 had an abnormal study, with HE rate 12.4% (20/161). Patients in Group 2 were much more likely to have a normal study than those in Group 1 (p<.001). An equivocal result is seen in 5 patients, with no cardiac events, while 5 patients had a non-cardiac death. These groups were too small for separate analysis. A COLD MIBI was required in 77.6% of group 1, but only 24.2% of group 2 patients (p<0.001). On univariate analysis, acute ischaemia on MIBI scan, history of prior MI, diabetes, Q wave on ECG and age are all predictors

  14. Objective evaluation of Tl-201 image efficacy for detection of myocardial infarction

    International Nuclear Information System (INIS)

    Nagai, Teruo; Murata, Kazuhiko; Torizuka, Kanji

    1982-01-01

    From 13 institutions, 343 cases were collected including 152 cases of myocardial infarction, 157 of heart diseases other than myocardial infarction, and 34 of undetermined heart diseases. Tl-201 image interpretation was conducted by 13 physicians specialized in nuclear medicine. They read twice with and without clinical information. In the reading without clinical information, sensitivity was 68.0 %; specificity, 86.3 %; accuracy, 78.0 %; in the reading with clinical information, these figures were 82.3 %, 91.5 %, and 84.7 %, respectively, showing an increase. Receiver operating characteristics analysis showed improved results in the reading with clinical information. Moreover, little variance among interpreters was suggested, but, much more effect of image quality on the results was demonstrated. (Ueda, J.)

  15. Evaluation in dogs of a new double-dose technique for imaging changes in myocardial perfusion

    International Nuclear Information System (INIS)

    Rothendler, J.A.; Okada, R.D.; Strauss, H.W.; Chesler, D.A.; Pohost, G.M.

    1984-01-01

    Assessment of myocardial perfusion with thallium immediately before and after an intervention that alters blood flow has been difficult due to presence of residual activity from the first tracer dose at the time of the second imaging. In a canine model the authors investigated a technique using two separate thallium injections during an intervention and after its reversal. Images were obtained after each injection, and a difference image was obtained by subtracting the first from the second image to correct for tracer persisting from the first injection. Interventions on coronary blood flow included: transient occlusion, subcritical stenosis with dipyridamole infusion, and permanent occlusion. The first images showed defects corresponding to the occlusion or stenosis, while the ''difference'' images correlated with myocardial perfusion at the time of the second injection

  16. Electrocardiographic left ventricular hypertrophy without echocardiographic abnormalities evaluated by myocardial perfusion and fatty acid metabolic imaging

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi

    2000-01-01

    The pathophysiologic process in patients with electrocardiographic left ventricular hypertrophy with ST, T changes but without echocardiographic abnormalities was investigated by myocardial perfusion imaging and fatty acid metabolic imaging. Exercise stress 99m Tc-methoxy-isobutyl isonitrile (MIBI) imaging and rest 123 I-beta-methyl-p-iodophenyl pentadecanoic acid (BMIPP) imaging were performed in 59 patients with electrocardiographic hypertrophy including 29 without apparent cause including hypertension and echocardiographic hypertrophy, and 30 with essential hypertension. Coronary angiography was performed in 6 patients without hypertension and 4 with hypertension and biopsy specimens were obtained from the left ventricular apex from 6 patients without hypertension. Myocardial perfusion and 123 I-BMIPP images were classified into 3 types: normal, increased accumulation of the isotope at the left ventricular apex (high uptake) and defect. Transient perfusion abnormality and apical defect observed by 123 I-BMIPP imaging were more frequent in patients without hypertension than in patients with hypertension (32% vs. 17%, p=0.04671 in perfusion; 62% vs. 30%, p=0.0236 in 123 I-BMIPP). Eighteen normotensive patients with apical defect by 123 I-BMIPP imaging included 3 of 10 patients with normal perfusion at exercise, 6 of 10 patients with high uptake and 9 of 9 patients with perfusion defect. The defect size revealed by 123 I-BMIPP imaging was greater than that of the perfusion abnormality. Coronary stenoses were not observed and myocardial specimens showed myocardial disarray with hypertrophy. Moreover, 9 patients with hypertension and apical defects by 123 I-BMIPP showed 3 different types of perfusion. Many patients without hypertension show a pathologic process similar to hypertrophic cardiomyopathy. Perfusion and 123 I-BMIPP imaging are useful for the identification of these patients. (author)

  17. Exercise-induced silent myocardial ischemia: Evaluation by thallium-201 emission computed tomography

    International Nuclear Information System (INIS)

    Kurata, C.; Sakata, K.; Taguchi, T.; Kobayashi, A.; Yamazaki, N.

    1990-01-01

    Factors associated with silent myocardial ischemia (SMI) during exercise testing were studied by means of thallium-201 emission computed tomography (ECT) in 471 patients. Coronary angiography was done in 290, of whom 167 were found to have significant coronary artery disease (CAD). Exercise-induced ischemia and its severity were defined with ECT. During exercise 108 (62%) of 173 patients with ischemia and 57 (50%) of 115 with ischemia and angiographically documented CAD had no chest pain. One third of the patients showed an inconsistency between scintigraphic ischemia and ischemia ST depression. Age, sex, prior myocardial infarction, and diabetes mellitus were not related to SMI. Patients with SMI had less severe ischemia despite a higher peak double product compared to those with painful ischemia. Among 91 with prior myocardial infarction and exercise-induced ischemia, 51 with periinfarction ischemia had a higher frequency of SMI than did 14 with ischemia remote from the prior infarct zone despite similarities in the severity of ischemia. In conclusion, factors localized within ischemic myocardium such as less severe ischemia or adjacency to a prior infarct made SMI more prevalent

  18. Evaluation of coronary hemodynamics and exercise 201Tl-myocardial scintigraphy in patients with vasospastic angina

    International Nuclear Information System (INIS)

    Matsumura, Kentaro; Nakase, Emiko; Haiyama, Tohru; Hasegawa, Akira; Saito, Takayuki

    1992-01-01

    To clarify the coronary hemodynamics and myocardial perfusion in patients with vasospastic angina, we performed exercise 201 Tl-myocardial scintigraphy (planar and SPECT) in 72 patients and left coronary digital subtraction angiography (DSA) in 37 patients without significant organic coronary artery stenosis. Coronary artery spasm was documented by coronary angiography in all patients. Fifty-four patients (75%) developed exercise-induced 201 Tl-myocardial perfusion defect on SPECT. 201 Tl pulmonary uptake (L/H) was significantly increased in patients with vasospastic angina. Especially, L/H was higher in patients with multiple small perfusion defect on 201 Tl-SPECT, so that exercise-induced left ventricular dysfunction existed in patients with vasospastic angina and especially in cases of multiple small perfusion defect on 201 Tl-SPECT. The left coronary circulation time (CCT) was prolonged in patients with vasospastic angina. The mechanism of prolonged CCT is still unknown, but we suspected that prolonged CCT was induced by increased peripheral coronary vascular resistance in patients with vasospastic angina. It was concluded that the peripheral coronary circulation was disturbed in patients with vasospastic angina, but its abnormal coronary circulation had no relation to location of spasm-induced vessels. We concluded that impaired coronary microcirculation was taken a part of pathophysiology in vasospastic angina. (author)

  19. Evaluation of the NICE mini-GRACE risk scores for acute myocardial infarction using the Myocardial Ischaemia National Audit Project (MINAP) 2003-2009: National Institute for Cardiovascular Outcomes Research (NICOR).

    Science.gov (United States)

    Simms, Alexander D; Reynolds, Stephanie; Pieper, Karen; Baxter, Paul D; Cattle, Brian A; Batin, Phillip D; Wilson, John I; Deanfield, John E; West, Robert M; Fox, Keith A A; Hall, Alistair S; Gale, Christopher P

    2013-01-01

    To evaluate the performance of the National Institute for Health and Clinical Excellence (NICE) mini-Global Registry of Acute Coronary Events (GRACE) (MG) and adjusted mini-GRACE (AMG) risk scores. Retrospective observational study. 215 acute hospitals in England and Wales. 137 084 patients discharged from hospital with a diagnosis of acute myocardial infarction (AMI) between 2003 and 2009, as recorded in the Myocardial Ischaemia National Audit Project (MINAP). Model performance indices of calibration accuracy, discriminative and explanatory performance, including net reclassification index (NRI) and integrated discrimination improvement. Of 495 263 index patients hospitalised with AMI, there were 53 196 ST elevation myocardial infarction and 83 888 non-ST elevation myocardial infarction (NSTEMI) (27.7%) cases with complete data for all AMG variables. For AMI, AMG calibration was better than MG calibration (Hosmer-Lemeshow goodness of fit test: p=0.33 vs pModel performance was reduced in patients with NSTEMI, chronic heart failure, chronic renal failure and in patients aged ≥85 years. The AMG and MG risk scores, utilised by NICE, demonstrated good performance across a range of indices using MINAP data, but performed less well in higher risk subgroups. Although indices were better for AMG, its application may be constrained by missing predictors.

  20. Significance of exercise-induced ST segment depression in patients with myocardial infarction involving the left circumflex artery. Evaluation by exercise thallium-201 myocardial single photon emission computed tomography

    International Nuclear Information System (INIS)

    Koitabashi, Norimichi; Toyama, Takuji; Hoshizaki, Hiroshi

    2000-01-01

    The significance of exercise-induced ST segment depression in patients with left circumflex artery involvement was investigated by comparing exercise electrocardiography with exercise thallium-201 single photon emission computed tomography (Tl-SPECT) and the wall motion estimated by left ventriculography. Tl-SPECT and exercise electrocardiography were simultaneously performed in 51 patients with left circumflex artery involvement (angina pectoris 30, myocardial infarction 21). In patients with myocardial infarction, exercise-induced ST depression was frequently found in the V 2 , V 3 and V 4 leads. In patients with angina pectoris, ST depression was frequently found in the II, III, aV F , V 5 and V 6 leads. There was no obvious difference in the leads of ST depression in patients with myocardial infarction with ischemia and without ischemia on Tl-SPECT images. In patients with myocardial infarction, the lateral wall motion of the infarcted area evaluated by left ventriculography was more significantly impaired in the patients with ST depression than without ST depression (p<0.01). Exercise-induced ST depression in the precordial leads possibly reflects wall motion abnormality rather than ischemia in the lateral infarcted myocardium. (author)

  1. Clinical evaluation of 99Tcm-MIBI myocardial perfusion imaging for the detection of coronary artery disease in patients with metabolic syndrome

    International Nuclear Information System (INIS)

    Tian Yueqin; Wei Hongxing; Guo Xinhua; Guo Feng; He Zuoxiang

    2008-01-01

    Objective: Metabolic syndrome is a combination of medical disorders that consist of a collection of independent factors at risk of developing coronary artery disease. The purpose of this study was to evaluate the value of 99 Tc m -methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging for the diagnosis of coronary artery disease in patients with metabolic syndrome. Methods: A total of 251 patients [mean age (59 ± 10) years, 179 men, 72 women] were included in this study. All patients underwent exercise and rest 99 Tc m -MIBI myocardial perfusion imaging and coronary angiography. Results: Of the 163 patients with significant coronary artery stenosis, 116 showed abnormal 99 Tc m -MIBI myocardial perfusion imaging; and among the 88 patients with normal coronary angiography, 82 showed normal myocardial perfusion imaging. The sensitivity, specificity and accuracy of 99 Tc m -MIBI myocardial perfusion imaging for coronary artery disease detection were 71% (116/163), 93% (82/88) and 79% (198/251), respectively. The positive and negative predictive values were 95% (116/122) and 64% (82/129), respectively. Conclusion: 99 Tc m -MIBI myocardial perfusion imaging has important clinical value for detecting coronary artery disease in patients with metabolic syndrome. (authors)

  2. The causes and clinical significance of exercise-induced silent myocardial ischemia evaluated by ischemic range and intensity with exercise Tl-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Moriai, Naoki; Nakai, Kenji; Hiramori, Katsuhiko

    1992-01-01

    We investigated the causes and long-term prognosis of exercise-induced silent myocardial ischemia (SMI) by means of exercise Tl-201 myocardial SPECT (Ex-SPECT) in 97 patients with effort angina or old myocardial infarction (OMI). These patients were proven to have significant stenosis by coronary angiography. The subjects were divided into three groups based on the presence or absence of Tl-201 redistribution (RD) or angina during exercise testing. Group one consisted of 34 patients who had RD on Ex-SPECT and angina during exercise testing: the painful myocardial ischemia (PMI) group. The second group consisted of 38 patients who had RD on Ex-SPECT, but no angina during exercise testing: the SMI group. The third group consisted of 25 patients who had no RD: the RD (-) group. The ischemic range and intensity were quantified by the defect volume ratio (DVR) and defect severity index (DSI), respectively. Comparison of the DVR and DSI values for the PMI and SMI groups revealed that the DVR and DSI values for the SMI group were lower than those of the PMI group. Also the prognosis of the SMI group tended to be worse than that of the RD (-) group. Thus, we concluded that the SMI and PMI groups should receive identical treatment. (author)

  3. Left ventricular regional myocardial motion and twist function in repaired tetralogy of Fallot evaluated by magnetic resonance tissue phase mapping

    International Nuclear Information System (INIS)

    Chang, Meng-Chu; Peng, Hsu-Hsia; Wu, Ming-Ting; Weng, Ken-Pen; Su, Mao-Yuan; Menza, Marius; Huang, Hung-Chieh

    2018-01-01

    We aimed to characterise regional myocardial motion and twist function in the left ventricles (LV) in patients with repaired tetralogy of Fallot (rTOF) and preserved LV global function. We recruited 47 rTOF patients and 38 age-matched normal volunteers. Tissue phase mapping (TPM) was performed for evaluating the LV myocardial velocity in longitudinal, radial, and circumferential (Vz, Vr, and VOe) directions in basal, middle, and apical slices. The VOe peak-to-peak (PTP) during systolic phases, the rotation angle of each slice, and VOe inconsistency were computed for evaluating LV twist function and VOe dyssynchrony. As compared to the controls, the rTOF patients presented decreased RV ejection fraction (RVEF) (p = 0.002) and preserved global LV ejection fraction (LVEF). They also demonstrated decreased systolic and diastolic Vz in several LV segments and higher diastolic Vr in the septum (all p < 0.05). A lower VOe PTP, higher VOe inconsistency, and reduced peak net rotation angle (all p < 0.05) were observed. The aforementioned indices demonstrated an altered LV twist function in rTOF patients in an early disease stage. MR TPM could provide information about early abnormalities of LV regional motion and twist function in rTOF patients with preserved LV global function. (orig.)

  4. Left ventricular regional myocardial motion and twist function in repaired tetralogy of Fallot evaluated by magnetic resonance tissue phase mapping

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Meng-Chu; Peng, Hsu-Hsia [National Tsing Hua University, Department of Biomedical Engineering and Environmental Sciences, Hsinchu (China); Wu, Ming-Ting [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (China); National Yang-Ming University, Faculty of Medicine, Taipei (China); Weng, Ken-Pen [National Yang-Ming University, Faculty of Medicine, Taipei (China); Kaohsiung Veterans General Hospital, Department of Pediatrics, Kaohsiung (China); Shu-Zen Junior College of Medicine and Management, Department of Physical Therapy, Kaohsiung (China); Su, Mao-Yuan [National Taiwan University Hospital, Department of Medical Imaging, Taipei (China); Menza, Marius [Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Radiology, Medical Physics, Freiburg (Germany); Huang, Hung-Chieh [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (China)

    2018-01-15

    We aimed to characterise regional myocardial motion and twist function in the left ventricles (LV) in patients with repaired tetralogy of Fallot (rTOF) and preserved LV global function. We recruited 47 rTOF patients and 38 age-matched normal volunteers. Tissue phase mapping (TPM) was performed for evaluating the LV myocardial velocity in longitudinal, radial, and circumferential (Vz, Vr, and VOe) directions in basal, middle, and apical slices. The VOe peak-to-peak (PTP) during systolic phases, the rotation angle of each slice, and VOe inconsistency were computed for evaluating LV twist function and VOe dyssynchrony. As compared to the controls, the rTOF patients presented decreased RV ejection fraction (RVEF) (p = 0.002) and preserved global LV ejection fraction (LVEF). They also demonstrated decreased systolic and diastolic Vz in several LV segments and higher diastolic Vr in the septum (all p < 0.05). A lower VOe PTP, higher VOe inconsistency, and reduced peak net rotation angle (all p < 0.05) were observed. The aforementioned indices demonstrated an altered LV twist function in rTOF patients in an early disease stage. MR TPM could provide information about early abnormalities of LV regional motion and twist function in rTOF patients with preserved LV global function. (orig.)

  5. Image quality improvements using adaptive statistical iterative reconstruction for evaluating chronic myocardial infarction using iodine density images with spectral CT.

    Science.gov (United States)

    Kishimoto, Junichi; Ohta, Yasutoshi; Kitao, Shinichiro; Watanabe, Tomomi; Ogawa, Toshihide

    2018-04-01

    Single-source dual-energy CT (ssDECT) allows the reconstruction of iodine density images (IDIs) from projection based computing. We hypothesized that adding adaptive statistical iterative reconstruction (ASiR) could improve image quality. The aim of our study was to evaluate the effect and determine the optimal blend percentages of ASiR for IDI of myocardial late iodine enhancement (LIE) in the evaluation of chronic myocardial infarction using ssDECT. A total of 28 patients underwent cardiac LIE using a ssDECT scanner. IDIs between 0 and 100% of ASiR contributions in 10% increments were reconstructed. The signal-to-noise ratio (SNR) of remote myocardia and the contrast-to-noise ratio (CNR) of infarcted myocardia were measured. Transmural extent of infarction was graded using a 5-point scale. The SNR, CNR, and transmural extent were assessed for each ASiR contribution ratio. The transmural extents were compared with MRI as a reference standard. Compared to 0% ASiR, the use of 20-100% ASiR resulted in a reduction of image noise (p ASiR images, reconstruction with 100% ASiR image showed the highest improvement in SNR (229%; p ASiR above 80% showed the highest ratio (73.7%) of accurate transmural extent classification. In conclusion, ASiR intensity of 80-100% in IDIs can improve image quality without changes in signal and maximizes the accuracy of transmural extent in infarcted myocardium.

  6. Myocardial Bridging

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2016-02-01

    Full Text Available Abstract Myocardial bridging is rare. Myocardial bridges are most commonly localized in the middle segment of the left anterior descending coronary artery. The anatomic features of the bridges vary significantly. Alterations of the endothelial morphology and the vasoactive agents impact on the progression of atherosclerosis of myocardial bridging. Patients may present with chest pain, myocardial infarction, arrhythmia and even sudden death. Patients who respond poorly to the medical treatment with β-blockers warrant a surgical intervention. Myotomy is a preferred surgical procedure for the symptomatic patients. Coronary stent deployment has been in limited use due to the unsatisfactory long-term results.

  7. Evaluation by contrast-enhanced MR imaging of the lateral border zone in reperfused myocardial infarction in a cat model

    International Nuclear Information System (INIS)

    Jeong, Ae Kyung; Choi, Sang Il; Kim, Dong Hun; Park, Sung Bin; Lee, Seoung Soo; Choi, Seong Hoon; Lim, Tae Hwan

    2000-01-01

    To identify and evaluate the lateral border zone by comparing the size and distribution of the abnormal signal area demonstrated by MR imaging with the infarct area revealed by pathological examination in a reperfused myocardial infarction cat model. In eight cats, the left anterior descending coronary artery was occluded for 90 minutes, and this was followed by 90 minutes of reperfusion. ECG-triggered breath-hold turbo spin-echo T2-weighted MR images were initially obtained along the short axis of the heart before the administration of contrast media. After the injection of Gadomer-17 and Gadophrin-2, contrastenhanced T1-weighted MR images were obtained for three hours. The size of the abnormal signal area seen on each image was compared with that of the infarct area after TTC staining. To assess ultrastructural changes in the myocardium at the infarct area, lateral border zone and normal myocardium, electron microscopic examination was performed. The high signal area seen on T2-weighted images and the enhanced area seen on Gadomer-17-enhanced T1WI were larger than the enhanced area on Gadophrin-2-enhanced T1WI and the infarct area revealed by TTC staining; the difference was expressed as a percentage of the size of the total left ventricle mass (T2= 39.2 %; Gadomer-17 =37.25 % vs Gadophrin-2 = 29.6 %; TTC staining = 28.2 %; p < 0.05). The ultrastructural changes seen at the lateral border zone were compatible with reversible myocardial damage. In a reperfused myocardial infarction cat model, the presence and size of the lateral border zone can be determined by means of Gadomer-17- and Gadophrin-2-enhanced MR imaging

  8. Evaluation of diagnostic efficiency of intelligence program for automatic diagnosis of circumferential profiles of myocardial short axial SPECT

    International Nuclear Information System (INIS)

    Bunko, Hisashi; Tada, Akira; Nakajima, Kenichi; Taki, Junichi; Kojima, Kazuhiko.

    1984-01-01

    Quantitative diagnosis using circumferential profile (CFP) is widely employed for Tl-201 myocardial imaging. However, its diagnostic efficiency is susceptible to the number and composition of the confirmed normal (CN) group. Intelligence program for CFP data file and automatic diagnosis (CAD), which was previously developed by us, was modified for creating universal data file (d-base) and evaluated its diagnostic efficiency for myocardial short axial images according to the number of CNs. CAD consists of following 3 major functions: (1) CFP data filing to d-base, (2) modification and correction of file data, and (3) automatic diagnosis of CFP. When function (1) or (2) is completed, new diagnostic criteria (mean-2 sd) are generated automatically using CN data in the d-base at that time. Because of this function, diagnostic criteria are changeable according to the number of CNs. Sensitivity (TP) and specificity (TN) of CAD program for Tl-201 7-pinhole images of 16 normals and 17 ischemic heart diseases (IHDs) were 100%, 44% (CN = 4), 88%, 94% (CN = 8 or 16) and 88%, 100% (CN = 12), respectively. Diagnostic efficiency reached plateau in more than 8 CNs. Although number of patients were limited (8 CNs and 6 IHDs), results of CAD for short axial SPECT showed consistent tendency with 7-pinhole images. In conclusion, intelligence program is necessary for automatic diagnosis using quantitative criteria under the clinical condition of daily increasing informations. Automatic diagnosis of CFP using CAD program is simple, effective and useful for interpretation of Tl-201 myocardial short axial images. CAD program is applicable to any quantitative distribution study using CFPs. (author)

  9. Myocardial response to a triathlon in male athletes evaluated by Doppler tissue imaging and biochemical parameters

    DEFF Research Database (Denmark)

    Leetmaa, T H; Dam, A; Glintborg, D

    2008-01-01

    (cTnT) and pro-brain natriuretic peptide (pro-BNP)] and echocardiography. Conventional echocardiography techniques and new Doppler tissue imaging (DTI) modalities were applied before and immediately after the competition. Blood samples were drawn 1 week before, immediately after and 12-24 h post...... and systolic velocities decreased, thus suggesting reversible cardiac fatigue. When using cardiac markers and echocardiographic findings, a triathlon was found to have no significant negative effects on left ventricular function or myocardial tissue in male athletes....

  10. EVALUATION OF CARDIOPROTECTIVE ACTIVITY OF MEDOHAR VATI BY ISOPROTERENOL INDUCED MYOCARDIAL DAMAGE IN RATS

    OpenAIRE

    Patel Jignasa S; Setty Seema K; Chakraborty Manodeep; Kamath Jagadish V

    2012-01-01

    This study was designed to investigate the cardioprotective activity of poly herbal formulation Medohar vati in isoproterenol (ISO)- induced myocardial necrosis in rats. Animals were treated with Medohar vati (150 and 300 mg/kg for 21 days) and Carvedilol (10mg/kg for 7 days) to the rats treated with ISO (85 mg/kg, sc) on the 22th and 23rd days. The group only treated with ISO demonstrated elevated level of Lactate dehydrogenasa (LDH), Creatine kinase (CK-MB) and CK- NAC in serum which was r...

  11. Clinical and statistical evaluation of the occurrence of acute myocardial infarction in the cold inland area of Hokkaido.

    Science.gov (United States)

    Hirasawa, K; Shibata, J; Yamamura, K

    1989-07-01

    We made a clinical and statistical evaluation of the occurrence of acute myocardial infarction with respect to the relation between its occurrence and the meterology of the cold inland area of Hokkaido (the Kamikawa Basin) over a period of 10 years (1976-1985). A total of 581 cases were studied. Monthly fluctuation of incidence was not found to be statistically significant. A cold period in the Kamikawa Basin was defined in this study as the period when ordinary mean atmospheric temperatures were below 0 degree C (from 7 Nov. to 16 Apr.). Canonical discriminant analysis was applied to 10 meterological factors between the days with occurrences and those without occurrences (245 days vs 245 days) in the cold periods of the investigated 10 years, and between the days with outdoor occurrences and those without occurrences (37 days vs 37 days). In order to compare the regional difference, this analysis was done on the same 10 factors for the cold periods over 3 years in Yamagata (46 days vs 46 days). The F values of 0.0003, 0.0155 and 0.0098 respectively in the above 3 analyses were small (much less than F 1(9) (0.25) = 1.51). A circadian rhythm of 2 cycles/day was recognized concerning the time of occurrence by power spectral analysis of the data of 562 patients for whom the time of the onset of myocardial infarction was known. Subdividing the patients into 2 groups according to physical activity just before the occurrence, the group who experienced an occurrence at rest showed a rhythm of 1 cycle/day, and the group who experienced an occurrence on effort showed a rhythm of 2 cycles/day. Therefore, the 10 meterological factors could not discriminate the probabilities between the days with occurrences and the days without occurrences of myocardial infarction in the cold periods. On the other hand, it was suggested that biological intrinsic rhythm participates in triggering the occurrence of myocardial infarction.

  12. Novel synthesis and initial preclinical evaluation of (18)F-[FDG] labeled rhodamine: a potential PET myocardial perfusion imaging agent.

    Science.gov (United States)

    AlJammaz, Ibrahim; Al-Otaibi, Basim; AlHindas, Hussein; Okarvi, Subhani M

    2015-10-01

    Myocardial perfusion imaging is one of the most commonly performed investigations in nuclear medicine studies. Due to the clinical importance of [(18)F]-fluoro-2-deoxy-D-glucose ([(18)F]-FDG) and its availability in almost every PET center, a new radiofluorinated [(18)F]-FDG-rhodamine conjugate was synthesized using [(18)F]-FDG as a prosthetic group. In a convenient and simple one-step radiosynthesis, [(18)F]-FDG-rhodamine conjugate was prepared in quantitative radiochemical yields, with total synthesis time of nearly 20 min and radiochemical purity of greater than 98%, without the need for HPLC purification, which make these approaches amenable for automation. Biodistribution studies in normal rats at 60 min post-injection demonstrated a high uptake in the heart (>11% ID/g) and favorable pharmacokinetics. Additionally, [(18)F]-FDG-rhodamine showed an extraction value of 27.63%±5.12% in rat hearts. These results demonstrate that [(18)F]-FDG-rhodamine conjugate may be useful as an imaging agent for the positron emission tomography evaluation of myocardial perfusion. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Evaluation of myocardial viability with 99Tcm-tetrofosmin after nitrate administration: comparison with FDG PET imaging

    International Nuclear Information System (INIS)

    He Wei; Cuocolo, A.

    2007-01-01

    Objective: The purpose of this study was to assess the relationship between tetrofosmin uptake after nitrate administration and the metabolic activity assessed by 18 F-FDG PET in patients with ischemic left ventricular (LV) dysfunction. Methods: A baseline 99 Tc m -tetrofosmin SPECT at rest and a repeated study after sublingual administration of 10 mg isosorbide dinitrate within two days were undertaken in 36 patients with chronic myocardial infarction and LV dysfunction. All patients underwent metabolic PET imaging with 18 F-FDG in the following week. 99 Tc m -tetrofosmin uptake and metabolic activity in 13 segments of myocardium were measured in every patient. A 55% peak activity on tetrofosmin and 50% peak activity on FDG were used as the differential threshold in evaluating myocardial viability, and the uptakes compared with regional LV function assessed by echocardiography. Results: Fifty-three (40%) of the 131 akinetic or dyskinetic segments had reduced tracer uptake. Of those segments, 14 (26%) segments showed increased tetrofosmin uptake after nitrate intervention (>10% vs baseline), 39 (74%) segments remained no change. The sensitivity and specificity of baseline tetrofosmin SPECT for detecting preserved metabolic activity were 69% and 86%, respectively. After nitrate administration, the sensitivity increased to 81% (P 99 Tc m -tetrofosmin SPECT after nitrate administration may improve the identification of ischemic but still viable myocardium in patients with chronic ischemic LV dysfunction. (authors)

  14. Multidetector computed tomography (MDCT) evaluation of myocardial viability: intraindividual comparison of monomeric vs. dimeric contrast media in a rabbit model

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H. [RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany)]|[RWTH Aachen University, Applied Medical Engineering, Helmholtz Institute, Aachen (Germany)]|[University Hospital, RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany); Jost, Gregor; Sieber, Martin; Seidensticker, Peter R.; Pietsch, Hubertus [Bayer-Schering Pharma AG, Berlin (Germany); Bruners, Philipp [RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany)]|[RWTH Aachen University, Applied Medical Engineering, Helmholtz Institute, Aachen (Germany); Guenther, Rolf W. [RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany)

    2009-02-15

    To evaluate the influence of different types of iodinated contrast media on the assessment of myocardial viability, acute myocardial infarction (MI) was surgically induced in six rabbits. Over a period of 45 min, contrast-enhanced cardiac MDCT (64 x 0.6 mm, 80 kV, 680mAs{sub eff.}) was repeatedly performed using a contrast medium dose of 600 mg iodine/kg body weight. Animals received randomized iopromide 300 and iodixanol 320, respectively. Attenuation values of healthy and infarcted myocardium were measured. The size of MI was computed and compared with nitroblue tetrazolium (NBT)-stained specimen. The highest attenuation differences between infarcted and healthy myocardium occurred during the arterial phase with 140.0{+-}3.5 HU and 141.0{+-}2.2 HU for iopromide and iodixanol, respectively. For iodixanol the highest attenuation difference on delayed contrast-enhanced images was achieved 3 min post injection (73.5 HU). A slightly higher attenuation difference was observed for iopromide 6 min after contrast medium injection (82.2 HU), although not statistically significant (p=0.6437). Mean infarct volume as measured by NBT staining was 33.5%{+-}13.6%. There was an excellent agreement of infarct sizes among NBT-, iopromide- and iodixanol-enhanced MDCT with concordance-correlation coefficients ranging from {rho}{sub (c)=} 0.9928-0.9982. Iopromide and iodixanol both allow a reliable assessment of MI with delayed contrast-enhanced MDCT. (orig.)

  15. A new dynamic myocardial phantom for evaluation of SPECT and PET quantitation in systolic and diastolic conditions

    International Nuclear Information System (INIS)

    Dreuille, O. de; Bendriem, B.; Riddell, C.

    1996-01-01

    We present a new dynamic myocardial phantom designed to evaluate SPECT and PET imaging in systolic and diastolic conditions. The phantom includes a thoracic attenuating media and the myocardial wall thickness varying during the scan can be performed. In this study the phantom was used with three different wall thickness characteristic of a systolic, end-diastolic and pathologic end-diastolic condition. The myocardium was filled with 99m Tc, 18 F and Gd and imaged by SPECT, PET and MRI. SPECT attenuation correction was performed using a modified PET transmission. A bull's eyes image was obtained for all data and wall ROI were then drawn for analysis. Using MRI as a reference, error from PET, SPECT and attenuation corrected SPECT were calculated. Systolic PET performances agree with MRI. Quantitation loss due to wall thickness reduction compared to the systole. Attenuation correction in SPECT leads to significant decrease of the error both in systole (from 29% to 14%) and diastole (35% to 22%). This is particularly sensitive for septum and inferior walls. SPECT residual errors (14% in systole and 22% in pathologic end-diastole) are likely caused by scatter, noise and depth dependent resolution effect. The results obtained with this dynamical phantom demonstrate the quantitation improvement achieved in SPECT with attenuation correction and also reinforce the need for variable resolution correction in addition to attenuation correction

  16. Rest/exercise thallium myocardial perfusion imaging: a new and rapid technique to evaluate coronary artery disease

    International Nuclear Information System (INIS)

    Segall, G.M.; Zipkin, R.E.; Stanford Univ., CA

    1993-01-01

    Twenty-six patients underwent conventional exercise/4-h redistribution thallium myocardial perfusion imaging as well as rest/exercise imaging on different days. For the rest/exercise study, patients were inmaged 10 min after receiving 1 mCi thallium at rest. The resting study was immediately followed by symptom-limited treadmill exercise. Patients were injected with 2 mCi thallium at peak exercise and imaged 10 min later. The entire rest/exercise study was completed in 2 h. There was a high degree of correlation between the two studies. Of the 130 segments analysed, 84 were normal and 46 were abnormal by exercise/redistribution imaging whereas 88 were normal and 42 were abnormal by rest/exercise imaging. Among the 14 patients who had coronary arteriography, both exercise/redistribution and rest/exercise imaging correctly identified 23/35 segments as abnormal (sensitivity [pi003] 66% and 34/35 segments as normal (specificity=97%). Furthermore, abnormal segments were more likely to be reversible on the rest/exercise study. The results suggest that the accuracy of rest/exercise thallium imaging is equal to conventional exercise/redistribution imaging in the evaluation of coronary artery disease. The significant time economy and possible improvement in assessing myocardial viability are important potential advantages of this new technique. (Author)

  17. Functional significance of coronary collateral circulation during dynamic exercise evaluated by thallium-201 myocardial scintigraphy

    International Nuclear Information System (INIS)

    Wainwright, R.J.; Maisey, M.N.; Edwards, A.C.; Sowton, E.

    1980-01-01

    Sixty-five patients with angiographically documented coronary artery disease were investigated by thallium-201 ( 201 Tl) scintigraphy to determine the role of the collateral circulation during dynamic exercise. Fifty-three patients had complete proximal occlusion of at least one major coronary artery. One patient had total occlusion of all three major coronary arteries. Sixty-four collateral channels were identified, graded, and compared with corresponding regions of the myocardial scintigram. Tracer uptake was also graded and classified as various degrees of protection from ischaemia. A significant correlation between good collaterals with complete protection and poor or absent collaterals with no protection was noted. Seventeen patients (20 occluded vessels) had total coronary occlusion without myocardial infarction. Collaterals conferred protection in 9/15 occlusions whereas no protection was seen in five occlusions without collaterals. There was no difference in the protective role of homocoronary and heterocoronary collateral vessels. Hypertrophy of the first septal left anterior descending perforator conferred significant protection from ischaemia in contrast to bridging collaterals and ghosting. During exercise the right coronary bed is preferentially protected from ischaemia, in contrast to the left anterior descending territory. This probably reflects the direction of a transmural flow gradient between left and right ventricles during exercise. (author)

  18. Evaluation of left ventricular hypertrophy using thallium-201 myocardial scintigraphy, echocardiography and vectorcardiography

    International Nuclear Information System (INIS)

    Tsukahara, Yasunori; Owada, Kenji; Suzuki, Shigebumi

    1983-01-01

    Thallium-201 ( 201 Tl) myocardial scintigraphy was performed in 40 patients with left ventricular hypertrophy(LVH). Twelve out of 40 patients had pressure overloading (Aortic stenosis: 5, Hypertension: 7), 14 patients had volume overloading (Aortic regurgitation: 9, Mitral regurgitation: 5) and 14 had idiopathic cardiomyopathy (Hypertrophic type (HCM): 8, Congestive type (CCM): 6), respectively. LV area, LV uptake index and Wall uptake ratio were calculated from left anterior oblique view of 201 Tl myocardial images. These three indices of both pressure overloading and volume overloading were significantly higher than those of controls. The degree of LVH was indicated by both LV area and LV uptake index. LV area was significantly larger in volume overloading than in pressure overloading. In idiopathic cardiomyopathy, these three indices of HCM and LV area and LV uptake index of CCM were significantly increased compared with those of controls. LV area of CCM was significantly larger than that of HCM, while Wall uptake ratio of HCM was significantly higher than that of CCM. LV uptake index and Wall uptake ratio of HCM became higher according as left ventricular cavity became smaller. LV area of CCM became larger in proportion as left ventricular cavity became larger and as left ventricular wall thickness became thinner. (author)

  19. Combined 201Th myocardial scintiscanning and ECG-triggered ventricular scintiscanning for an evaluation of the left ventricular function after myocardial infarction

    International Nuclear Information System (INIS)

    Nuetzel, W.

    1978-01-01

    74 patients in whom old transmural myocardial infarctions had been detected by catheterisation of the heart were examined by 201 Th myocardial scintiscanning and ECG-triggered ventricular scintiscanning. There was a control group of 16 patients where coronary disease was excluded by the catheter examination. The findings of the nuclear methods are compared with those of invasive and non-invasive cardiological diagnostics. Nuclear techniques were more sensitive (95%) than ECG (77%) in detecting old infarctions. In volumina determination, there was a satisfactory correlation with angiography for the telediastolic volume (r = 0.77) and a good correlation for the telesystolic volume (r = 0.84) and the ejection fraction (r = 0.89). (orig./AJ) [de

  20. Evaluation of myocardial fatty acid metabolism in the area of fill-in after thallium reinjection in patients with prior myocardial infarction

    International Nuclear Information System (INIS)

    Matsunari, Ichiro; Fujino, Susumu; Nishikawa, Takahiro; Ichiyanagi, Kenji; Taki, Junichi; Nakajima, Kenichi; Tonami, Norihisa; Hisada, Kinichi.

    1995-01-01

    Myocardial fatty acid utilization in the area with thallium fill-in after reinjection was assessed using 123 I-labeled 15-(p-iodophenyl) 3R, S-methylpentadecanoic acid (BMIPP). We studied 22 patients with prior myocardial infarction that revealed persistent defects on standard exercise-redistribution thallium imaging. In each patient, exercise-redistribution-reinjection thallium imaging was performed. Within two weeks of the thallium study, resting BMIPP imaging was performed 20 min after injection of BMIPP (148 MBq). Following qualitative analysis of the obtained thallium and BMIPP images, quantitative analysis was performed on the basis of relative regional uptake. Of 199 myocardial segments that showed persistent defects on exercise-redistribution images, 73 segments showed apparent fill-in on the reinjection images (fill-in positive), and the remaining 126 segments did not (fill-in negative). When BMIPP images were compared with the corresponding thallium reinjection images, reduced BMIPP uptake compared with thallium was frequently observed in the area of fill-in positive segments (65 of 73 segments, 89%). Quantitative analysis also showed decrease in BMIPP activity compared to thallium activity in the area of fill-in (49.7±16.1 vs. 65.8±16.0%, p<0.001). In contrast, only 24 of the 126 fill-in negative segments (19%) showed lower BMIPP uptake than thallium. These results suggest that impaired fatty acid utilization in the area of thallium new fill-in after reinjection already exists at resting condition. Thus, BMIPP imaging combined with exercise-redistribution-reinjection thallium imaging provides insights to understanding fatty acid utilization in ischemic but viable myocardium identified by thallium reinjection in patients with prior myocardial infarction. (author)

  1. Short-lived cyclotron produced radionuclides evaluation on the myocardial imaging agents

    International Nuclear Information System (INIS)

    Rikitake, Tomoyuki; Tateno, Yukio; Yamane, Akiko; Matsumoto, Touru; Umegaki, Youichiro

    1978-01-01

    Organ uptake after venous administration of 13 N-ammonia, 43 K, 86 Rb, 201 Tl and after rectal administration of 13 N-ammonia was studied. Each nuclides highly accumulated in myocardium after intravenous injection, but rectal administrated 13 N-ammonia did not show this tendency. Intravenously injected 13 N-ammonia showed very early myocardial uptake and early secretion from kidney. Rectal administrated 13 N-ammonia was less accumulated in myocardium. 43 KCl and 13 NH 4 Cl were injected intravenously and administrated from the rectum to the rabbits under imaging scintilator system. Whole-body scintiscanner with display-processing unit was used for a 43 KCl injected rabbit. A positroncamera with computer system (TOSBAC 3400 on line system) was used for 13 NH 4 Cl (i.v. and rectal ad.) rabbits. The dynamic studies of 43 KCl, 13 NH 4 Cl were made from these imaging data. The countratio of heart to the liver after 43 K injection was nearly equal or less than the liver. The peakcount was at 15 min after 13 NH 4 Cl intravenous injection. 13 N accumulated promptly at upper mediastinal part and kidney, and soon disappeared from these part. Uptake of the heat was high and that of the liver was low. When 13 NH 4 Cl was administrated from the rectum, 13 N trapped at the liver, and uptake of the heart was very low level. Scintiscanning after 13 KCl intravenously injected, did not show the high resolution. Rabbit heart was distinguishable from the liver, but there are no visibility of the detail. Seeing positronscintigram after 13 NH 4 Cl administration both from intravenously and from rectum, the detail was well visible. We concluded the positron scintigram after 13 NH 4 Cl injection should be a good myocardial imaging agent. Furthermore, 13 Nh 4 Cl has two eminent characters as a myocardial imaging agent comparing 201 TlCl. One is prompt making of image, the others is the very low radiation dose. (auth.)

  2. Shape anisotropy: tensor distance to anisotropy measure

    Science.gov (United States)

    Weldeselassie, Yonas T.; El-Hilo, Saba; Atkins, M. S.

    2011-03-01

    Fractional anisotropy, defined as the distance of a diffusion tensor from its closest isotropic tensor, has been extensively studied as quantitative anisotropy measure for diffusion tensor magnetic resonance images (DT-MRI). It has been used to reveal the white matter profile of brain images, as guiding feature for seeding and stopping in fiber tractography and for the diagnosis and assessment of degenerative brain diseases. Despite its extensive use in DT-MRI community, however, not much attention has been given to the mathematical correctness of its derivation from diffusion tensors which is achieved using Euclidean dot product in 9D space. But, recent progress in DT-MRI has shown that the space of diffusion tensors does not form a Euclidean vector space and thus Euclidean dot product is not appropriate for tensors. In this paper, we propose a novel and robust rotationally invariant diffusion anisotropy measure derived using the recently proposed Log-Euclidean and J-divergence tensor distance measures. An interesting finding of our work is that given a diffusion tensor, its closest isotropic tensor is different for different tensor distance metrics used. We demonstrate qualitatively that our new anisotropy measure reveals superior white matter profile of DT-MR brain images and analytically show that it has a higher signal to noise ratio than fractional anisotropy.

  3. Angiotensin-converting enzyme inhibition after myocardial infarction: the Trandolapril Cardiac Evaluation Study

    DEFF Research Database (Denmark)

    Torp-Pedersen, C; Køber, L; Carlsen, J

    1996-01-01

    % of patients in both treatment groups reached the target dose of 4 mg trandolapril or placebo at the end of dose titration. Nearly half of the patients in both treatment groups discontinued taking study medication before death or trial closure. The need for open-label ACE inhibition was the reason...... for discontinuation for 48 and 75 patients in the trandolapril and placebo groups, respectively. In conclusion, long-term treatment with trandolapril in patients with reduced left ventricular function shortly after myocardial infarction significantly reduced mortality and morbidity. Most patients received the target...... dose of 4 mg trandolapril daily. The benefit observed is likely to reflect the benefit in clinical practice because the majority of eligible patients were randomized and the difference in patients leaving the trial to receive open-label ACE inhibition was moderate....

  4. An evaluation of the ECG gated cardiac CT on old myocardial infarction

    International Nuclear Information System (INIS)

    Tanegashima, Kazuhiro; Tejima, Yasuaki; Nakasone, Noriyo; Hyodo, Haruo

    1984-01-01

    In order to examine the accuracy of ECG gated cardiac CT (G-CCT), G-CCT findings were compared with ECG and cardiac echographic findings in 25 cases of old myocardial infarction. From the detection rate according to the infarct area, abnormal findings in the anterior wall and the septum obtained from G-CCT were in good accordance with those from ECG. Although all of the G-CCT findings did not agree with those of cardiac echography in cases in which abnormal findings were seen in multiple areas, the detection rate of cardiac abnormal findings as a whole by G-CCT was the same as that by cardiac echography. (Namekawa K.)

  5. Thallium-201 myocardial perfusion scintigraphy to evaluate patients with chest pain (preliminary study)

    International Nuclear Information System (INIS)

    Mahfouz, M.; Elhaddad, S.; Elghoneimy, I.; Elmesidy, S.; Haggag, F.; Sbdou, S.; Dayem, K.A.; Ezzeldiy, H.

    1985-01-01

    201 Tl perfusion scintigraphy for the diagnosis of coronary artery disease was carried out in 25 patients of mean age years, presenting with chest pain. Scintiscan were obtained at rest and after exercise and were compared with ECG studies at rest and after exercise. In all patients with previous myocardial infarctions, perfusion defects were present at rest, two of these patients showed abnormal stress scintigraphy consistent with a new ischemic response which was not detected by the stress ECG. In 3 out of the 8 patients with normal ECG, in 2 out of the 4 patients with response suggesting ischemia and in 4 out of the 7 patients with definite ECG proof of ischemia infarction was detected by 201 Tl. In all the previous, resting and exercise ECG failed to show evidence of infarction.1 fig.,2 tab

  6. Technetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom.

    LENUS (Irish Health Repository)

    Wong, C F

    2008-06-01

    Because death with a functioning graft remains one of the most important causes of long-term renal transplant failure, cardiac risk stratification and screening for coronary artery disease are essential components of pretransplant assessment. Pretransplant screening for occult coronary artery disease in a subset of these patients may improve outcome. The UK follows the European Best practice guideline 1.5.5 E. Although echocardiography, thallium myocardial perfusion scanning (MPS), dobutamine stress echocardiography, and coronary angiography have been suggested as means of cardiovascular assessment, the best means of assessment remains undetermined. Therefore, we investigated the role of 99m technetium sestamibi myocardial perfusion scanning as an assessment tool for identifying those patients with end-stage renal failure at high risk of cardiovascular death after renal transplantation. Retrospectively, we studied 126 patients that had a MPS as part of their pretransplant assessment. Overall unadjusted survival was 65% at 3 years. Twelve deaths resulted from cardiovascular causes. A reversible defect on MPS was associated with a fatal cardiac event and all-cause mortality. The unadjusted hazard ratio of cardiac event with reversible defect on MPS was 3.1 (95% confidence interval, 1.1 to 18.2) and hazard ratio of death with reversible defect on MPS was 1.92 (95% confidence interval, 1.1 to 4.4). Thus, MPS may be a useful tool in cardiac risk stratification and in selecting patients with a favorable outcome after renal transplantation. Our patients with a reversible defect in particular have increased cardiac mortality. This group may benefit from coronary angiography.

  7. Evaluation of nonradioactive, colored microspheres for measurement of regional myocardial blood flow in dogs

    International Nuclear Information System (INIS)

    Hale, S.L.; Alker, K.J.; Kloner, R.A.

    1988-01-01

    Measurement of regional myocardial blood flow (RMBF) is crucial in experimental studies of myocardial ischemia and reperfusion in dogs. The standard measurement technique uses radioactive microspheres; however, not all institutions are able to dispose of radioactive waste and therefore cannot make use of this method. We tested a new, nonradioactive microsphere, labeled with colors instead of nuclides. Simultaneous blood flow measurements with two nuclide-labeled and two colored microspheres were performed after coronary occlusion in dogs. Both techniques show a within-method correlation of r greater than 0.98. Duplicate variability for paired RMBF values in 80 samples was 8.7 +/- 0.1% when computed with radioactive microspheres and 13.2 +/- 1.8% when computed with colored microspheres. There was a good correlation in the measurement of RMBF between the radioactive- and colored-microsphere methods (r = 0.98). The best-fitting linear regression line was expressed by the formula: Colored-microsphere RMBF = 1.11 (radioactive-microsphere RMBF)-0.02. When measured by colored microspheres, RMBF was approximately 8% higher than when computed with radioactive microspheres for blood flow values of 0-2 ml/min/g. When blood flow was increased pharmacologically to levels of 2-7.5 ml/min/g, colored microspheres yielded blood flow values 39% higher than the values computed by radioactive microspheres. We conclude that the nonradioactive, colored-microsphere method correlates with the radioactive technique, but at high flows, it yields values greater than those obtained with radioactive microspheres

  8. Prediction of postpercutaneous coronary intervention myocardial infarction: insights from intravascular imaging, coronary flow, and biomarker evaluation.

    Science.gov (United States)

    Hoole, Stephen P; Hernández-Sánchez, Jules; Brown, Adam J; Giblett, Joel P; Bennett, Martin R; West, Nick E J

    2018-05-01

    Percutaneous coronary intervention-induced myocardial infarction (PMI) has prognostic significance. Identifying patients at high risk for PMI is desirable as it may alter strategy and facilitate early preventative therapy. We therefore sought to establish whether preprocedural demographic, interventional (plaque characteristics and coronary microcirculatory function), and inflammatory, endothelial damage, and platelet-derived biomarker data could predict the risk of PMI. We performed target vessel pressure wire to assess fractional flow reserve, index of microcirculatory resistance (IMR) and coronary flow reserve, plaque characterization by virtual histology intravascular ultrasound, and assayed peripheral biomarkers before uncomplicated PCI in 88 patients. We then analyzed post-PCI cardiac troponin level to adjudicate PMI based on the third universal definition of myocardial infarction. Overall incidence of PMI was 27%. Women [10/15 (66%) vs. 14/73 (19%), PPMI. Preprocedural coronary flow reserve was lower in individuals with a subsequent PMI (1.8±1.2 vs. 2.1±1.3. P=0.03), and patients with higher pre-PCI IMR were more likely to sustain PMI [IMR>22: 10/23 (44%) vs. ≤22: 14/65 (22%), P=0.04], although neither was predictive after multivariate analysis. Plaque characterization by virtual histology intravascular ultrasound did not discriminate those at risk of PMI. However, peripheral venous interleukin (IL)-18 and IL-8 levels were independently negatively and positively associated with PMI, respectively. Women and those with low BMI, particularly when associated with high IL-8 and low IL-18 levels, appear to be at increased risk of PMI.

  9. Radioimmunoassay of serum myoglobin: evaluation and modification of a commercial kit and assessment of its usefulness for detecting acute myocardial infarction

    International Nuclear Information System (INIS)

    Kubasik, N.P.; Guiney, W.; Warren, K.; D'Souza, J.P.; Sine, H.E.; Brody, B.B.

    1978-01-01

    We evaluated a modified procedure for a commercially available myoglobin radioimmunoassay kit (Nuclear Medical Systems). Within-run and run-to-run precision was acceptable. Normal ranges were established and parallelism studies performed. Clinical usefulness was assessed in 100 consecutive patients admitted to our coronary-care facility. The determinations were done daily, along with creatine kinase and its isoenzymes, and lactate dehydrogenase and its isoenzymes. Fifty of the 100 patients ultimately were shown to have had acute myocardial infarction. Myoglobinemia was present in most of the patients with acute myocardial infarction, but information on its presence was less useful clinically than was detection of creatine kinase isoenzyme MB

  10. Psychometric Evaluation of a Persian Version of the Cardiac Depression Scale in Iranian Patients With Acute Myocardial Infarction.

    Science.gov (United States)

    Nia, Hamid Sharif; Sharif, Saeed Pahlevan; Froelicher, Erika Sivarajan; Boyle, Christopher; Goudarzian, Amir Hossein; Yaghoobzadeh, Ameneh; Oskouie, Fatemeh

    2018-04-01

    The aim of this study was to validate a Persian version of the Cardiac Depression Scale (CDS) in Iranian patients with acute myocardial infarction (AMI). The CDS was forward translated from English into Persian and back-translated to English. Validity was assessed using face, content, and construct validity. Also Cronbach's alpha (α), theta (), and McDonald's omega coefficient were used to evaluate the reliability. Construct validity of the scale showed two factors with eigenvalues greater than one. The Cronbach's α, , McDonald's omega, and construct reliability were greater than .70. The Persian version of the CDS has a two-factor structure (i.e., death anxiety and life satisfaction) and has acceptable reliability and validity. Therefore, the validated instrument can be used in future studies to assess depression in patients with AMI in Iranians.

  11. Clinical evaluation of the 99mTc-labelled myocardial imaging agent, hexakis (t-butylisonitrile)-technetium

    International Nuclear Information System (INIS)

    Liu Xiujie; Shi Rongfang; Wang Yanquen; Guo Xiuzhen; He Zuoxiang; Wang Xuebin; Liu Boli; Chinese Academy of Medical Sciences, Beijing. Div. of Nuclear Cardiology; Chinese Academy of Medical Sciences, Beijing. Cardiovascular Inst.; Beijing Normal Univ.

    1987-01-01

    99m Tc-TBI myocardial perfusion imaging has been studied in 7 normal subjects and 24 patients with coronary artery disease. Scintigraphic data revealed that 99m Tc-TBI myocardial perfusion imaging is more sensitive than ECG in detecting myocardial infarction. In comparing 99m Tc-TBI imaging with contrast angiography, its' sensitivity for the diagnosis of coronary artery disease was 91.7%. (orig.)

  12. Evaluation of myocardial perfusion reserve in patients with CAD using Contrast-Enhanced MRI: A comparison between semiquantitative and quantitative methods

    International Nuclear Information System (INIS)

    Schmitt, M.; Mohrs, O.K.; Petersen, S.E.; Kreitner, K.F.

    2002-01-01

    Objective: Comparison between two semiquantitative methods and a quantitative evaluation of myocardial blood flow (MBF) for assessment of myocardial perfusion reserve (MPR) in patients with CAD. Material and Methods: 9 patients with coronary stenoses>50% were examined with an ECG-gated Saturation Recovery Turbo FLASH sequence by using Gd-DTPA as contrast agent (CA). The entive measurements were performed both during rest and hyperemia induced by adenosine. The up-slopes of the signal-time S(t) curves in the myocardium and left ventricular (LV) cavity were evaluated by a linear fit. MPR was calculated from the original up-slopes of the myocardial S(t) curves and from the up-slopes, which were normalized to the up-slopes of the LV S(t) curves, respectively. For quantification of MBF values, the mathematical model MMID 4 was used and MPR was evaluated from the MBF values. Results: With all tested methods, MPR was reduced in myocardial regions subtended by arteries with stenoses≥70% compared with remote regions. With MMID 4 and the normalized up-slope method, differences between severe ischemic and remote regions were statistically significant. Conclusion: The up-slope method with normalization and quantification with MMID 4 are more sensitive methods to differentiate between remote and ischemic myocardium than the up-slope method without normalization. (orig.) [de

  13. Different Causes of Death in Patients with Myocardial Infarction Type 1, Type 2, and Myocardial Injury.

    Science.gov (United States)

    Lambrecht, Sascha; Sarkisian, Laura; Saaby, Lotte; Poulsen, Tina S; Gerke, Oke; Hosbond, Susanne; Diederichsen, Axel C P; Thygesen, Kristian; Mickley, Hans

    2018-05-01

    Data outlining the mortality and the causes of death in patients with type 1 myocardial infarction, type 2 myocardial infarction, and those with myocardial injury are limited. During a 1-year period from January 2010 to January 2011, all hospitalized patients who had cardiac troponin I measured on clinical indication were prospectively studied. Patients with at least one cardiac troponin I value >30 ng/L underwent case ascertainment and individual evaluation by an experienced adjudication committee. Patients were classified as having type 1 myocardial infarction, type 2 myocardial infarction, or myocardial injury according to the criteria of the universal definition of myocardial infarction. Follow-up was ensured until December 31, 2014. Data on mortality and causes of death were obtained from the Danish Civil Registration System and the Danish Register of Causes of Death. Overall, 3762 consecutive patients were followed for a mean of 3.2 years (interquartile range 1.3-3.6 years). All-cause mortality differed significantly among categories: Type 1 myocardial infarction 31.7%, type 2 myocardial infarction 62.2%, myocardial injury 58.7%, and 22.2% in patients with nonelevated troponin values (log-rank test; P causes, vs 42.6% in patients with type 2 myocardial infarction (P = .015) and 41.2% in those with myocardial injury (P causes of death did not differ substantially between patients with type 2 myocardial infarction and those with myocardial injury. Patients with type 2 myocardial infarction and myocardial injury exhibit a significantly higher long-term mortality compared with patients with type 1 myocardial infarction . However, most patients with type 1 myocardial infarction die from cardiovascular causes in contrast to patients with type 2 myocardial infarction and myocardial injury, in whom noncardiovascular causes of death predominate. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Usefulness of 99mTc-methoxy-iso-butyl-isonitrile myocardial single photon emission computed tomography during infusion of low-dose dobutamine and nitroglycerin. Evaluation of myocardial viability

    International Nuclear Information System (INIS)

    Yagi, Hidenori

    1995-01-01

    This study evaluated myocardial viability with 99m Tc-methoxy-iso-butyl-isonitrile (MIBI) single photon emission computed tomography (SPECT) during infusion of low-dose of dobutamine (DOB) and nitroglycerin (NTG). The subjects were 13 patients with coronary artery disease associated with wall motion abnormalities. Myocardial SPECT with MIBI was performed during infusion of NTG followed by infusion of DOB. Rest MIBI study was also performed on a separate day. The regional uptake of MIBI was visually evaluated by scoring (from 0=normal to 3=defect) in 9 regions of left ventricular wall in comparison with LVG or echocardiography data. The regional uptake of MIBI was quantitatively evaluated in 33 segments of left ventricular wall by a computer. The uptake of MIBI during infusion of both DOB and NTG was compared with that at rest study in the region of wall motion abnormalities. The mean uptake score of MIBI during infusion of both DOB and NTG and that of MIBI at rest was 1.8 and 2.1, respectively. The uptake of MIBI was significantly improved by infusion of both DOB and NTG (p<0.01). Percent of the peak activity of MIBI during infusion of both DOB and NTG and that of MIBI at rest in the region where the uptake score had been improved was 76.6±12.7% versus 74.0±13.1% (p<0.01). Percent of the peak activity of MIBI in the region where the uptake score had not been improved was 60.1±18.1% versus 60.7±18.7% (NS). Quantitative study also showed a significant improvement of MIBI uptake on the study of DOB and NTG. These results suggest that MIBI SPECT during infusion of both DOB and NTG infusion might be useful for evaluating myocardial viability. (S.Y.)

  15. Myocardial infarction

    International Nuclear Information System (INIS)

    Ando, Jyoji; Yasuda, Hisakazu; Miyamoto, Atsushi; Kobayashi, Tsuyoshi

    1980-01-01

    sup(99m)Tc-pyrophosphate (PYP) scintigraphy and 201 Tl myocardial scintigraphy were utilized for the diagnoses of the presence, the region, and the extent of myocardial infarction. Exercise 201 Tl myocardial scintigrams and exercise radionuclide ventriculography were utilized for diagnosis of coronary artery lesions in angina pectoris. Radionuclide ventriculography was used to investigate effects of coronary artery lesions on cardiac function and hemodynamics. In order to select adequate treatments for myocardial infarction and estimate the prognosis, it was necessary to detect the presence, the region, and the extent of acute myocardial infarction and to investigate effects of partial infarction on hemodynamics by using radionuclide imaging. Exercise myocardial scintigraphy could be carried out noninvasively and repeatedly for diagnosis of coronal artery disease. Therefore, this method could be applied widely. It was possible to use this method as a screening test of coronary artery diseases for the diagnoses of asymptomatic patients who showed ST changes in ECG, the patients with cardiac neurosis and the patency after a reconstructive surgery of coronary artery. (Tsunoda, M.)

  16. Effect of inversion time on the precision of myocardial late gadolinium enhancement quantification evaluated with synthetic inversion recovery MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Varga-Szemes, Akos; Schoepf, U.J.; De Cecco, Carlo N.; Fuller, Stephen R.; Suranyi, Pal [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Geest, Rob J. van der [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Spottiswoode, Bruce S. [Siemens Medical Solutions, Chicago, IL (United States); Muscogiuri, Giuseppe [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Bambino Gesu Children' s Hospital IRCCS, Department of Imaging, Rome (Italy); Wichmann, Julian L. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Mangold, Stefanie [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Eberhard-Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Maurovich-Horvat, Pal; Merkely, Bela [Semmelweis University, MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Budapest (Hungary); Litwin, Sheldon E. [Medical University of South Carolina, Division of Cardiology, Department of Medicine, Charleston, SC (United States); Vliegenthart, Rozemarijn [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Groningen, University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, Department of Radiology, Groningen (Netherlands)

    2017-08-15

    To evaluate the influence of inversion time (TI) on the precision of myocardial late gadolinium enhancement (LGE) quantification using synthetic inversion recovery (IR) imaging in patients with myocardial infarction (MI). Fifty-three patients with suspected prior MI underwent 1.5-T cardiac MRI with conventional magnitude (MagIR) and phase-sensitive IR (PSIR) LGE imaging and T1 mapping at 15 min post-contrast. T1-based synthetic MagIR and PSIR images were calculated with a TI ranging from -100 to +150 ms at 5-ms intervals relative to the optimal TI (TI{sub 0}). LGE was quantified using a five standard deviation (5SD) and full width at half-maximum (FWHM) thresholds. Measurements were compared using one-way analysis of variance. The MagIR{sub sy} technique provided precise assessment of LGE area at TIs ≥ TI{sub 0}, while precision was decreased below TI{sub 0}. The LGE area showed significant differences at ≤ -25 ms compared to TI{sub 0} using 5SD (P < 0.001) and at ≤ -65 ms using the FWHM approach (P < 0.001). LGE measurements did not show significant difference over the analysed TI range in the PSIR{sub sy} images using either of the quantification methods. T1 map-based PSIR{sub sy} images provide precise quantification of MI independent of TI at the investigated time point post-contrast. MagIR{sub sy}-based MI quantification is precise at TI{sub 0} and at longer TIs while showing decreased precision at TI values below TI{sub 0}. (orig.)

  17. Relationship between evaluation by quantitative fatty acid myocardial scintigraphy and response to {beta}-blockade therapy in patients with dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Tatsuo; Hoshida, Shiro; Nishino, Masami; Aoi, Toshiyuki; Egami, Yasuyuki; Takeda, Toshihiro; Kawabata, Masayoshi; Tanouchi, Jun; Yamada, Yoshio; Kamada, Takenobu [Div. of Cardiology, Osaka Rosai Hospital (Japan)

    2001-12-01

    Predicting the effect of {beta}-blockade therapy on the clinical outcome of patients with dilated cardiomyopathy (DCM) is difficult prior to the initiation of therapy. Myocardial fatty acid metabolism has been shown to be impaired in patients with DCM. We examined whether the extent of myocardial injury, as assessed by iodine-123 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) myocardial scintigraphy, is related to the response of patients with DCM to {beta}-blockade therapy. Thirty-seven patients with DCM were examined using BMIPP myocardial scintigraphy before and after 6 months of treatment with metoprolol. Myocardial BMIPP uptake (%BM uptake) was estimated quantitatively as a percentage of the total injected count ratio. The left ventricular end-diastolic and end-systolic dimensions (LVDd, LVDs) and ejection fraction (LVEF) were also evaluated. The patients were divided into two groups according to their functional improvement (>10% elevation of LVEF) after 6 months of metoprolol therapy. Twenty-eight patients responded to the therapy, while nine did not. Prior to the therapy, no significant differences in LVDd, LVDs or LVEF were observed between the responders and non-responders. However, the %BM uptake was significantly lower in the non-responders than in the responders (1.0%{+-}0.2% vs 2.1%{+-}0.5%, P<0.001). The %BM uptake could be used to distinguish the responders from the non-responders with a sensitivity of 0.93 and a specificity of 1.00 at a threshold value of 1.4. After the metoprolol therapy, the %BM uptake improved significantly in the responders (2.5%{+-}0.5%, P<0.01) but did not change in the non-responders. These results indicate that myocardial BMIPP uptake could predict the response of DCM patients to {beta}-blockade therapy. (orig.)

  18. Evaluation of myocardial distribution of iodine-123 labeled metaiodobenzylguanidine (123I-MIBG) in normal subjects

    International Nuclear Information System (INIS)

    Tsuchimochi, Shinsaku; Tamaki, Nagara; Shirakawa, Seishi; Fujita, Toru; Yonekura, Yoshiharu; Konishi, Junji; Nohara, Ryuji; Sasayama, Shigetake; Nishioka, Kenya

    1994-01-01

    The normal pattern of the myocardial sympathetic innervation was studied in 15 subjects using gamma camera scintigraphy with iodine-123 labeled metaiodobenzylguanidine ( 123 I-MIBG). Seven younger subjects (mean age 24.6±3.6) and eight older patients (mean age 60.9±8.4) with normal cardiac function were studied. Planar imaging was obtained at 15 minutes and 3 hours, and SPECT was also performed 3 hours after injection of 111 MBq (3 mCi) of MIBG. The younger subjects showed higher the heart to mediastinum count ratio (2.91±0.25 vs. 2.67±0.34; p<0.05) and higher inferior to anterior count ratio (1.19±0.15 vs. 0.97±0.13; p<0.05) on the late scan. The bull's-eye polar map also differences in counts in the mid-inferior (p<0.005), basal-inferior (p<0.005) and mid-lateral sectors (p<0.01). But there was no significant difference in MIBG washout rate from myocardium between two groups. These data suggest that there is a difference of the cardiac sympathetic innervation, with older subjects having fewer sympathetic nerve terminals, especially in inferior than younger subjects. We conclude that the age difference in sympathetic nerve function should be considered in the interpretation of MIBG scan. (author)

  19. Influence of revascularization on myocardial perfusion, metabolism and function evaluated with I-123-IPPA

    International Nuclear Information System (INIS)

    Kropp, J.; Krois, M.; Eichhorn, B.; Feske, W.; Likungu, J.; Kirchhoff, P.J.; Luederitz, B.; Biersack, H.J.; Knapp, F.F. Jr.

    1993-01-01

    Patients with coronary artery disease (CAD) were investigated with sequential SPECT-scintigraphy after administration of 200 MBq of 15-(p-[I-123]iodophenyl)pentadecanoic acid (IPPA) at peak submaximal exercise. Twenty patients underwent coronary angioplasty (PTCA) from which 14 had control coronary arteriography (CA) and left ventricular cineventriculography (LVCV). Nineteen pts underwent bypass graft surgery (ACB) and stress sonagraphy. Semi-quantification of uptake (Up related to perfusion) and turnover (Tr) was obtained by segmental comparison of oblique slices. About 90% of the reperfused myocardial segments in the PTCA-group and 76% in the ACB-group showed an improvement of uptake after therapy (RUp). Of these, 50% and 66% exhibited increased turnover (RTr) after PTCA or ACB. Pathologic RTr was highly correlated with regional wall motion abnormalities after therapy in both groups. In the ACB-group presence of improvement of RTr was correlated with improved RWM at rest and stress. IPPA-studies show potential to provide information about changes of perfusion and metabolism after reperfusion and IPPA-turnover is a good predictor of the pattern of contractile function

  20. The significance of 123I-BMIPP myocardial SPECT on the evaluation of angina pectoris

    International Nuclear Information System (INIS)

    Kurosawa, Kazuhiko; Ohtani, Hiroshi; Saitou, Tomiyoshi; Maruyama, Yukio; Katohno, Eiichi; Ohwada, Kenji

    1998-01-01

    Some patients of ischemic heart disease have low uptake in 123 I-labeled beta methyl-iodophenyl pentadecanoic acid (BMIPP) SPECT in spite of normal uptake in thallium-201 (Tl) SPECT. To investigate their clinical significance, we performed both Tl and BMIPP myocardial SPECT in 26 cases with stable angina (n=16) and unstable angina (n=10), and compared with clinical backgrounds electrocardiogram (ECG) and left ventriculography (LVG). In 11 patients of them, the uptake of BMIPP was moderately reduced. We divided 26 cases into two groups according to uptake of BMIPP (normal/reduced). The two groups had no differences in length of angina attack and duration of disease, but they had a significant difference in the abnormality of either ECG or LVG. Three to six months after PTCA, we examined LVG in 18 cases, 12 of 16 cases with the abnormality of LVG showed the improvement of wall motion. We concluded the reduced uptake of BMIPP with normal uptake of Tl was related to more severe ischemia in cases with unstable angina. (author)

  1. Clinical evaluation of coronary territory map by using unfolded map of Tl-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Uehara, Toshiisa; Nishimura, Tsunehiko; Katafuchi, Tetsuro; Yamagami, Hidetoshi; Kumita, Shinichirou; Hayashida, Kohei; Hayashi, Makoto

    1990-01-01

    Coronary territory map was developed on unfolded map of exercise Tl-201 myocardial SPECT. Each coronary territory was determined by summing the each unfolded map of 54 cases of single vessel disease respectively, and standardizing with normal pattern obtained from normal patients. The diagnostic accuracy of coronary territory map to identify the diseased coronary artery was analyzed in 104 clinical cases and was compared with that of planar and SPECT visual diagnosis, simple unfolded map (raw map) and extent and severity map. The results were as follows. (1) Territory map showed excellent diagnostic accuracy in single or double vessel disease, especially in diagnosis of left circumflex coronary artery lesion. (2) In triple vessel disease, the diagnostic accuracy of territory map or other unfolded maps was 30% at best, and was inferior to planar or SPECT visual analysis. The cause of this inferiority seemed that the quantitatively analyzed map had no information about the degree of Tl-uptake into lung or myocardium, which give useful information in visual diagnosis. (3) The diagnostic agreement ratio in two observers was the highest in territory map diagnosis, so that the territory map diagnosis seemed to be the most objective one. (4) The unfolded map diagnosis with apical display obtained from long-axis tomogram was useful to diagnose left anteior descending coronary (LAD) lesion, which improve not only the sensitivity of LAD but also specificity of right coronary artery single vessel disease. (author)

  2. SPECT myocardial perfusion versus fractional flow reserve for evaluation of functional ischemia: A meta analysis

    International Nuclear Information System (INIS)

    Zhou, Tao; Yang, Lin-feng; Zhai, Ji-liang; Li, Jiang; Wang, Qi-meng; Zhang, Rui-jie; Wang, Sen; Peng, Zhao-hui; Li, Min; Sun, Gang

    2014-01-01

    Purpose: The present meta-analysis illustrates the accuracy of myocardial perfusion SPECT (MPS) to diagnose functional stenotic coronary artery disease (CAD) with fractional flow reserve (FFR) as standard reference. Methods: All investigators screened and selected studies that compared MPS with FFR in symptomatic patients with suspected CAD. Patients and study characteristics were independently extracted by two investigators; differences were resolved by consensus. Results: 13 articles, including 1,017 patients, 699 vessels were included in the study. No significant publication bias was detected (P = 0.65). At the patient level, the summary sensitivity and specificity were 77% (95% confidence interval [CI], 70–83%) and 77% (95%CI, 67–84%) for MPS. Vessel-level pooled sensitivity was 66% (95%CI, 57–74%) and specificity was 81% (95%CI, 70–89%). The overall diagnostic performance of MPS was moderate. [The area under the summary receiver operating characteristic (sROC) curve was 0.83]. No study influenced the pooled results larger than 0.03. Conclusions: The accuracy between FFR and MPS SPECT was moderate

  3. SPECT myocardial perfusion versus fractional flow reserve for evaluation of functional ischemia: A meta analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Tao; Yang, Lin-feng [Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031 (China); Zhai, Ji-liang [Department of Medical Imaging, The Branch of TaiAn Central Hospital, Middle of Changcheng Road, Shandong Province, China. 271000 (China); Li, Jiang [Department of Medical Imaging, Affiliated Hospital of Taishan Medical University, No, 706, Taishan Road, Shandong Province, China. 271000 (China); Wang, Qi-meng [Department of Medical Imaging, Taishan Hospital of Traditional Chinese Medicine, No, 216, Yingxuan Street, Shandong Province, China. 271000. (China); Zhang, Rui-jie; Wang, Sen; Peng, Zhao-hui [Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031 (China); Li, Min, E-mail: liminyingxiang@163.com [Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031 (China); Sun, Gang, E-mail: cjr.sungang@vip.163.com [Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031 (China)

    2014-06-15

    Purpose: The present meta-analysis illustrates the accuracy of myocardial perfusion SPECT (MPS) to diagnose functional stenotic coronary artery disease (CAD) with fractional flow reserve (FFR) as standard reference. Methods: All investigators screened and selected studies that compared MPS with FFR in symptomatic patients with suspected CAD. Patients and study characteristics were independently extracted by two investigators; differences were resolved by consensus. Results: 13 articles, including 1,017 patients, 699 vessels were included in the study. No significant publication bias was detected (P = 0.65). At the patient level, the summary sensitivity and specificity were 77% (95% confidence interval [CI], 70–83%) and 77% (95%CI, 67–84%) for MPS. Vessel-level pooled sensitivity was 66% (95%CI, 57–74%) and specificity was 81% (95%CI, 70–89%). The overall diagnostic performance of MPS was moderate. [The area under the summary receiver operating characteristic (sROC) curve was 0.83]. No study influenced the pooled results larger than 0.03. Conclusions: The accuracy between FFR and MPS SPECT was moderate.

  4. The evaluation of dobutamine 99mTc-MIBI myocardial perfusion imaging in the diagnosis of coronary heart disease

    International Nuclear Information System (INIS)

    He Qing; Qu Wanying; Gong Junhui; Zhou Ying

    1996-01-01

    The method and the clinical value of dobutamine stress test as a substitute for exercise test in 99m Tc-MIBI myocardial perfusion imaging was investigated. 40 Patients were intravenously infused with dobutamine through IVAC syringe pumps by incremental doses, and 99m Tc-MIBI was injected at the peak dobutamine heart rate. The myocardial imaging was then performed. The rest myocardial imaging was done after 48 hours. 30 of the 31 patients with coronary heart disease showed reversible perfusion defects in dobutamine 99m Tc-MIBI myocardial perfusion images and 7 of the 9 patients without coronary heart disease showed normal images. The sensitivity of this test was 96.8% and the specificity 77.8%. None of the studies was discontinued due to dobutamine side effect. Dobutamine 99m Tc-MIBI myocardial perfusion imaging is a safe and sensitive method in the diagnosis of coronary heart disease

  5. The need for standardisation of cardiac FDG PET imaging in the evaluation of myocardial viability in patients with chronic ischaemic left ventricular dysfunction

    International Nuclear Information System (INIS)

    Kuuti, J.; Schelbert, H.R.; Bax, J.J.

    2002-01-01

    The evaluation of myocardial glucose utilisation with fluorine-18 fluorodeoxyglucose (FDG) and positron emission tomography is currently considered the most reliable tool for the identification of myocardial viability. However, the investigations using FDG imaging to predict improvement in left ventricular (LV) function after revascularisation have reported wide ranges for sensitivity (71%-100%) and, in particular, for specificity (33%-91%). The variable results may be related to differences in study populations but also to differences in the imaging protocols employed. Detailed analysis of the published studies has revealed differences in study populations, patient selection criteria, the methods for assessing changes in LV function post revascularisation and the timing of these assessments. Even more importantly, protocols have varied substantially with regard to imaging equipment, perfusion tracers, metabolic conditions, data analysis and interpretation of results. In addition, evaluation of patients with insulin resistance appears to represent a specific challenge. This review examines the different study protocols and methodologies used for myocardial FDG imaging in order to draw conclusions concerning optimal imaging protocols. It appears that the optimisation and standardisation of study protocols and analysis of FDG images for the assessment of myocardial viability are critical. In addition, multi-centre trials seem warranted on prediction of long-term function, congestive heart failure symptoms, survival and quality of life

  6. Evaluation of the Role of Creatine Phosphokinase as a Biomarker in Acute Myocardial Infarction Patients

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    Priyal Agrawal

    2017-01-01

    Full Text Available Introduction: The study hypothesized that salivary creatine phosphokinase (CPK can act as a biomarker in diagnosing acute myocardial infarction (AMI as an alternative to serum CPK, which is a contributory effort towards noninvasive procedures to detect the disease. Aims and Objectives: The main aim of our study was to propose the normal range of salivary CPK in patients with AMI, and to explore the relationship between serum and saliva levels of CPK with comparison of salivary CPK as a biomarker between healthy individuals and patients with AMI. Materials and Methods: A case-control study was carried out including 144 participants who were divided in two main groups – 72 normal healthy individuals and 72 with AMI. CPK levels were assayed in serum and unstimulated whole saliva of AMI and controls by International Federation of Clinical Chemistry (IFCC method. Statistical Analysis: Statistical analysis was performed using unpaired t-test and Pearson correlation coefficient test. Results: The normal proposed range of salivary CPK of patients with AMI was found to range from 11.30 to 184.50 U/L in males and 20.17 to 69.00 U/L in females. The mean salivary and serum CPK was significantly higher in patients with AMI as compared to healthy individuals with P < 0.001. Saliva CPK concentration correlated significantly with serum CPK of AMI and healthy individuals with r = 0.247. Conclusion: Salivary CPK can be used as an alternative to serum CPK in patients with AMI.

  7. Hospital evaluation of health literacy and associated outcomes in patients after acute myocardial infarction.

    Science.gov (United States)

    Rymer, Jennifer A; Kaltenbach, Lisa A; Anstrom, Kevin J; Fonarow, Gregg C; Erskine, Nathaniel; Peterson, Eric D; Wang, Tracy Y

    2018-04-01

    Low health literacy is common in the United States and may affect outcomes after myocardial infarction (MI). How often hospitals screen for low health literacy is unknown. We surveyed 122 hospitals in the TRANSLATE-ACS study and divided them into those that reported routinely (>75% of patients), selectively (1%-75%), or never (0%) screening MI patients for low health literacy prior to discharge. We performed logistic regression with random intercepts to compare 6-week and 6-month patient-reported medication adherence and multivariable Cox regression to compare 1-year major adverse cardiovascular events and all-cause readmission risks between hospital groups. Overall, 25 (20.5%), 47 (38.5%), and 50 (41.0%) hospitals reported routinely, selectively, or never screening patients for low health literacy, respectively. Patients discharged from hospitals that routinely screened were more likely to report 6-week medication adherence [routinely: adjusted odds ratio (OR) 1.26, 95% CI 1.01-1.57; selectively: adjusted OR 1.19, 95% CI 1.00-1.43, both referenced to those discharged from hospitals that never screened]. Compared with hospitals that never screened health literacy, 1-year major adverse cardiovascular events were similar for hospitals that reported routinely screening (adjusted HR 0.92, 95% CI 0.75-1.14) or selectively screening (adjusted HR 1.01, 95% CI 0.84-1.21). Hospitals that reported selectively screening health literacy were associated with a lower adjusted risk of 1-year all-cause readmission (adjusted HR 0.89, 95% CI 0.79-1.00, P=.041). Only a minority of US hospitals routinely screen MI patients for low health literacy. Hospital screening was associated with higher medication adherence and lower readmission risk. Further investigation is needed to understand how inpatient screening can be implemented to improve longitudinal post-MI care. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Evaluation of potassium-43 scintillation images during early myocardial ischemia in an animal model

    International Nuclear Information System (INIS)

    Haider, B.; Oldewurtel, H.A.; Moschos, C.B.; Regan, T.J.

    1976-01-01

    To assess the validity of myocardial imaging with potassium-43 ( 43 K) early after the onset of ischemia, the left anterior descending artery was occluded with a balloon tip catheter in 32 intact anesthetized dogs. /sup 99m/Technetium ventriculograms localized the left ventricle. 43 K was administered intravenously and serial images were obtained in four views using an Anger camera with a pinhole collimator. The heart was arrested after 60 minutes and removed for imaging and tissue counts to ascertain extracardiac and geometric factors. In normals (group 1) left ventricular images were relatively homogeneous, except for the thin walled apex, both in vivo and in the isolated heart. Equilibration with 43 K prior to ischemia (group 2) gave similar images to group 1, associated with a small reduction in tissue counts after one hour of ischemia. Group 3 was infused with 43 K after initiation of ischemia. Despite a reduction of 43 K counts in the ischemic area to less than one-fourth of the nonischemic site (P < 0.001), demonstration of a ''cold area'' in vivo was inconstant, occurring in only 34 percent of studies. Lead shielding did not improve accuracy. In the isolated heart the ability to detect the cold area was improved to 73 percent. However, when the left ventricle was incised and spread flat, so that low and high activity areas were contiguous rather than superimposed, a widespread area of ischemia was present without exception in the anterior wall. Use of a rectilinear scanner in seven animals failed to improve diagnostic yield; areas of reduced radioactivity were seen at the apex in normals by both techniques. Thus, while detection of low flow areas in the isolated heart is feasible by isotopic imaging early after the onset of ischemia, both extracardiac and geometric factors can contribute to qualitative and quantitative errors in vivo

  9. Psychometric Evaluation of Persian Version of Death Depression Scale in Iranian Patients with Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Hamid Sharif Nia

    2017-06-01

    Full Text Available AbstractObjective: The psychometric properties of a scale should be re-assessed routinely with different samples to ensure its generalizability. The present study aimed to determine the reliability and validity of the Persian Version of Death Depression Scale (DDS in Iranian patients with Acute Myocardial Infarction (AMI.Methods: The face validity, content validity and construct validity (i.e. factorial, convergent, and discriminant validity of the DDS were assessed using a sample of 407 AMI patients. Confirmatory factor analysis was conducted using the ratio chi-square by degrees of freedom (χ2/df, the Goodness-of-fit index (GFI, Comparative Fit Index (CFI, Incremental Fit Index (IFI, Normed Fit Index (NFI, and Root Mean Square Error of Approximation (RMSEA. Convergent and discriminant validity were assessed using average variance extracted (AVE, maximum shared squared variance (MSV, and average shared square variance (ASV. Internal consistency, test–retest, and construct reliability (CR were used to assess reliability of the Persian Version of DDS.Results: Based on principle component analysis and consideration of conceptual meaning, a four-factor solution was selected, explaining 75.89% of the total variance. Goodness-of-fit indices (c2(98 = 583.646, p < .05, c2/df= 5.956, GFI = .856, CFI = .902, NFI = .885, IFI = .902, RMSEA (90% C.I. = .110 (.102 - .119 in the final DDS structure demonstrated the adequacy of the four-domain structure of the DDS. Convergent and discriminant validity was used to assess the construct validity of the DDS. The reliability was greater than .70.Conclusion: The DDS was found to be a valid and reliable assessment tool for death depression in Iranian patients with AMI.

  10. Dobutamine stress thallium-201 single-photon emission tomography versus echocardiography for evaluation of the extent and location of coronary artery disease late after myocardial infarction

    International Nuclear Information System (INIS)

    Elhendy, A.; Bax, J.J.; Domburg, R.T. van; Cornel, J.H.; Roelandt, J.R.T.C.; Valkema, R.; Reijs, A.E.M.; Krenning, E.P.

    1999-01-01

    Dobutamine stress echocardiography and thallium-201 myocardial perfusion scintigraphy are clinically useful methods for the evaluation of coronary artery disease (CAD). However, the relative merits of these imaging modalities in the evaluation of the extent of CAD after myocardial infarction have not been well studied. The aim of this study was to compare the accuracy of dobutamine stress echocardiography and simultaneous 201 Tl single-photon emission tomography (SPET) imaging for the diagnosis and localization of CAD late after acute myocardial infarction. Dobutamine (up to 40 μg kg -1 min -1 )-atropine (up to 1 mg) stress echocardiography in conjunction with stress-reinjection 201 Tl SPET was performed for the evaluation of myocardial ischaemia in 90 patients with previous myocardial infarction who underwent coronary angiography. Significant CAD was predicted on bases of myocardial ischemia (new or worsening wall motion abnormalities on echocardiography and reversible perfusion defects on 201 Tl SPET). Significant CAD (≥ 50% luminal diameter stenosis) was detected in 73 (81%) patients. The sensitivity, specificity and accuracy of echocardiography in detecting remote ischaemia for the diagnosis of remote CAD (present in 53 patients) were, respectively, 79% (CI 70%-88%), 85% (CI 77%-93%) and 81% (CI 73%-90%), while the corresponding figures for 201 Tl SPET were 75% (CI 66%-85%), 78% (CI 69%-87%) and 76% (CI 67%-86%) respectively (P = NS vs echocardiography). The sensitivity, specificity and accuracy of echocardiography in detecting peri-infarction ischaemia for the diagnosis of infarct-related artery stenosis (present in 70 patients) were, rspectively, 77% (CI 68%-86%), 85% (CI 78%-92%) and 79% (CI 70%-87%) while the corresponding figures for 201 Tl SPET were 73% (CI 64%-82%), 85% (CI 78%-92%) and 76% (CI 67%-84%) respectively (P = NS vs echocardiography). The agreement between the two methods for the diagnosis of peri-infarction and remote ischaemia was 70

  11. Evaluation of acute myocardial infarction by 201Tl single-photon emission computed tomography using scoring system

    International Nuclear Information System (INIS)

    Setsuta, Koichi

    1991-01-01

    In 36 patients with acute myocardial infarction (AMI) 201 Tl single photon emission computed tomography (SPECT) examinations were performed in a relatively early phase of AMI. The short and long axis views of the left ventricle (LV) were divided into 6 segments. Images of each segment were assigned scores (segmental scores) based on a visual evaluation of the extent of 201 Tl accumulations. SPECT scores were compared with max GOT, max LDT, max CPK and max CK-MB, Killip classification and Forrester hemodynamic subset on admission, and LV ejection fraction (LVEF). Segmental scores were compared with LV wall motion evaluated by left ventriculography. The results are as follows: There were significant correlations between SPECT scores and max GOT, max LDH, max CPK and max CK-MB. SPECT scores in patients with Killip group III were significantly higher than in patients with Killip group I+II. However, no significant differences in max GOT, max LDH, max CPK and max CK-MB were observed between patients with Killip group III and those with Killip group I+II. SPECT scores were significantly higher in patients with Forrester group III+IV than in patients with Forrester group I+II. Segmental scores in segments evaluated as akinesis, dyskinesis and aneurysm by left ventriculography were significantly higher than those evaluated as hypokinesis or normal. Segmental scores in segments evaluated as hypokinesis were significantly high in comparison with normal segments. Significant correlations were observed between LVEF and SPECT scores. However, LVEF correlated poorly with max GOT, max LDH and max CPK, and no significant correlation was observed between LVEF and max CK-MB. SPECT examinations were performed in 11 patients in both the acute and chronic phase of AMI. SPECT scores in the chronic phase did not change in 4 patients, decreased in 5, increased in 2. These results suggest that SPECT scores and segmental scores can be useful indices in the evaluation of AMI. (J.P.N.)

  12. Evaluation of ECG-gated [(11)C]acetate PET for measuring left ventricular volumes, mass, and myocardial external efficiency.

    Science.gov (United States)

    Hansson, Nils Henrik; Tolbod, Lars; Harms, Johannes; Wiggers, Henrik; Kim, Won Yong; Hansen, Esben; Zaremba, Tomas; Frøkiær, Jørgen; Jakobsen, Steen; Sørensen, Jens

    2016-08-01

    Noninvasive estimation of myocardial external efficiency (MEE) requires measurements of left ventricular (LV) oxygen consumption with [(11)C]acetate PET in addition to LV stroke volume and mass with cardiovascular magnetic resonance (CMR). Measuring LV geometry directly from ECG-gated [(11)C]acetate PET might enable MEE evaluation from a single PET scan. Therefore, we sought to establish the accuracy of measuring LV volumes, mass, and MEE directly from ECG-gated [(11)C]acetate PET. Thirty-five subjects with aortic valve stenosis underwent ECG-gated [(11)C]acetate PET and CMR. List mode PET data were rebinned into 16-bin ECG-gated uptake images before measuring LV volumes and mass using commercial software and compared to CMR. Dynamic datasets were used for calculation of mean LV oxygen consumption and MEE. LV mass, volumes, and ejection fraction measured by CMR and PET correlated strongly (r = 0.86-0.92, P PET (P PET-based MEE, corrected for bias, correlated fairly with PET/CMR-based MEE (r = 0.60, P PET-based MEE bias was strongly associated with LV wall thickness. Although analysis-related improvements in accuracy are recommended, LV geometry estimated from ECG-gated [(11)C]acetate PET correlate excellently with CMR and can indeed be used to evaluate MEE.

  13. Evaluation of ventricular function of patients with tetralogy of Fallot before and after operation by radionuclide myocardial imaging

    International Nuclear Information System (INIS)

    Zhang Nanbin; Wang Zengwei; Zhang Renfu; Chen Xianying; Liu Zhifan; Zhang Zhaozhong; Wang Kaigen

    1996-01-01

    Radionuclide myocardial imaging was utilized to evaluate the ventricular function of 43 patients with tetralogy of Fallot in preoperative and postoperative periods. The examination was made before and 25∼35 days after operation respectively. Ventricular ejection fraction, peak ejection rate and peak filling rate were used as indices for cardiac function. Before operation, the average left ventricular ejection fraction (LVEF) was 55%, the average left ventricular peak ejection rate (LVPER) was 2.95EDV/s and the average left ventricular peak filling rate (LVPFR) was 3.05EDV/s. After operation, the above three values were increased to 71%, 4.35EDV/s and 5.05EDV/s respectively, all with P<0.01. The function of right ventricle before operation was decreased and was significantly improved after operation (RVEF 42% vs 50%, RVPER 2.35EDV/s vs 3.00EDV/s and RVPFR 2.32EDV/s vs 3.36EDV/s, P<0.01). Poor right ventricular function in patients with tetralogy of Fallot is improved after surgical operation. Evaluation of the right ventricular function status is useful for assessing the degree of obstruction of right ventricular outflow tract

  14. The evaluation of usefulness of quantitative analysis method with {sup 99m}Tc-tetrofosmin on effective dicision of reperfusion therapy to acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Takagi, Hitoshi; Sone, Takahito [Ogaki Municipal Hospital, Gifu (Japan)

    1998-01-01

    SPECT on acute and chronic period of {sup 99m}Tc-tetrofosmin on 46 patients with acute myocardial infarction were analyzed to evaluate about usefulness of quantitative analysis method used by unfolding image that was gotten by Bull`s eye analysis on reperfusion therapy in acute myocardial infarction, and we could get undermentioned results. 60% black out area in resional of interested was best on the obstacle myocardium using analysis of unfolding image. Significantly betterment from acute to chronic phase on the obstacle area of myocardium and the mean uptake ratio of the obstacle area was confirmed by this method. The relation between myocardial salvage and factors of myocardial damage, for example reperfusion time TIMI grade, rentrop grade and reperfusion phenomenon could be analyzed by this method. This method was suspected to underestimate the areas of obstacle myocardium on the cases of defect of apex. Error of analysis was suspected on the case of accumulation of TF to other than myocardium. The problems were minimised by some techniques mention in this paper. (author)

  15. SURGERY OF SYMPTOMATIC MYOCARDIAL BRIDGING

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    N. Maghamipour N. Safaei

    2007-06-01

    Full Text Available Myocardial bridging with systolic compression of the left anterior descending coronary artery (LAD may be associated with myocardial ischemia. In symptomatic myocardial bridging unresponsive to medical treatment, surgical unroofing of the left LAD can be performed. Little information is available about the long-term prognosis of patients with this coronary anomaly after the surgical unroofing, so we decided to evaluate the result of this operation. A total of 26 patients underwent surgical unroofing of myocardial bridging. Patients had a myocardial bridge of at least 3 cm in length in the middle of LAD and with more than 70% compression during systole. Unroofing was performed with cardiopulmonary bypass in 16 and with off pump technique in 10 patients. In 6 patients repeat angiographies for control of myotomy were done. In one of them a nonsignificant 20% narrowing was seen. Postoperative scintigraphic and angiographic studies demonstrated restoration of coronary flow and myocardial perfusion without residual myocardial bridges under beta-stimulation in 24 patients. Two patients had residual narrowing. With off pump technique, 1 patient had perforation of the right ventricle and 1 patient underwent reoperation because of incomplete unroofing during the first operation. None of the patients with cardiopulmonary bypass technique had residual chest pain or other complications. Surgical unroofing of myocardial bridging with the aid of cardiopulmonary bypass is a safe and easy procedure with low operative risk and with excellent functional results.

  16. Evaluation of (99)  (m)TcN-MPO as a new myocardial perfusion imaging agent in normal dogs and in an acute myocardial infarction canine model: comparison with (99)  (m)Tc-sestamibi.

    Science.gov (United States)

    Bu, Lihong; Li, Renfei; Jin, Zhongnan; Wen, Xiaofei; Liu, Shuang; Yang, Baofeng; Shen, Baozhong; Chen, Xiaoyuan

    2011-02-01

    (99)  (m)TcN-MPO ([(99)  (m)TcN(mpo)(PNP5)](+): mpo = 2-mercaptopyridine oxide and PNP5 = N-ethoxyethyl-N,N-bis[2-(bis(3-methoxypropyl)phosphino)ethyl]amine) is a cationic (99)  (m)Tc-nitrido complex, which has favorable biodistribution and myocardial uptake with rapid liver clearance in Sprague Dawley rats. The objective of this study was to compare the biodistribution and pharmacokinetics of (99)  (m)TcN-MPO and (99)  (m)Tc-Sestamibi in normal dogs, and to evaluate the potential of (99)  (m)TcN-MPO as a myocardial perfusion agent in canines with acute myocardial infarction. Five normal mongrel dogs were injected intravenously with (99)  (m)TcN-MPO. Venous blood samples were collected via a femoral vein catheter at 0.5, 1, 2, 3, 4, 5, 10, 20, 30, 40, 60, and 90 min post-injection (p.i.). Anterior-posterior planar images were acquired by γ-camera at 10, 20, 30, 60, 90, and 120 min p.i. Regions of interest (ROIs) were drawn around the heart, liver, and lungs. The heart/liver and heart/lung ratios were calculated by dividing the mean counts in heart ROI by the mean counts in the liver and lung ROI, respectively. For comparison, (99)  (m)Tc-sestamibi was also evaluated in the same five dogs. The interval period between the two examinations was 1 week to eliminate possible interference between these two radiotracers. In addition, single positron emission computed tomography (SPECT) images in the canine infarct model were collected 24 h after myocardial infarction at 30 and 60 min after the administration of (99)  (m)TcN-MPO (n = 4) or (99)  (m)Tc-Sestamibi (n = 4). It was found that (99)  (m)TcN-MPO and (99)  (m)Tc-Sestamibi displayed very similar blood clearance characteristics during the first 90 min p.i. Both (99)  (m)TcN-MPO and (99)  (m)Tc-Sestamibi had a rapid blood clearance with less than 50% of initial radioactivity remaining at 1 min and less than 5% at 30 min p.i. (99)  (m)TcN-MPO and (99)  (m)Tc-Sestamibi both showed good

  17. Effects of MR parameter changes on the quantification of diffusion anisotropy and apparent diffusion coefficient in diffusion tensor imaging: Evaluation using a diffusional anisotropic phantom

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Joon; Choi, Choong Gon; Kim, Jeong Kon [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Yun, Sung Cheol [Dept. of Biostatistics, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Jeong, Ha Kyu [Dept. of Radiology, East-West Neomedical Center, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Kim, Eun Ju [Clinical Scientist, MR, Philips Healthcare, Seoul (Korea, Republic of)

    2015-04-15

    To validate the usefulness of a diffusional anisotropic capillary array phantom and to investigate the effects of diffusion tensor imaging (DTI) parameter changes on diffusion fractional anisotropy (FA) and apparent diffusion coefficient (ADC) using the phantom. Diffusion tensor imaging of a capillary array phantom was performed with imaging parameter changes, including voxel size, number of sensitivity encoding (SENSE) factor, echo time (TE), number of signal acquisitions, b-value, and number of diffusion gradient directions (NDGD), one-at-a-time in a stepwise-incremental fashion. We repeated the entire series of DTI scans thrice. The coefficients of variation (CoV) were evaluated for FA and ADC, and the correlation between each MR imaging parameter and the corresponding FA and ADC was evaluated using Spearman's correlation analysis. The capillary array phantom CoVs of FA and ADC were 7.1% and 2.4%, respectively. There were significant correlations between FA and SENSE factor, TE, b-value, and NDGD, as well as significant correlations between ADC and SENSE factor, TE, and b-value. A capillary array phantom enables repeated measurements of FA and ADC. Both FA and ADC can vary when certain parameters are changed during diffusion experiments. We suggest that the capillary array phantom can be used for quality control in longitudinal or multicenter clinical studies.

  18. Acute myocardial ischemia after aortic valve replacement: A comprehensive diagnostic evaluation using dynamic multislice spiral computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Lembcke, Alexander [Department of Radiology, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany)]. E-mail: alexander.lembcke@gmx.de; Hein, Patrick A. [Department of Radiology, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany); Enzweiler, Christian N.H. [Department of Radiology, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany); Hoffmann, Udo [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Klessen, Christian [Department of Radiology, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany); Dohmen, Pascal M. [Department of Cardiovascular Surgery, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany)

    2006-03-15

    We describe the case of a 72-year-old man presenting with endocarditis and clinical signs of acute myocardial ischemia after biological aortic valve replacement. A comprehensive cardiac dynamic multislice spiral computed tomography demonstrated: (1) an endocarditic vegetation of the aortic valve; (2) a subvalvular leakage feeding a paravalvular pseudoaneurysm based on an aortic root abscess with subsequent compromise of the systolic blood flow in the left main coronary artery and the resulting myocardial perfusion deficit.

  19. Acute myocardial ischemia after aortic valve replacement: A comprehensive diagnostic evaluation using dynamic multislice spiral computed tomography

    International Nuclear Information System (INIS)

    Lembcke, Alexander; Hein, Patrick A.; Enzweiler, Christian N.H.; Hoffmann, Udo; Klessen, Christian; Dohmen, Pascal M.

    2006-01-01

    We describe the case of a 72-year-old man presenting with endocarditis and clinical signs of acute myocardial ischemia after biological aortic valve replacement. A comprehensive cardiac dynamic multislice spiral computed tomography demonstrated: (1) an endocarditic vegetation of the aortic valve; (2) a subvalvular leakage feeding a paravalvular pseudoaneurysm based on an aortic root abscess with subsequent compromise of the systolic blood flow in the left main coronary artery and the resulting myocardial perfusion deficit

  20. Synthesis and biological evaluation of cyclic analogs of L-carnitine as potential agents in the treatment of myocardial ischemia

    International Nuclear Information System (INIS)

    Woster, P.M.

    1987-01-01

    The purpose of this research was to synthesize a number of cyclic, rigid analogs of L-carnitine, having a variety of predetermined positional and stereochemical orientations, to be used as probes into the spatial and conformational requirements of the enzyme known as carnitine/acylcarnitine translocase. The ability of these analogs to serve as substrates for this enzyme was to be determined by assessing the degree to which they initiate efflux of 14 C-L-carnitine from isolated heart mitochondria. Toward this end, synthesis of several such analogs was attempted, resulting in the isolation and characterization of 9 cyclic analogs of carnitine, 5 of which are previously unreported. Bioevaluation of these synthetic carnitine analogs was conducted in a previously described assay system. Rat heart mitochondria were isolated by differential centrifugation and prepared for the study by incubation with 14 C-L-carnitine. Efflux of radiolabeled carnitine was then monitored in the presence of the compound being evaluated. This represents the first instance in which non-naturally occurring analogs of L-carnitine have been shown to undergo transport via this mitochondrial translocase, suggesting the possibility that cyclic carnitine analogs may find utility as agents in the treatment of myocardial ischemia

  1. Systematic drug safety evaluation based on public genomic expression (Connectivity Map) data: myocardial and infectious adverse reactions as application cases.

    Science.gov (United States)

    Wang, Kejian; Weng, Zuquan; Sun, Liya; Sun, Jiazhi; Zhou, Shu-Feng; He, Lin

    2015-02-13

    Adverse drug reaction (ADR) is of great importance to both regulatory agencies and the pharmaceutical industry. Various techniques, such as quantitative structure-activity relationship (QSAR) and animal toxicology, are widely used to identify potential risks during the preclinical stage of drug development. Despite these efforts, drugs with safety liabilities can still pass through safety checkpoints and enter the market. This situation raises the concern that conventional chemical structure analysis and phenotypic screening are not sufficient to avoid all clinical adverse events. Genomic expression data following in vitro drug treatments characterize drug actions and thus have become widely used in drug repositioning. In the present study, we explored prediction of ADRs based on the drug-induced gene-expression profiles from cultured human cells in the Connectivity Map (CMap) database. The results showed that drugs inducing comparable ADRs generally lead to similar CMap expression profiles. Based on such ADR-gene expression association, we established prediction models for various ADRs, including severe myocardial and infectious events. Drugs with FDA boxed warnings of safety liability were effectively identified. We therefore suggest that drug-induced gene expression change, in combination with effective computational methods, may provide a new dimension of information to facilitate systematic drug safety evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. China Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of Acute Myocardial Infarction: Study Design

    Directory of Open Access Journals (Sweden)

    Jing Li

    2016-01-01

    Full Text Available Background: Despite the rapid growth in the incidence of acute myocardial infarction (AMI in China, there is limited information about patients′ experiences after AMI hospitalization, especially on long-term adverse events and patient-reported outcomes (PROs. Methods: The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE-Prospective AMI Study will enroll 4000 consecutive AMI patients from 53 diverse hospitals across China and follow them longitudinally for 12 months to document their treatment, recovery, and outcomes. Details of patients′ medical history, treatment, and in-hospital outcomes are abstracted from medical charts. Comprehensive baseline interviews are being conducted to characterize patient demographics, risk factors, presentation, and healthcare utilization. As part of these interviews, validated instruments are administered to measure PROs, including quality of life, symptoms, mood, cognition, and sexual activity. Follow-up interviews, measuring PROs, medication adherence, risk factor control, and collecting hospitalization events are conducted at 1, 6, and 12 months after discharge. Supporting documents for potential outcomes are collected for adjudication by clinicians at the National Coordinating Center. Blood and urine samples are also obtained at baseline, 1- and 12-month follow-up. In addition, we are conducting a survey of participating hospitals to characterize their organizational characteristics. Conclusion: The China PEACE-Prospective AMI study will be uniquely positioned to generate new information regarding patient′s experiences and outcomes after AMI in China and serve as a foundation for quality improvement activities.

  3. N-13 ammonia for the noninvasive evaluation of myocardial blood flow by positron emission computed tomography

    International Nuclear Information System (INIS)

    Schelbert, H.R.; Phelps, M.E.

    1979-01-01

    The kinetics and characteristics of nitrogen-13 labelled ammonia as an indicator of blood flow in the myocardium were evaluated in open-chest dogs. Its utility as an imaging agent was tested in animals and man

  4. Slow electron contribution to inelastic reflection anisotropy

    International Nuclear Information System (INIS)

    Podsvirov, O.A.; Kuznetsov, Yu.A.

    1980-01-01

    Investigated is electron contribution with low energy (up to 1 keV) to the anisotropy of electron inelastic reflection (IRE) from silicon monocrystal (111) within 12-50 keV energy range of primary electrons. Experimental data on IRE anisotropy are presented: delay curves for silicon monocrystal, permitting to separate electrons with the energy up to 1 keV, dependences of IRE anisotropy on the energy of primary electrons for the systems - monocrystalline silicon-amorphous silicon film and delay curves for such systems (film thickness varies from 20 to 2000 A). Suggested is a phenomenologic model, permitting to take into account the contribution of slow electrons to IRE anisotropy: it is supposed, that three groups of electrons take part in the formation of the latter: elastic and inelastic reflected electrons, slow electrons, excited by primary electrons and slow electrons, generated by the reverse flow of the scattered electrons. Contribution of electrons, different by origin, to IRE anisotropy is evaluated in accordance with the experimental data on the basis of this model. It is stated, that slow electrons constitute approximately one half of the IRE anisotropy value, the contribution of both groups of slow electrons being approximately equal

  5. Myocardial contusion following nonfatal blunt chest trauma

    International Nuclear Information System (INIS)

    Kumar, S.A.; Puri, V.K.; Mittal, V.K.; Cortez, J.

    1983-01-01

    Currently available diagnostic techniques for myocardial contusion following blunt chest trauma were evaluated. We investigated 30 patients prospectively over a period of 1 year for the presence of myocardial contusion. Among the 30 patients, eight were found to have myocardial contusion on the basis of abnormal electrocardiograms, elevated creatine phosphokinase MB fraction (CPK-MB), and positive myocardial scan. Myocardial scan was positive in seven of eight patients (87.5%). CPK-MB fraction was elevated in four of eight patients (50%). Definitive electrocardiographic changes were seen in only two of eight patients (25%). It appears that myocardial scan using technetium pyrophosphate and CPK-MB fraction determinations are the most reliable aids in diagnosis of myocardial contusion following blunt chest trauma

  6. A randomized trial evaluating different modalities of levosimendan administration in cardiac surgery patients with myocardial dysfunction

    NARCIS (Netherlands)

    de Hert, Stefan G.; Lorsomradee, Suraphong; vanden Eede, Hervé; Cromheecke, Stefanie; van der Linden, Philippe J.

    2008-01-01

    OBJECTIVE: To evaluate the effects of 2 different administration modalities of levosimendan (start before cardiopulmonary bypass [CPB] and at the end of CPB) compared with a standard treatment with milrinone started at the end of CPB in cardiac surgery patients with a preoperative ejection fraction

  7. Evaluation of myocardial preconditioning and adenosine effects in cardioprotection in rat hearts with ischemia-reperfusion injury using 99MTc-glucarate imaging

    International Nuclear Information System (INIS)

    Liu Zhonglin; Barrett, H.H.; Koon Yan Pak

    2004-01-01

    Significant tolerance to myocardial ischemia-reperfusion injury, as assessed by biochemical assay and noninvasive infarct-avid imaging, was induced with an IPC protocol in the rat model. The cardioprotection of IPC could be simulated by adenosine receptor A1 agonist CCPA, or blocked by antagonist SPT. Thus, adenosine mediates protection by ischemic preconditioning in this specific rat heart model. 99mTc-glucarate imaging is not only useful in detecting early ischemia-reperfusion injury, but also invaluable in evaluating the effects of cardioprotective treatments. uantitative anal ses on dynamic images with 99m Tc-glucarate would make it possible to identify myocardial ischemia-reperfusion injury more accurate, and provide a unique tool for evaluation of cardioprotection. The FASTSPECT imaging with the ischenuc-reperfused rat heart model provides a solution-specific approach with high-resolution and fast dynamic acquisition for kinetic studies of new myocardial imaging agents as the evidence of its major role in the present study. (authors)

  8. The accuracy of myocardial perfusion SPECT imaging in the evaluation of coronary artery disease in women and men

    International Nuclear Information System (INIS)

    Kaminek, M.; Myslivecek, M.; Huyak, V.; Koranda, P.; Skvarilova, M.; Ostransky, J.

    2001-01-01

    The purpose of this study is to compare sensitivity, specificity and accuracy of myocardial perfusion SPECT for the detection of coronary artery disease (CAD) in women and men. 588 patients (455 males and 133 females, 273 after a previous myocardial infarction) underwent stress myocardial perfusion SPECT. The accuracy of myocardial perfusion SPECT was proved by coronary angiography (stenosis >50% was considered as a CAD). The sensitivity of SPECT was slightly higher, but statistically not significant, in men than in women (94% versus 91%, p > 0.05). The specificity was higher in women than in men (93% versus 82%), but this difference was not statistically significant either (p > 0.05). The accuracy of SPECT was the same for both sexes (92%). In angiographically verified group of patients the selection bias was obvious - patients with CAD dominated (74%) and the fraction of patients with CAD in men's group (83%) was significantly higher than in women's group (50%), p < 0.05. No significant difference was revealed in the accuracy of myocardial perfusion SPECT in men and women. Our results are in accordance with the prevailing opinion in literature that discovered differences in sensitivity, specificity and diagnostic accuracy are usually not statistically significant or that they can be explained by the selection bias of patients in angiographically verified groups (significantly higher fraction of patients with CAD in men's group). (author)

  9. Relationship between myocardial T2* values and cardiac volumetric and functional parameters in β-thalassemia patients evaluated by cardiac magnetic resonance in association with serum ferritin levels

    Energy Technology Data Exchange (ETDEWEB)

    Liguori, Carlo, E-mail: c.liguori@unicampus.it [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Pitocco, Francesca, E-mail: f.pitocco@unicampus.it [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Di Giampietro, Ilenia, E-mail: i.digiampietro@unicampus.it [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Vivo, Aldo Eros de, E-mail: devivoeros@gmail.com [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Schena, Emiliano, E-mail: e.schena@unicampus.it [Unit of Measurements and Biomedical Instrumentation, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy); Cianciulli, Paolo, E-mail: CIANCIULLI.PAOLO@aslrmc.it [Thalassemia Unit, Ospedale Sant Eugenio, Piazzale dell’Umanesimo 10, 00143 Rome (Italy); Zobel, Bruno Beomonte, E-mail: b.zobel@unicampus.it [Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome (Italy)

    2013-09-15

    Purpose: Myocardial T2* cardiovascular magnetic resonance provides a rapid and reproducible assessment of cardiac iron load in thalassemia patients. Although cardiac involvement is mainly characterized by left ventricular dysfunction caused by iron overload, little is known about right ventricular function. The aim of this study was to assess the relationship between T2* value in myocardium and left–right ventricular volumetric and functional parameters and to evaluate the existing associations between left–right ventricles volumetric and functional parameter, myocardial T2* values and blood ferritin levels. Materials and methods: A retrospective analysis of 208 patients with β-thalassemia major and thalassemia intermedia was performed (109 males and 99 females; mean age 37.7 ± 13 years; 143 thalassemia major, 65 thalassemia intermedia). Myocardial iron load was assessed by T2* measurements, and volumetric functions were analyzed using the steady state free precession sequence. Results: A significant correlation was observed between EFLV and T2* (p = 0.0001), EFRV and T2* (p = 0.0279). An inverse correlation was present between DVLV and T2* (p = 0.0468), SVLV and T2* (p = 0.0003), SVRV and T2* (p = 0.0001). There was no significant correlation between cardiac T2* and LV–RV mass indices. A significant correlation was observed between T2* and serum ferritin levels (p < 0.001) and between EFLV and serum ferritin (p < 0.05). Conclusion: Myocardial iron load assessed by T2* cardiac magnetic resonance is associated with deterioration in left–right ventricular function; this is more evident when T2* values fall below 14 ms. CMR appears to be a promising approach for cardiac risk evaluation in TM patients.

  10. Relationship between myocardial T2* values and cardiac volumetric and functional parameters in β-thalassemia patients evaluated by cardiac magnetic resonance in association with serum ferritin levels

    International Nuclear Information System (INIS)

    Liguori, Carlo; Pitocco, Francesca; Di Giampietro, Ilenia; Vivo, Aldo Eros de; Schena, Emiliano; Cianciulli, Paolo; Zobel, Bruno Beomonte

    2013-01-01

    Purpose: Myocardial T2* cardiovascular magnetic resonance provides a rapid and reproducible assessment of cardiac iron load in thalassemia patients. Although cardiac involvement is mainly characterized by left ventricular dysfunction caused by iron overload, little is known about right ventricular function. The aim of this study was to assess the relationship between T2* value in myocardium and left–right ventricular volumetric and functional parameters and to evaluate the existing associations between left–right ventricles volumetric and functional parameter, myocardial T2* values and blood ferritin levels. Materials and methods: A retrospective analysis of 208 patients with β-thalassemia major and thalassemia intermedia was performed (109 males and 99 females; mean age 37.7 ± 13 years; 143 thalassemia major, 65 thalassemia intermedia). Myocardial iron load was assessed by T2* measurements, and volumetric functions were analyzed using the steady state free precession sequence. Results: A significant correlation was observed between EFLV and T2* (p = 0.0001), EFRV and T2* (p = 0.0279). An inverse correlation was present between DVLV and T2* (p = 0.0468), SVLV and T2* (p = 0.0003), SVRV and T2* (p = 0.0001). There was no significant correlation between cardiac T2* and LV–RV mass indices. A significant correlation was observed between T2* and serum ferritin levels (p < 0.001) and between EFLV and serum ferritin (p < 0.05). Conclusion: Myocardial iron load assessed by T2* cardiac magnetic resonance is associated with deterioration in left–right ventricular function; this is more evident when T2* values fall below 14 ms. CMR appears to be a promising approach for cardiac risk evaluation in TM patients

  11. Positron emission tomography with [11C]-acetate for evaluation of myocardial oxidative metabolism. Clinical use

    International Nuclear Information System (INIS)

    Litvinova, I.S.; Litvinov, M.M.; Rozhkova, G.G.; Leont'eva, I.V.; Sebeleva, I.A.; Tumanyan, M.R.; Koledinskij, D.G.; Sukhorukov, V.S.

    2001-01-01

    The diagnostic potentials of positron emission tomography (PET) with [ 11 C]-acetate as applied to mitochondrial disorders in children with cardiomyopathies (CMP) are evaluated. PET examinations are performed in 17 patients of the mean age of 7.5 ± 3.1 years with CMP. A dynamic study with [ 11 C]-acetate is conducted to evaluate the Krebs cycle activity. The experiments have indicated to a fewer accumulation of [ 11 C]-acetate and to its slower clearance in the ischemic zone as compared with the normal myocardium. The Krebs cycle activity has been reduced. By means of PET with [ 11 C]-acetate the oxidation rate constant of the Krebs cycle and the [ 11 C]-acetate-activity clearance half-time can be quantified. This makes possible to assess the extent of oxidative metabolism malfunction, including the case of perfusion reduction [ru

  12. Systematic drug safety evaluation based on public genomic expression (Connectivity Map) data: Myocardial and infectious adverse reactions as application cases

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Kejian, E-mail: kejian.wang.bio@gmail.com [Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, Shanghai (China); Weng, Zuquan [Japan National Institute of Occupational Safety and Health, Kawasaki (Japan); Sun, Liya [Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, Shanghai (China); Sun, Jiazhi; Zhou, Shu-Feng [Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL (United States); He, Lin, E-mail: helin@Bio-X.com [Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, Shanghai (China)

    2015-02-13

    Adverse drug reaction (ADR) is of great importance to both regulatory agencies and the pharmaceutical industry. Various techniques, such as quantitative structure–activity relationship (QSAR) and animal toxicology, are widely used to identify potential risks during the preclinical stage of drug development. Despite these efforts, drugs with safety liabilities can still pass through safety checkpoints and enter the market. This situation raises the concern that conventional chemical structure analysis and phenotypic screening are not sufficient to avoid all clinical adverse events. Genomic expression data following in vitro drug treatments characterize drug actions and thus have become widely used in drug repositioning. In the present study, we explored prediction of ADRs based on the drug-induced gene-expression profiles from cultured human cells in the Connectivity Map (CMap) database. The results showed that drugs inducing comparable ADRs generally lead to similar CMap expression profiles. Based on such ADR-gene expression association, we established prediction models for various ADRs, including severe myocardial and infectious events. Drugs with FDA boxed warnings of safety liability were effectively identified. We therefore suggest that drug-induced gene expression change, in combination with effective computational methods, may provide a new dimension of information to facilitate systematic drug safety evaluation. - Highlights: • Drugs causing common toxicity lead to similar in vitro gene expression changes. • We built a model to predict drug toxicity with drug-specific expression profiles. • Drugs with FDA black box warnings were effectively identified by our model. • In vitro assay can detect severe toxicity in the early stage of drug development.

  13. Systematic drug safety evaluation based on public genomic expression (Connectivity Map) data: Myocardial and infectious adverse reactions as application cases

    International Nuclear Information System (INIS)

    Wang, Kejian; Weng, Zuquan; Sun, Liya; Sun, Jiazhi; Zhou, Shu-Feng; He, Lin

    2015-01-01

    Adverse drug reaction (ADR) is of great importance to both regulatory agencies and the pharmaceutical industry. Various techniques, such as quantitative structure–activity relationship (QSAR) and animal toxicology, are widely used to identify potential risks during the preclinical stage of drug development. Despite these efforts, drugs with safety liabilities can still pass through safety checkpoints and enter the market. This situation raises the concern that conventional chemical structure analysis and phenotypic screening are not sufficient to avoid all clinical adverse events. Genomic expression data following in vitro drug treatments characterize drug actions and thus have become widely used in drug repositioning. In the present study, we explored prediction of ADRs based on the drug-induced gene-expression profiles from cultured human cells in the Connectivity Map (CMap) database. The results showed that drugs inducing comparable ADRs generally lead to similar CMap expression profiles. Based on such ADR-gene expression association, we established prediction models for various ADRs, including severe myocardial and infectious events. Drugs with FDA boxed warnings of safety liability were effectively identified. We therefore suggest that drug-induced gene expression change, in combination with effective computational methods, may provide a new dimension of information to facilitate systematic drug safety evaluation. - Highlights: • Drugs causing common toxicity lead to similar in vitro gene expression changes. • We built a model to predict drug toxicity with drug-specific expression profiles. • Drugs with FDA black box warnings were effectively identified by our model. • In vitro assay can detect severe toxicity in the early stage of drug development

  14. Evaluation of the metabolism in rat hearts of two new radioiodinated 3-methyl-branched fatty acid myocardial imaging agents

    Energy Technology Data Exchange (ETDEWEB)

    Ambrose, K R; Owen, B A; Goodman, M M; Knapp, Jr, F F

    1987-01-01

    The biological fate of two new radioiodinated 3-methyl-branched fatty acids has been evaluated in rat hearts following intravenous administration. Methyl-branching was introduced in (15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) and 15-(p-iodophenyl)-3,3-dimethylpentadecanoic acid (DMIPP) to inhibit ..beta..-oxidation. The goals of these studies were to correlate the effects of methyl-branching on the incorporation of these agents into the various fatty acid pools and subcellular distribution profiles, and to relate these data to the myocardial retention properties. The properties of BMIPP and DMIPP were compared with the 15-(p-iodophenyl)pentadecanoic acid straight-chain analogue (IPP). Differences in the heart retention of the analogues after intravenous administration in rats correlated with differences observed in subcellular distribution patterns. The dimethyl DMIPP analogue showed the longest retention and the highest association with the mitochondrial and microsomal fractions (34%, 38%) 30 min after injection. These data are in contrast to the rapid clearance of the straight-chain IPP analogue which showed much lower relative association with the mitochondria and microsomes (18%, 15%). The distribution patterns of each analogue in the various lipid pools appeared consistent with the expected capacity of the analogues to be metabolized by ..beta..-oxidation. In contrast to the rapid oxidation of the straight-chain IPP analogue, the 3-monomethyl BMIPP analogue appeared to undergo slower oxidation and clearance, whereas the dimethyl-branched DMIPP analogue was apparatently not catabolized by the myocardium. All three analogues showed some incorporation into triglycerides. The metabolism patterns of the branched analogues reported here may provide useful information in the description of the mechanisms by which BMIPP and DMIPP are retained in rat myocardium.

  15. Evaluation of heart perfusion in patients with acute myocardial infarction using dynamic contrast-enhanced magnetic resonance imaging

    DEFF Research Database (Denmark)

    Nielsen, Gitte; Fritz-Hansen, Thomas; Dirks, Christina G

    2004-01-01

    with acute transmural myocardial infarction were studied using a Turbo-fast low angle shot (FLASH) MRI sequence to monitor the first pass of an extravascular contrast agent (CA), gadolinium diethylene triamine pentaacetic acid (Gd-DTPA). Quantitation of perfusion, expressed as Ki (mL/100 g/minute), in five......PURPOSE: To investigate the diagnostic ability of quantitative magnetic resonance imaging (MRI) heart perfusion in acute heart patients, a fast, multislice dynamic contrast-enhanced MRI sequence was applied to patients with acute myocardial infarction. MATERIALS AND METHODS: Seven patients...

  16. Plasma sheet pressure anisotropies

    International Nuclear Information System (INIS)

    Stiles, G.S.; Hones, E.W. Jr; Bame, S.J.; Asbridge, J.R.

    1978-01-01

    The ecliptic plane components of the pressure tensors for low-energy ( or =1.2 approximately 25% of the time. Due to the low energy density of the electrons, however, this anisotropy is not itself sufficient to balance the tension of the magnetic field

  17. CMB anisotropies interpolation

    NARCIS (Netherlands)

    Zinger, S.; Delabrouille, Jacques; Roux, Michel; Maitre, Henri

    2010-01-01

    We consider the problem of the interpolation of irregularly spaced spatial data, applied to observation of Cosmic Microwave Background (CMB) anisotropies. The well-known interpolation methods and kriging are compared to the binning method which serves as a reference approach. We analyse kriging

  18. Synthesis and preliminary evaluation of {sup 18}F-labeled 4-thia palmitate as a PET tracer of myocardial fatty acid oxidation

    Energy Technology Data Exchange (ETDEWEB)

    DeGrado, Timothy R. E-mail: trd@petsparc.mc.duke.edu; Wang Shuyan; Holden, James E.; Nickles, R. Jerome; Taylor, Michael; Stone, Charles K

    2000-04-01

    Interest remains strong for the development of a noninvasive technique for assessment of regional fatty acid oxidation rate in the myocardium. {sup 18}F-labeled 4-thia palmitate (FTP, 16-[{sup 18}F]fluoro-4-thia-hexadecanoic acid) has been synthesized and preliminarily evaluated as a metabolically trapped probe of myocardial fatty acid oxidation for positron emission tomography (PET). The radiotracer is synthesized by Kryptofix 2.2.2/K{sub 2}CO{sub 3} assisted nucleophilic radiofluorination of an iodo-ester precursor, followed by alkaline hydrolysis and by purification by reverse phase high performance liquid chromatography. Biodistribution studies in rats showed high uptake and long retention of FTP in heart, liver, and kidneys consistent with relatively high fatty acid oxidation rates in these tissues. Inhibition of carnitine palmitoyl-transferase-I caused an 80% reduction in myocardial uptake, suggesting the dependence of trapping on the transport of tracer into the mitochondrion. Experiments with perfused rat hearts showed that the estimates of the fractional metabolic trapping rate (FR) of FTP tracked inhibition of oxidation rate of palmitate with hypoxia, whereas the FR of the 6-thia analog 17-[{sup 18}F]fluoro-6-thia-heptadecanoic acid was insensitive to hypoxia. In vivo defluorination of FTP in the rat was evidenced by bone uptake of radioactivity. A PET imaging study with FTP in normal swine showed excellent myocardial images, prolonged myocardial retention, and no bone uptake of radioactivity up to 3 h, the last finding suggesting a species dependence for defluorination of the omega-labeled fatty acid. The results support further investigation of FTP as a potential PET tracer for assessing regional fatty acid oxidation rate in the human myocardium.

  19. Combined evaluation of regional coronary artery calcium and myocardial perfusion by {sup 82}Rb PET/CT in the identification of obstructive coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Zampella, Emilia; Assante, Roberta; Nappi, Carmela; Mainolfi, Ciro Gabriele; Green, Roberta; Cantoni, Valeria; Klain, Michele; Cuocolo, Alberto [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Acampa, Wanda [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); National Council of Research, Institute of Biostructure and Bioimaging, Naples (Italy); Gaudieri, Valeria; Panico, Mariarosaria [National Council of Research, Institute of Biostructure and Bioimaging, Naples (Italy); Petretta, Mario [University Federico II, Department of Translational Medical Sciences, Naples (Italy); Slomka, Piotr J. [Cedars-Sinai Medical Center, Department of Medicine, Los Angeles, CA (United States); UCLA, David Geffen School of Medicine, Los Angeles, CA (United States)

    2018-04-15

    Cardiac imaging with PET/CT allows measurement of coronary artery calcium (CAC), myocardial perfusion and coronary vascular function. We investigated whether the combined assessment of regional CAC score, ischemic total perfusion deficit (ITPD) and quantitative coronary vascular function would further improve the diagnostic accuracy of PET/CT in predicting obstructive coronary artery disease (CAD). We analyzed 113 patients with suspected CAD referred to {sup 82}Rb PET/CT myocardial perfusion imaging with available coronary angiographic data. Obstructive CAD was defined as ≥75% stenosis. The receiver operating characteristic area under curve (AUC) was applied to evaluate the ability of CAC score, ITPD, hyperemic myocardial blood flow (MBF) and coronary flow reserve (CFR) to identify CAD. Vessels with obstructive CAD (71 vessels) had higher ITPD (4.6 ± 6.2 vs. 0.6 ± 1.3) and lower hyperemic MBF (1.01 ± 0.5 vs. 1.75 ± 0.6 ml/min/g) and CFR (1.56 ± 0.6 vs. 2.38 ± 0.7; all p < 0.001) than those without. In prediction of per-vessel CAD, the AUCs for the models including CAC/ITPD/hyperemic MBF (0.869) and CAC/ITPD/CFR (0.875) were higher (both p < 0.01) than for the model including CAC/ITPD (0.790). Compared with CAC/ITPD, continuous net reclassification improvement was 0.69 (95% bootstrap confidence interval, CI, 0.365-1.088) for the CAC/ITPD/hyperemic MBF model and 0.99 (95% bootstrap CI 0.64-1.26) for the CAC/ITPD/CFR model. Hyperemic MBF and CFR provide incremental information about the presence of CAD over CAC score and perfusion imaging parameters. The combined use of CAC, myocardial perfusion imaging and quantitative coronary vascular function in may help predict more accurately the presence of obstructive CAD. (orig.)

  20. Usefulness of {sup 123}I-Meta-iodobenzylguanidine (MIBG) myocardial scintigraphy for evaluation of cardiac sympathetic nervous system function in diabetic patients.

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Koji; Nakatani, Yuko; Doi, Kenji; Adachi, Gakuji; Takada, Kou

    2001-11-01

    The cardiac sympathetic nervous system function of diabetic patients with no definite cardiovascular complications other than hypertension was evaluated by {sup 123}I -MIBG myocardial scintigraphy. The subjects consisted of 82 diabetic patients, 59 men, 23 women, mean age 57 years, 17 with hypertension and 65 with normal blood pressure, and they were compared with normal controls (8 men and 3 women, mean age 54 years). Myocardial scintigraphy was performed 10 minutes and 4 hours after administration of MIBG. The superior mediastinum and whole myocardium were set as regions of interest, and the heart-to-mediastinum ratio (H/M ratio) and the washout rate (%WR) were calculated. The mean observation period was 18{+-}12 months, and 17 of the 65 diabetic patients with normal blood pressure before the study developed hypertension during the observation period. There were significant differences in H/M ratio and %WR between the diabetic patients and normal controls (H/M ratio; 1.96{+-}0.34 vs 2.27{+-}0.20, %WR; 24.71{+-}16.99% vs 12.89{+-}11.94). The diabetic patients with hypertension had higher morbidity with diabetic retinopathy and a lower H/M ratio. The 17 patients who developed hypertension during the observation period showed an increase in %WR and a reduction in the H/M ratio. Five patients who died during the observation period had a reduced H/M ratio and increased of %WR. {sup 123}I-MIBG myocardial scintigraphy in diabetic patients was shown to be useful for detecting cardiac sympathetic nervous system dysfunction, predicting the development of hypertension, and identifying patients who had a poor outcome. Diabetic patients with abnormal signals on MIBG myocardial scintigraphy need to be monitored much more carefully. (K.H.)

  1. Usefulness of 123I-Meta-iodobenzylguanidine (MIBG) myocardial scintigraphy for evaluation of cardiac sympathetic nervous system function in diabetic patients

    International Nuclear Information System (INIS)

    Tamura, Koji; Nakatani, Yuko; Doi, Kenji; Adachi, Gakuji; Takada, Kou; Onishi, Satoshi

    2001-01-01

    The cardiac sympathetic nervous system function of diabetic patients with no definite cardiovascular complications other than hypertension was evaluated by 123 I -MIBG myocardial scintigraphy. The subjects consisted of 82 diabetic patients, 59 men, 23 women, mean age 57 years, 17 with hypertension and 65 with normal blood pressure, and they were compared with normal controls (8 men and 3 women, mean age 54 years). Myocardial scintigraphy was performed 10 minutes and 4 hours after administration of MIBG. The superior mediastinum and whole myocardium were set as regions of interest, and the heart-to-mediastinum ratio (H/M ratio) and the washout rate (%WR) were calculated. The mean observation period was 18±12 months, and 17 of the 65 diabetic patients with normal blood pressure before the study developed hypertension during the observation period. There were significant differences in H/M ratio and %WR between the diabetic patients and normal controls (H/M ratio; 1.96±0.34 vs 2.27±0.20, %WR; 24.71±16.99% vs 12.89±11.94). The diabetic patients with hypertension had higher morbidity with diabetic retinopathy and a lower H/M ratio. The 17 patients who developed hypertension during the observation period showed an increase in %WR and a reduction in the H/M ratio. Five patients who died during the observation period had a reduced H/M ratio and increased of %WR. 123 I-MIBG myocardial scintigraphy in diabetic patients was shown to be useful for detecting cardiac sympathetic nervous system dysfunction, predicting the development of hypertension, and identifying patients who had a poor outcome. Diabetic patients with abnormal signals on MIBG myocardial scintigraphy need to be monitored much more carefully. (K.H.)

  2. Synthesis and preliminary evaluation of 18F-labeled 4-thia palmitate as a PET tracer of myocardial fatty acid oxidation

    International Nuclear Information System (INIS)

    DeGrado, Timothy R.; Wang Shuyan; Holden, James E.; Nickles, R. Jerome; Taylor, Michael; Stone, Charles K.

    2000-01-01

    Interest remains strong for the development of a noninvasive technique for assessment of regional fatty acid oxidation rate in the myocardium. 18 F-labeled 4-thia palmitate (FTP, 16-[ 18 F]fluoro-4-thia-hexadecanoic acid) has been synthesized and preliminarily evaluated as a metabolically trapped probe of myocardial fatty acid oxidation for positron emission tomography (PET). The radiotracer is synthesized by Kryptofix 2.2.2/K 2 CO 3 assisted nucleophilic radiofluorination of an iodo-ester precursor, followed by alkaline hydrolysis and by purification by reverse phase high performance liquid chromatography. Biodistribution studies in rats showed high uptake and long retention of FTP in heart, liver, and kidneys consistent with relatively high fatty acid oxidation rates in these tissues. Inhibition of carnitine palmitoyl-transferase-I caused an 80% reduction in myocardial uptake, suggesting the dependence of trapping on the transport of tracer into the mitochondrion. Experiments with perfused rat hearts showed that the estimates of the fractional metabolic trapping rate (FR) of FTP tracked inhibition of oxidation rate of palmitate with hypoxia, whereas the FR of the 6-thia analog 17-[ 18 F]fluoro-6-thia-heptadecanoic acid was insensitive to hypoxia. In vivo defluorination of FTP in the rat was evidenced by bone uptake of radioactivity. A PET imaging study with FTP in normal swine showed excellent myocardial images, prolonged myocardial retention, and no bone uptake of radioactivity up to 3 h, the last finding suggesting a species dependence for defluorination of the omega-labeled fatty acid. The results support further investigation of FTP as a potential PET tracer for assessing regional fatty acid oxidation rate in the human myocardium

  3. Operative characteristic of the myocardial perfusion of repose in the evaluation of the thoracic pain in urgencies

    International Nuclear Information System (INIS)

    Merlano, Sonia; Murgueitio, Ramon; Rodriguez, Edgard; Carvajal, Andres; Suarez, Martin

    2000-01-01

    Conventional emergency department testing strategies for patients with chest pain often provide equivocal diagnosis of coronary artery disease. This study was conducted in order to determine the sensitivity, specificity, positive predictive value (PPV) negative predictive value (NPV) and negative likelihood ratio (LR-) of the myocardial perfusion imaging with single photon emission computed tomography (SPECT) imaging at rest

  4. Use of blood-pool imaging in evaluation of diffuse activity patterns in technetium-99m pyrophosphate myocardial scintigraphy.

    Science.gov (United States)

    Cowley, M J; Mantle, J A; Rogers, W J; Russell, R O; Rackley, C E; Logic, J R

    1979-06-01

    It has been suggested that diffuse Tc-99m pyrophosphate precordial activity may be due to persistent blood-pool activity in routine delayed views during myocardial imaging. To answer this question, we reviewed myocardial scintigrams recorded 60--90 min following the injection of 12--15 mCi of Tc-99m pyrophosphate for the presence of diffuse precordial activity, and compared these with early images of the blood pool in 265 patients. Diffuse activity in the delayed images was identified in 48 patients: in 20 with acute myocardial infarction and in 28 with no evidence of it. Comparison of these routine delayed images with early views of the blood pool revealed two types of patterns. In patients with acute infarction, 95% had delayed images that were distinguishable from blood pool either because the activity was smaller than the early blood pool, or by the presence of localized activity superimposed on diffuse activity identical to blood pool. In those without infarction, 93% had activity distribution in routine delayed views matching that in the early blood-pool images. The usefulness of the diffuse TcPPi precordial activity in myocardial infarction is improved when early blood-pool imaging is used to exclude persistence of blood-pool activity as its cause. Moreover, it does not require additional amounts of radioactivity nor complex computer processing, a feature that may be of value in the community hospital using the technique to "rule out" infarction 24--72 hr after onset of suggestive symptoms.

  5. A model that accounts for the interdependence of extent and severity in the automatic evaluation of myocardial defects

    DEFF Research Database (Denmark)

    El-Ali, Henrik Hussein; Palmer, John; Edenbrandt, Lars

    2006-01-01

    The extent and severity are two important parameters when describing a regional defect in myocardial single-photon emission computed tomography (SPECT) perfusion imaging. Intuitively, these two parameters should be independent of each other, but we have shown in a previous study that there is an ...

  6. Evaluation of latent cardiac disease in diabetic patients with Tl-201 exercise myocardial scintigram and blood pool scintigram

    International Nuclear Information System (INIS)

    Miyashita, Takeo; Kasai, Ryutaro; Ikebe, Nobuhiko; Nagai, Yoshikazu; Yamasawa, Ikuhiro; Ibukiyama, Chiharu; Notoya, Yoko

    1990-01-01

    To find latent heart disease in diabetic patients, 142 diabetic patients were divided into 4 groups: (1) no hypertension and normal ECG (DM group); (2) hypertension recognized clinically (HT group); (3) myocardial damage on ECG (MD group); (4) group associated with the previous 2 (HT+MD group). In all groups Tl-201 exercise myocardial scintigrams and blood pool scintigrams were taken for comparative analysis. Positive rates of SPECT were 27.7% (23/83) in the DM group, 30.0% (9/30) in the HT group, 50.0% (6/12) in the MD group, and 70.6% (12/17) in the HT+MD group. The rate in the HT+MD group was significantly higher than in that of the DM and HT groups (p<0.001, p<0.01). Blood pool scintigrams revealed that in the HT+MD group, as compared with the normal control group, both 1/3 FF and PFR were significantly depressed, in addition to significant TPF prolongation in the former (p<0.001, p<0.05, p<0.05). These findings suggest that in diabetic patients hypertension and myocardial damage would lead to a high incidence of abnormality in SPECT and left ventricular rapid filling dysfunction. This indicate a high incidence of latent cardiac disease which can be recognized in diabetic patients by stress myocardial and blood pool scintigrams. (author)

  7. Use of blood-pool imaging in evaluation of diffuse activity patterns in technetium-99m pyrophosphate myocardial scintigraphy

    International Nuclear Information System (INIS)

    Cowley, M.J.; Mantle, J.A.; Rogers, W.J.; Russell, R.O. Jr.; Rackley, C.E.; Logic, J.R.

    1979-01-01

    It has been suggested that diffuse 99m Tc pyrophosphate precordial activity may be due to persistent blood-pool activity in routine delayed views during myocardial imaging. To answer this question, we reviewed myocardial scintigrams recorded 60 to 90 min following the injection of 12 to 15 mCi of 99m Tc pyrophosphate for the presence of diffuse precordial activity, and compared these with early images of the blood pool in 265 patients. Diffuse activity in the delayed images was identified in 48 patients: in 20 with acute myocardial infarction and in 28 with no evidence of it. Comparison of these routine delayed images with early views of the blood pool revealed two types of patterns. In patients with acute infarction, 95% had delayed images that were distinguishable from blood pool either because the activity was smaller than the early blood pool, or by the presence of localized activity superimposed on diffuse activity identical to blood pool. In those without infarction, 93% had activity distribution in routine delayed views matching that in the early blood-pool images. The usefulness of the diffuse TcPPi precordial activity in myocardial infarction is improved when early blood-pool imaging is used to exclude persistence of blood-pool activity as its cause. Moreover, it does not require additional amounts of radioactivity nor complex computer processing, a feature that may be of value in the community hospital using the technique to rule out infarction 24 to 72 hr after onset of suggestive symptoms

  8. T1 and T2 mapping for evaluation of myocardial involvement in patients with ANCA-associated vasculitides.

    Science.gov (United States)

    Greulich, Simon; Mayr, Agnes; Kitterer, Daniel; Latus, Joerg; Henes, Joerg; Steubing, Hannah; Kaesemann, Philipp; Patrascu, Alexandru; Greiser, Andreas; Groeninger, Stefan; Braun, Niko; Alscher, M Dominik; Sechtem, Udo; Mahrholdt, Heiko

    2017-01-06

    Myocardial involvement in AAV patients might be silent, presenting with no or nonspecific symptoms, normal ECG, and preserved left-ventricular ejection fraction (LV-EF). Since up to 50% of deaths in these patients may be due to myocardial involvement, a reliable diagnostic tool is warranted. In contrast to LGE-CMR, which has its strengths in detecting focal inflammatory or fibrotic processes, recent mapping techniques are able to detect even subtle, diffuse inflammatory or fibrotic processes. Our study sought to investigate ANCA (antineutrophil cytoplasmic antibody) associated vasculitides (AAV) patients for myocardial involvement by a cardiovascular magnetic resonance (CMR) protocol, including late gadolinium enhancement (LGE) and mapping sequences. Thirty seven AAV patients were prospectively enrolled and underwent CMR imaging. Twenty healthy volunteers served as controls. Mean LV-EF was 64%; LGE prevalence of the AAV patients was 43%. AAV patients had higher median native T1 (988 vs. 952 ms, p T2 (53 vs. 49 ms, p T2 in AAV patients showed the highest prevalence of abnormally increased values beyond the 95% percentile of controls. AAV patients demonstrated increased T1, ECV, and T2 values, with native T1 and T2 showing the highest prevalence of values beyond the 95% percentile of normal. Since these findings seem to be independent of LGE, mapping techniques may provide complementary information to LGE-CMR in the assessment of myocardial involvement in patients with AAV.

  9. Evaluation of heart perfusion in patients with acute myocardial infarction using dynamic contrast-enhanced magnetic resonance imaging

    DEFF Research Database (Denmark)

    Nielsen, Gitte; Hansen, Thomas Fritz; Dirks, Christina G

    2004-01-01

    with acute transmural myocardial infarction were studied using a Turbo-fast low angle shot (FLASH) MRI sequence to monitor the first pass of an extravascular contrast agent (CA), gadolinium diethylene triamine pentaacetic acid (Gd-DTPA). Quantitation of perfusion, expressed as Ki (mL/100 g/minute), in five...

  10. Technical Note: Evaluation of a 160-mm/256-row CT scanner for whole-heart quantitative myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    So, Aaron, E-mail: aso@robarts.ca [Imaging Program, Lawson Health Research Institute, London, Ontario N6A 4V2 (Canada); Imai, Yasuhiro; Nett, Brian; Jackson, John; Nett, Liz; Hsieh, Jiang [CT Engineering, GE Healthcare, Waukesha, Wisconsin 53188 (United States); Wisenberg, Gerald; Teefy, Patrick; Yadegari, Andrew [Cardiology, University Hospital, London Health Sciences Centre, London, Ontario N6A 5A5 (Canada); Islam, Ali [Radiology, St. Joseph’s Hospital London, Ontario N6A 4V2 (Canada); Lee, Ting-Yim [Imaging Program, Lawson Health Research Institute, London, Ontario N6A 4V2, Canada and Imaging Research Laboratories, Robarts Research Institute, London, Ontario N6A 5K8 (Canada)

    2016-08-15

    Purpose: The authors investigated the performance of a recently introduced 160-mm/256-row CT system for low dose quantitative myocardial perfusion (MP) imaging of the whole heart. This platform is equipped with a gantry capable of rotating at 280 ms per full cycle, a second generation of adaptive statistical iterative reconstruction (ASiR-V) to correct for image noise arising from low tube voltage potential/tube current dynamic scanning, and image reconstruction algorithms to tackle beam-hardening, cone-beam, and partial-scan effects. Methods: Phantom studies were performed to investigate the effectiveness of image noise and artifact reduction with a GE Healthcare Revolution CT system for three acquisition protocols used in quantitative CT MP imaging: 100, 120, and 140 kVp/25 mAs. The heart chambers of an anthropomorphic chest phantom were filled with iodinated contrast solution at different concentrations (contrast levels) to simulate the circulation of contrast through the heart in quantitative CT MP imaging. To evaluate beam-hardening correction, the phantom was scanned at each contrast level to measure the changes in CT number (in Hounsfield unit or HU) in the water-filled region surrounding the heart chambers with respect to baseline. To evaluate cone-beam artifact correction, differences in mean water HU between the central and peripheral slices were compared. Partial-scan artifact correction was evaluated from the fluctuation of mean water HU in successive partial scans. To evaluate image noise reduction, a small hollow region adjacent to the heart chambers was filled with diluted contrast, and contrast-to-noise ratio in the region before and after noise correction with ASiR-V was compared. The quality of MP maps acquired with the CT system was also evaluated in porcine CT MP studies. Myocardial infarct was induced in a farm pig from a transient occlusion of the distal left anterior descending (LAD) artery with a catheter-based interventional procedure. MP

  11. Technical Note: Evaluation of a 160-mm/256-row CT scanner for whole-heart quantitative myocardial perfusion imaging

    International Nuclear Information System (INIS)

    So, Aaron; Imai, Yasuhiro; Nett, Brian; Jackson, John; Nett, Liz; Hsieh, Jiang; Wisenberg, Gerald; Teefy, Patrick; Yadegari, Andrew; Islam, Ali; Lee, Ting-Yim

    2016-01-01

    Purpose: The authors investigated the performance of a recently introduced 160-mm/256-row CT system for low dose quantitative myocardial perfusion (MP) imaging of the whole heart. This platform is equipped with a gantry capable of rotating at 280 ms per full cycle, a second generation of adaptive statistical iterative reconstruction (ASiR-V) to correct for image noise arising from low tube voltage potential/tube current dynamic scanning, and image reconstruction algorithms to tackle beam-hardening, cone-beam, and partial-scan effects. Methods: Phantom studies were performed to investigate the effectiveness of image noise and artifact reduction with a GE Healthcare Revolution CT system for three acquisition protocols used in quantitative CT MP imaging: 100, 120, and 140 kVp/25 mAs. The heart chambers of an anthropomorphic chest phantom were filled with iodinated contrast solution at different concentrations (contrast levels) to simulate the circulation of contrast through the heart in quantitative CT MP imaging. To evaluate beam-hardening correction, the phantom was scanned at each contrast level to measure the changes in CT number (in Hounsfield unit or HU) in the water-filled region surrounding the heart chambers with respect to baseline. To evaluate cone-beam artifact correction, differences in mean water HU between the central and peripheral slices were compared. Partial-scan artifact correction was evaluated from the fluctuation of mean water HU in successive partial scans. To evaluate image noise reduction, a small hollow region adjacent to the heart chambers was filled with diluted contrast, and contrast-to-noise ratio in the region before and after noise correction with ASiR-V was compared. The quality of MP maps acquired with the CT system was also evaluated in porcine CT MP studies. Myocardial infarct was induced in a farm pig from a transient occlusion of the distal left anterior descending (LAD) artery with a catheter-based interventional procedure. MP

  12. Technical Note: Evaluation of a 160-mm/256-row CT scanner for whole-heart quantitative myocardial perfusion imaging.

    Science.gov (United States)

    So, Aaron; Imai, Yasuhiro; Nett, Brian; Jackson, John; Nett, Liz; Hsieh, Jiang; Wisenberg, Gerald; Teefy, Patrick; Yadegari, Andrew; Islam, Ali; Lee, Ting-Yim

    2016-08-01

    The authors investigated the performance of a recently introduced 160-mm/256-row CT system for low dose quantitative myocardial perfusion (MP) imaging of the whole heart. This platform is equipped with a gantry capable of rotating at 280 ms per full cycle, a second generation of adaptive statistical iterative reconstruction (ASiR-V) to correct for image noise arising from low tube voltage potential/tube current dynamic scanning, and image reconstruction algorithms to tackle beam-hardening, cone-beam, and partial-scan effects. Phantom studies were performed to investigate the effectiveness of image noise and artifact reduction with a GE Healthcare Revolution CT system for three acquisition protocols used in quantitative CT MP imaging: 100, 120, and 140 kVp/25 mAs. The heart chambers of an anthropomorphic chest phantom were filled with iodinated contrast solution at different concentrations (contrast levels) to simulate the circulation of contrast through the heart in quantitative CT MP imaging. To evaluate beam-hardening correction, the phantom was scanned at each contrast level to measure the changes in CT number (in Hounsfield unit or HU) in the water-filled region surrounding the heart chambers with respect to baseline. To evaluate cone-beam artifact correction, differences in mean water HU between the central and peripheral slices were compared. Partial-scan artifact correction was evaluated from the fluctuation of mean water HU in successive partial scans. To evaluate image noise reduction, a small hollow region adjacent to the heart chambers was filled with diluted contrast, and contrast-to-noise ratio in the region before and after noise correction with ASiR-V was compared. The quality of MP maps acquired with the CT system was also evaluated in porcine CT MP studies. Myocardial infarct was induced in a farm pig from a transient occlusion of the distal left anterior descending (LAD) artery with a catheter-based interventional procedure. MP maps were generated

  13. Quantitative assessment of 201TlCl myocardial SPECT

    International Nuclear Information System (INIS)

    Uehara, Toshiisa

    1987-01-01

    Clinical evaluation of the quantitative analysis of Tl-201 myocardial tomography by SPECT (Single Photon Emission Computed Tomography) was performed in comparison with visual evaluation. The method of quantitative analysis has been already reported in our previous paper. In this study, the program of re-standardization in the case of lateral myocardial infarction was added. This program was useful mainly for the evaluation of lesions in the left circumflex coronary artery. Regarding the degree of diagnostic accuracy of myocardial infarction in general, quantitative evaluation of myocardial SPECT images was highest followed by visual evaluation of myocardial SPECT images, and visual evaluation of myocardial planar images. However, in the case of anterior myocardial infarction, visual evaluation of myocardial SPECT images has almost the same detectability as quantitative evaluation of myocardial SPECT images. In the case of infero-posterior myocardial infarction, quantitative evaluation was superior to visual evaluation. As for specificity, quantitative evaluation of SPECT images was slightly inferior to visual evaluation of SPECT images. An infarction map was made by quantitative analysis and this enabled us to determine the infarction site, extent and degree according to easily recognizable patterns. As a result, the responsible coronary artery lesion could be inferred correctly and the calculated infarction score could be correlated with the residual left ventricular function after myocardial infarction. (author)

  14. Elastic Anisotropy of Basalt

    Science.gov (United States)

    Becker, K.; Shapiro, S.; Stanchits, S.; Dresen, G.; Kaselow, A.; Vinciguerra, S.

    2005-12-01

    Elastic properties of rocks are sensitive to changes of the in-situ stress and damage state. In particular, seismic velocities are strongly affected by stress-induced formation and deformation of cracks or shear-enhanced pore collapse. The effect of stress on seismic velocities as a result of pore space deformation in isotropic rock at isostatic compression may be expressed by the equation: A+K*P-B*exp (-D*P) (1), where P=Pc-Pp is the effective pressure, the pure difference between confining pressure and pore pressure. The parameter A, K, B and D describe material constants determined using experimental data. The physical meaning of the parameters is given by Shapiro (2003, in Geophysics Vol.68(Nr.2)). Parameter D is related to the stress sensitivity of the rock. A similar relation was derived by Shapiro and Kaselow (2005, in Geophysics in press) for weak anisotropic rocks under arbitrary load. They describe the stress dependent anisotropy in terms of Thomson's (1986, in Geophysics, Vol. 51(Nr.10)) anisotropy parameters ɛ and γ as a function of stress in the case of an initially isotropic rock: ɛ ∝ E2-E3, γ ∝ E3-E2 (2) with Ei=exp (D*Pi). The exponential terms Ei are controlled by the effective stress components Pi. To test this relation, we have conducted a series of triaxial compression tests on dry samples of initially isotropic Etnean Basalt in a servo-controlled MTS loading frame equipped with a pressure cell. Confining pressure was 60, 40 and 20 MPa. Samples were 5 cm in diameter and 10 cm in length. Elastic anisotropy was induced by axial compression of the samples through opening and growth of microcracks predominantly oriented parallel to the sample axis. Ultrasonic P- and S- wave velocities were monitored parallel and normal to the sample axis by an array of 20 piezoceramic transducers glued to the surface. Preamplified full waveform signals were stored in two 12 channel transient recorders. According to equation 2 the anisotropy parameters are

  15. Nuclear medicine and coronary artery disease: evaluation of tracers of myocardial perfusion and vulnerable atherosclerotic plaque; Medecine nucleaire et maladie coronarienne: evaluation de traceurs de la perfusion myocardique et de la plaque d'atherome vulnerable

    Energy Technology Data Exchange (ETDEWEB)

    Broisat, A

    2005-04-15

    Coronary artery disease is one of the primary cause of mortality worldwide. Nuclear medicine is the major imaging technique for diagnosis and following of this disease. perfusion: nowadays, major radioactive agents used in clinical practice are myocardial perfusion tracers. The reference tracer is thallium-201. However, {sup 201}Tl presents some drawbacks. {sup 99m}Tcn-noet has been proposed for its replacement. This study shows that in contrast with previous studies realized in vitro on cardio myocytes, verapamil, an l-type calcium channel inhibitor, does not inhibit myocardial fixation of {sup 99m}Tcn-noet in vivo in dog. This data is in agreement with the hypothesis of a non specific endothelial fixation of this tracer. Moreover, this study shows that as a pure tracer of myocardial perfusion, {sup 99m}Tcn-noet can also be used to assess myocardial viability on a model of myocardial chronic infarction in rat. atherosclerosis: disruption of vulnerable atherosclerotic plaques is the main event leading to coronary accidents. The second part of this study concerns the evaluation of new potential tracers of the vulnerable atherosclerotic plaque in an experimental model of rabbit with an inheritable hypercholesterolemia. The four tracers evaluated (b2702(r), b2702-I, b2702-Tc and Tc-raft-b2702) are synthetic peptides comprising the residues 75-84 of hla-b2702, a molecule known to link vcam-1, an adhesion molecule expressed in vulnerable atherosclerotic plaque. The autoradiography studies show that all tracers accumulate within atherosclerotic plaque expressing vcam- and that. i-b2702 shows the best plaque/control fixation ratio. (author)

  16. Nuclear medicine and coronary artery disease: evaluation of tracers of myocardial perfusion and vulnerable atherosclerotic plaque; Medecine nucleaire et maladie coronarienne: evaluation de traceurs de la perfusion myocardique et de la plaque d'atherome vulnerable

    Energy Technology Data Exchange (ETDEWEB)

    Broisat, A

    2005-04-15

    Coronary artery disease is one of the primary cause of mortality worldwide. Nuclear medicine is the major imaging technique for diagnosis and following of this disease. perfusion: nowadays, major radioactive agents used in clinical practice are myocardial perfusion tracers. The reference tracer is thallium-201. However, {sup 201}Tl presents some drawbacks. {sup 99m}Tcn-noet has been proposed for its replacement. This study shows that in contrast with previous studies realized in vitro on cardio myocytes, verapamil, an l-type calcium channel inhibitor, does not inhibit myocardial fixation of {sup 99m}Tcn-noet in vivo in dog. This data is in agreement with the hypothesis of a non specific endothelial fixation of this tracer. Moreover, this study shows that as a pure tracer of myocardial perfusion, {sup 99m}Tcn-noet can also be used to assess myocardial viability on a model of myocardial chronic infarction in rat. atherosclerosis: disruption of vulnerable atherosclerotic plaques is the main event leading to coronary accidents. The second part of this study concerns the evaluation of new potential tracers of the vulnerable atherosclerotic plaque in an experimental model of rabbit with an inheritable hypercholesterolemia. The four tracers evaluated (b2702(r), b2702-I, b2702-Tc and Tc-raft-b2702) are synthetic peptides comprising the residues 75-84 of hla-b2702, a molecule known to link vcam-1, an adhesion molecule expressed in vulnerable atherosclerotic plaque. The autoradiography studies show that all tracers accumulate within atherosclerotic plaque expressing vcam- and that. i-b2702 shows the best plaque/control fixation ratio. (author)

  17. Acute myocardial infarction

    International Nuclear Information System (INIS)

    RISCHPLER, Christoph

    2016-01-01

    Inflammatory processes after myocardial infarction have gained major interest in recent cardiovascular research. It is believed that not only the degree of cell recruitment to the heart plays a pivotal role in the quality of wound healing after myocardial infarction, but also the balance between different types or even subtypes of cells. It is also this balance which is thought to control key processes in tissue repair, such as apoptosis and neoangiogenesis. In this paper, we aim to review imaging strategies (with a special focus on nuclear molecular imaging strategies) that target cells and processes involved in postischemic inflammation and that have a high potential to be translated into clinic or that are already being used and evaluated in humans.

  18. Development of 4D mathematical observer models for the task-based evaluation of gated myocardial perfusion SPECT

    Science.gov (United States)

    Lee, Taek-Soo; Frey, Eric C.; Tsui, Benjamin M. W.

    2015-04-01

    This paper presents two 4D mathematical observer models for the detection of motion defects in 4D gated medical images. Their performance was compared with results from human observers in detecting a regional motion abnormality in simulated 4D gated myocardial perfusion (MP) SPECT images. The first 4D mathematical observer model extends the conventional channelized Hotelling observer (CHO) based on a set of 2D spatial channels and the second is a proposed model that uses a set of 4D space-time channels. Simulated projection data were generated using the 4D NURBS-based cardiac-torso (NCAT) phantom with 16 gates/cardiac cycle. The activity distribution modelled uptake of 99mTc MIBI with normal perfusion and a regional wall motion defect. An analytical projector was used in the simulation and the filtered backprojection (FBP) algorithm was used in image reconstruction followed by spatial and temporal low-pass filtering with various cut-off frequencies. Then, we extracted 2D image slices from each time frame and reorganized them into a set of cine images. For the first model, we applied 2D spatial channels to the cine images and generated a set of feature vectors that were stacked for the images from different slices of the heart. The process was repeated for each of the 1,024 noise realizations, and CHO and receiver operating characteristics (ROC) analysis methodologies were applied to the ensemble of the feature vectors to compute areas under the ROC curves (AUCs). For the second model, a set of 4D space-time channels was developed and applied to the sets of cine images to produce space-time feature vectors to which the CHO methodology was applied. The AUC values of the second model showed better agreement (Spearman’s rank correlation (SRC) coefficient = 0.8) to human observer results than those from the first model (SRC coefficient = 0.4). The agreement with human observers indicates the proposed 4D mathematical observer model provides a good predictor of the

  19. Development of 4D mathematical observer models for the task-based evaluation of gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Lee, Taek-Soo; Frey, Eric C; Tsui, Benjamin M W

    2015-01-01

    This paper presents two 4D mathematical observer models for the detection of motion defects in 4D gated medical images. Their performance was compared with results from human observers in detecting a regional motion abnormality in simulated 4D gated myocardial perfusion (MP) SPECT images. The first 4D mathematical observer model extends the conventional channelized Hotelling observer (CHO) based on a set of 2D spatial channels and the second is a proposed model that uses a set of 4D space-time channels. Simulated projection data were generated using the 4D NURBS-based cardiac-torso (NCAT) phantom with 16 gates/cardiac cycle. The activity distribution modelled uptake of 99m Tc MIBI with normal perfusion and a regional wall motion defect. An analytical projector was used in the simulation and the filtered backprojection (FBP) algorithm was used in image reconstruction followed by spatial and temporal low-pass filtering with various cut-off frequencies. Then, we extracted 2D image slices from each time frame and reorganized them into a set of cine images. For the first model, we applied 2D spatial channels to the cine images and generated a set of feature vectors that were stacked for the images from different slices of the heart. The process was repeated for each of the 1,024 noise realizations, and CHO and receiver operating characteristics (ROC) analysis methodologies were applied to the ensemble of the feature vectors to compute areas under the ROC curves (AUCs). For the second model, a set of 4D space-time channels was developed and applied to the sets of cine images to produce space-time feature vectors to which the CHO methodology was applied. The AUC values of the second model showed better agreement (Spearman’s rank correlation (SRC) coefficient = 0.8) to human observer results than those from the first model (SRC coefficient = 0.4). The agreement with human observers indicates the proposed 4D mathematical observer model provides a good predictor of the

  20. Quarkonium dissociation by anisotropy

    Science.gov (United States)

    Chernicoff, Mariano; Fernández, Daniel; Mateos, David; Trancanelli, Diego

    2013-01-01

    We compute the screening length for quarkonium mesons moving through an anisotropic, strongly coupled mathcal{N} = 4 super Yang-Mills plasma by means of its gravity dual. We present the results for arbitrary velocities and orientations of the mesons, as well as for arbitrary values of the anisotropy. The anisotropic screening length can be larger or smaller than the isotropic one, and this depends on whether the comparison is made at equal temperatures or at equal entropy densities. For generic motion we find that: (i) mesons dissociate above a certain critical value of the anisotropy, even at zero temperature; (ii) there is a limiting velocity for mesons in the plasma, even at zero temperature; (iii) in the ultra-relativistic limit the screening length scales as (1 - v 2)ɛ with ɛ = 1 /2, in contrast with the isotropic result ɛ = 1 /4.

  1. Fractal analysis of heart rate dynamics as a predictor of mortality in patients with depressed left ventricular function after acute myocardial infarction. TRACE Investigators. TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Mäkikallio, T H; Høiber, S; Køber, L

    1999-01-01

    A number of new methods have been recently developed to quantify complex heart rate (HR) dynamics based on nonlinear and fractal analysis, but their value in risk stratification has not been evaluated. This study was designed to determine whether selected new dynamic analysis methods of HR...... variability predict mortality in patients with depressed left ventricular (LV) function after acute myocardial infarction (AMI). Traditional time- and frequency-domain HR variability indexes along with short-term fractal-like correlation properties of RR intervals (exponent alpha) and power-law scaling...

  2. Assessment of viability by quantitative evaluation of 24h-redistribution in 201-thallium myocardial scintigraphy (SPECT): A comparative study versus clinical follow-up after revascularisation

    International Nuclear Information System (INIS)

    Stirner, H.; Spreng, M.; Picker, D.; Pfafferott, C.

    1992-01-01

    Results of regional quantitative assessment of 24h-redistribution in routinely performed Thallium myocardial scintigraphy (SPECT) were compared to findings of coronary angiography/ventriculography and/or echocardiography as well as clinical status 6 months after revascularisation in up to now 34 patients. In respect of positive and negative predictive values evaluation of 24h-redistribution behaves best (81/100%) compared to perfusion and 3h-redistribution alone. Performing an additional 24h-study gives a gain of at least 80% of diagnostic information. (orig.) [de

  3. The helical ventricular myocardial band of Torrent-Guasp.

    Science.gov (United States)

    Kocica, Mladen J; Corno, Antonio F; Lackovic, Vesna; Kanjuh, Vladimir I

    2007-01-01

    We live in an era of substantial progress in understanding myocardial structure and function at genetic, molecular, and microscopic levels. Yet, ventricular myocardium has proven remarkably resistant to macroscopic analyses of functional anatomy. Pronounced and practically indefinite global and local structural anisotropy of its fibers and other ventricular wall constituents produces electrical and mechanical properties that are nonlinear, anisotropic, time varying, and spatially inhomogeneous. The helical ventricular myocardial band of Torrent-Guasp is a revolutionary new concept in understanding global, 3-dimensional, functional architecture of the ventricular myocardium. This concept defines the principal, cumulative vectors, integrating the tissue architecture (ie, form) and net forces developed (ie, function) within the ventricular mass. The primary purpose of this review is to emphasize the importance of this concept, in the light of collaborative efforts to establish an integrative approach, defining ventricular form and function by linking across multiple scales of biological organization, as explained in the ongoing Physiome project. Because one of the most important scientific missions in this century is integration of basic research with clinical medicine, we believe that this knowledge is not of merely academic importance, but is also the essential prerequisite in clinical evaluation and treatment of different heart diseases.

  4. Supernovae anisotropy power spectrum

    Energy Technology Data Exchange (ETDEWEB)

    Ghodsi, Hoda; Baghram, Shant [Department of Physics, Sharif University of Technology, P.O. Box 11155-9161, Tehran (Iran, Islamic Republic of); Habibi, Farhang, E-mail: h.ghodsi@mehr.sharif.ir, E-mail: baghram@sharif.edu, E-mail: habibi@lal.in2p3.fr [LAL-IN2P3/CNRS, BP 34, 91898 Orsay Cedex (France)

    2017-10-01

    We contribute another anisotropy study to this field of research using Type Ia supernovae (SNe Ia). In this work, we utilise the power spectrum calculation method and apply it to both the current SNe Ia data and simulation. Using the Union2.1 data set at all redshifts, we compare the spectrum of the residuals of the observed distance moduli to that expected from an isotropic universe affected by the Union2.1 observational uncertainties at low multipoles. Through this comparison we find a dipolar anisotropy with tension of less that 2σ towards l = 171° ± 21° and b = −26° ± 28° which is mainly induced by anisotropic spatial distribution of the SNe with z > 0.2 rather than being a cosmic effect. Furthermore, we find a tension of ∼ 4σ at ℓ = 4 between the two spectra. Our simulations are constructed with the characteristics of the upcoming surveys like the Large Synoptic Survey Telescope (LSST), which shall bring us the largest SNe Ia collection to date. We make predictions for the amplitude of a possible dipolar anisotropy that would be detectable by future SNe Ia surveys.

  5. Myocardial scintigraphy: methods and indications

    International Nuclear Information System (INIS)

    Knapp, W.H.

    1993-01-01

    Myocardial scintigraphy comprises perfusion imaging using TI-201 or - more recently - Tc-99m-labeled compounds with high affinity to myocytes. Imaging with these agents has become an important procedure in the detection of coronary artery disease, particularly in patients with non-diagnostic stress-ECG, in the functional evaluation of coronary stenoses after angiographical documentation in order to meet the adequate therapy decision, in therapy monitoring and follow-up, in the post infarction assessment of myocardial viability and differentiation between severe ischemia and scar and, occasionally, in acute ischemia. The use of positron emitters does not offer significant advantages for mere perfusion imaging, but is indispensable for the scintigraphic investigation of certain aspects of myocardial metabolism, particularly for the differentiation of viable ischemic wall segments from irreversibly damaged tissue. Imaging of myocardial necrosis has been improved by the introduction of labeled antimyosin antibody fragments and offers a considerable clinical potential in the diagnosis of myocarditis and cardiac transplant rejection. Neurohumoral aspects are increasingly involved in our understanding of myocardial failure. Scintigraphy of innervation/neurotransmission contributes to the investigation of pathophysiological alterations in myocardial insufficiency and in heart transplants. (orig.) [de

  6. Evaluation of exercise-induced myocardial stunning by means of immediate post-exercise Tc-99m sestamibi gated SPECT

    International Nuclear Information System (INIS)

    Ouvrier, M.J.; Hitzel, A.; Vera, P.; Manrique, A.; Bernard, M.; Manrique, A.

    2009-01-01

    Aim: Repeated episodes of myocardial stunning may lead to chronic ventricular dysfunction. We attempted to assess the parameters related to post-exercise stunning in patients undergoing gated SPECT. Methods: Six hundred patients undergoing a one-day stress/rest 99m Tc-sestamibi gated SPECT were studied. Stress imaging was acquired within 15 minutes after injection. Summed perfusion scores (S.S.S., S.R.S. and S.D.S.) were calculated using Q.P.S., and L.V. function assessed using Q.G.S.. Stunning was defined as the association of ischemia (S.S.S. = 4 and SDS > 0) and a minimum of 5% decrease in post-stress E.F.. Results: Ischemia was found in 225 (37.5%) patients. Among these, 67 (30%) showed myocardial stunning. Patients with stunning had a lower rest E.S.V. (47 ± 24 ml vs 65 ± 52 ml, p < 0.0003) and E.D.V. (108± 35 ml vs 122 ± 66 ml, p 0.03), an increased rest L.V.E.F. (58 ± 10% vs 52 ± 13%, p < 0.0001) and a decreased post-stress L.V.E.F. (49 ± 10% vs 53 ± 13%, p < 0.02) compared to patients with no stunning. The number of myocardial segments showing reversible perfusion defects was increased in patients with stunning (2.7 ± 2.6 vs 1.7 ± 2.1, p < 0.02). On logistic regression, an extent of ischemia greater than two segments and a rest E.F. greater than 45% were independent predictors of the occurrence of myocardial stunning in patients with ischemia. Conclusions: In patients with ischemia, exercise-induced stunning was associated with an increased extent of ischemia but also preserved rest ventricular function. (authors)

  7. Evaluation of sympathetic activity by 123I-metaiodobenzylguanidine myocardial scintigraphy in dilated cardiomyopathy patients with sleep breathing disorder

    International Nuclear Information System (INIS)

    Nanjo, Shuji; Fujimoto, Shinichiro; Yamashiro, Yoshihiro

    2009-01-01

    Because increased sympathetic nervous activity (SNA) in patients with dilated cardiomyopathy (DCM) associated with sleep breathing disorder (SBD) is known to deteriorate the prognosis of cardiac failure, 123 I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was used as the investigative tool in the present study. The study group comprised 53 patients (47 men, 6 women; mean age 56±3 years) with chronic stable DCM. Patients were divided into SBD(+) or SBD(-) group according to 24-h pulse oximetry results. SBD(+) was defined when the 3% oxygen desaturation index was more than 15/h during sleep. In total, 32 patients were SBD(-) and 21 were SBD(+). In both groups, pulse oximetry were performed during sleep and awakening pulse rate, and measurement of the blood levels of catecholamines and B-type natriuretic peptide was performed. MIBG myocardial scintigraphy and echocardiography were performed at the same time. No significant difference was found between the 2 groups in catecholamine levels or left ventricular ejection fraction. However, MIBG had a significantly increased washout rate and a significantly decreased delayed heart to mediastinum ratio in the SBD(+) group compared with the SBD(-) group. SNA is increased in DCM patients when associated with SBD. MIBG myocardial scintigraphy may be a sensitive method of detecting increased SNA. (author)

  8. Evaluation of the prevalence of stress and its phases in acute myocardial infarction in patients active in the labor market

    Directory of Open Access Journals (Sweden)

    Luciane Boreki Lucinda

    2015-02-01

    Full Text Available Introduction: Acute myocardial infarction is a social health problem of epidemiological relevance, with high levels of morbidity and mortality. Stress is one of the modifiable risk factors that triggers acute myocardial infarction. Stress is a result of a set of physiological reactions, which when exaggerated in intensity or duration can lead to imbalances in one's organism, resulting in vulnerability to diseases. Objective: To identify the presence of stress and its phases in hospitalized and active labor market patients with unstable myocardial infarction and observe its correlation with the life of this population with stress. Methods: The methodology used was a quantitative, descriptive and transversal research approach conducted with a total of 43 patients, who were still active in the labor market, presenting or not morbidities. Data collection occurred on the fourth day of their hospitalization and patients responded to Lipp's Stress Symptom Inventory for adults. Results: Thirty-one patients (72.1% presented stress and twelve (27.8% did not. In patients with stress, the identified phases were: alert - one patient (3.2%; resistance -twenty-two patients (71.0%; quasi-exhaustion - six patients (19.4% and exhaustion - two patients (6.5%. All women researched presented stress. Conclusion: The results suggest a high level of stress, especially in the resistance phase, in the male infarcted population, hospitalized and active in the labor market.

  9. Function's evaluation, perfusion and metabolism by positron emission tomography associated with multislice tomography (PET/CT) in patient with previous diagnosis to myocardial necrosis

    International Nuclear Information System (INIS)

    Campisi, Roxana; Aramayo, Natalia; Osorio, Amilcar

    2010-01-01

    A 64-years-old male patient with previous diagnosis of myocardial necrosis as assessed by myocardial perfusion gated single photon emission computed tomography (gSPECT) with 3-vessel-disease, left ventricular dysfunction and symptomatic by epigastric pain. The patient was referred for myocardial viability assessment by positron emission tomography (PET) to define clinical management decision. (authors) [es

  10. 99 mTc-MIBI washout as a complementary factor in the evaluation of idiopathic dilated cardiomyopathy (IDCM) using myocardial perfusion imaging.

    Science.gov (United States)

    Shiroodi, Mohammad Kazem; Shafiei, Babak; Baharfard, Nastaran; Gheidari, Mohammad Esmail; Nazari, Babak; Pirayesh, Elaheh; Kiasat, Ali; Hoseinzadeh, Samaneh; Hashemi, Abolghassem; Akbarzadeh, Mohammad Ali; Javadi, Hamid; Nabipour, Iraj; Assadi, Majid

    2012-01-01

    Rapid technetium-99 m methoxyisobutylisonitrile (99 mTc-MIBI) washout has been shown to occur in impaired myocardia. This study is based on the hypothesis that scintigraphy can be applied to calculate the myocardial 99 mTc-MIBI washout rate (WR) to diagnose and evaluate heart failure severity and other left ventricular functional parameters specifically in idiopathic dilated cardiomyopathy (IDCM) patients. Patients with IDCMP (n = 17; 52.65 ± 11.47 years) and normal subjects (n = 6; 49.67 ± 10.15 years) were intravenously administered 99 mTc-hexakis-2-methoxyisobutylisonitrile (99 mTc-MIBI). Next, early and delayed planar data were acquired (at 3.5-h intervals), and electrocardiogram (ECG)-gated myocardial perfusion single photon emission computed tomography (SPECT) was performed. The 99 mTc-MIBI WR was calculated using early and delayed planar images. Left ventricular functional parameters were also analyzed using quantitative gated SPECT (QGS) data. In target group, myocardial WRs (29.13 ± 6.68%) were significantly higher than those of control subjects (14.17 ± 3.31%; P 99 mTc-MIBI WR increased with the increasing severity of the NYHA functional class (23.16 ± 1.72% for class I, 30.25 ± 0.95% for class II, 32.60 ± 6.73% for class III, and 37.50 ± 7.77% for class IV; P = 0.02). The WR was positively correlated with the end-diastolic volume (EDV) index (r (2) = 0.216; β = 0.464; P = 0.02 [ml/m(2)], the end-systolic volume (ESV) index (r (2) = 0.234; β = 0.484; P = 0.01 [ml/m(2)]), the summed motion score (SMS) (r (2) = 0.544; β = 0.738; P = 0.00), and the summed thickening score (STS) (r (2) = 0.656; β = 0.810; P = 0.00); it was negatively correlated with the left ventricular ejection fraction (LVEF) (r (2) = 0.679; β = -0.824; P = 0.00). It can be concluded that 99 mTc-MIBI scintigraphy might be a valuable molecular imaging tool for the diagnosis and evaluation of myocardial damage or dysfunction severity.

  11. The Myocardial Ischemia Evaluated by Real-Time Contrast Echocardiography May Predict the Response to Cardiac Resynchronization Therapy: A Large Animal Study

    Science.gov (United States)

    Chen, Yongle; Cheng, Leilei; Yao, Haohua; Chen, Haiyan; Wang, Yongshi; Zhao, Weipeng; Pan, Cuizhen; Shu, Xianhong

    2014-01-01

    Evidence-based criteria for applying cardiac resynchronization therapy (CRT) in patients with ischemic cardiomyopathy are still scarce. The aim of the present study was to evaluate the predictive value of real-time myocardial contrast echocardiography (RT-MCE) in a preclinical canine model of ischemic cardiomyopathy who received CRT. Ischemic cardiomyopathy was produced by ligating the first diagonal branch in 20 beagles. Dogs were subsequently divided into two groups that were either treated with bi-ventricular pacing (CRT group) or left untreated (control group). RT-MCE was performed at baseline, before CRT, and 4 weeks after CRT. Two-dimensional speckle tracking imaging was used to evaluate the standard deviation of circumferential (Cir12SD), radial (R12SD), and longitudinal (L12SD) strains of left ventricular segments at basal as well as middle levels. Four weeks later, the Cir12SD, R12SD, and myocardial blood flow (MBF) of the treated group were significantly improved compared to their non-CRT counterparts. Furthermore, MBF values measured before CRT were significantly higher in responders than in non-responders to bi-ventricular pacing. Meanwhile, no significant differences were observed between the responder and non-responder groups in terms of Cir12SD, R12SD, and L12SD. A high degree of correlation was found between MBF values before CRT and LVEF after CRT. When MBF value>24.9 dB/s was defined as a cut-off point before CRT, the sensitivity and specificity of RT-MCE in predicting the response to CRT were 83.3% and 100%, respectively. Besides, MBF values increased significantly in the CRT group compared with the control group after 4 weeks of pacing (49.8±15.5 dB/s vs. 28.5±4.6 dB/s, p<0.05). Therefore, we considered that myocardial perfusion may be superior to standard metrics of LV synchrony in selecting appropriate candidates for CRT. In addition, CRT can improve myocardial perfusion in addition to cardiac synchrony, especially in the setting of ischemic

  12. Evaluation of cellular viability by quantitative autoradiographic study of myocardial uptake of a fatty acid analogue in isoproterenol-induced focal rat heart necrosis

    International Nuclear Information System (INIS)

    Humbert, T.; Luu-Duc, C.; Comet, M.; Demenge, P.

    1991-01-01

    Previous studies led us to hypothesize that a fatty acid analogue, 15-p-iodophenyl-β-methyl pentadecanoic acid (IMPPA or BMIPP), which is taken up but not quickly metabolized by heart cells, would be a more suitable tracer of cellular viability that 201 Tl. Biodistribution studies of 1- 14 C-IMPPA in conscious, freely moving rats showed that the concentration ratio of radioactivity in the heart with respect to the blood was about 8 for at least 60 min after intravenous administration, permitting its use as a putative tracer in these conscious, freely moving rats. Thereafter, the myocardial uptake of 14 C-IMPPA was studied in isoproterenol-treated rats (daily treatment for 10 days in order to induce cardiac hypertrophy and necrotic foci) with respect to control ones. Comparison of myocardial localizations by quantitative autoradiography of the uptake of 201 Tl and 14 C-IMPPA with that of triphenyltetrazolium chloride (TTC) staining enabled comparative evaluation of nutritional blood flow, localization and uptake of 14 C-IMPPA and necrotic foci size. Distributions of 14 C-IMPPA and 201 Tl in control rats' hearts were homogenous, like TTC staining. In infarcted hearts, areas of decreased 14 C-IMPPA uptake were nearly the same (100%±5%) as those unstained by TTC. These areas were larger than those showing a decrease in thallium uptake (about 70%±5% of the total scar size). Therefore, IMPPA seems to be a more accurate and sensitive indicator of necrosis localization compared with thallium. It may be a useful agent for assessment of myocardial viability by single photon emission tomography (SPET) imaging. (orig.)

  13. Flow stress anisotropy

    DEFF Research Database (Denmark)

    Winther, G.

    1996-01-01

    stress Variation in the rolling plane, which may be as high as 20%, are presented. The traditional Taylor model is applied to the data to account for the effect of texture. However, texture effects alone are not enough to explain all of the observed anisotropy. New models which take the combined effects...... of texture and deformation microstructure into account are presented. The models are based on the Taylor and Sachs models but modified with an anisotropic critical shear stress to account for the effect of the microstructure. The agreement between experimental data and model predictions is definitely better...

  14. Non-Gaussianity and the Cosmic Microwave Background Anisotropies

    CERN Document Server

    Bartolo, N; Riotto, A

    2010-01-01

    We review in a pedagogical way the present status of the impact of non-Gaussianity (NG) on the Cosmic Microwave Background (CMB) anisotropies. We first show how to set the initial conditions at second-order for the (gauge invariant) CMB anisotropies when some primordial NG is present. However, there are many sources of NG in CMB anisotropies, beyond the primordial one, which can contaminate the primordial signal. We mainly focus on the NG generated from the post-inflationary evolution of the CMB anisotropies at second-order in perturbation theory at large and small angular scales, such as the ones generated at the recombination epoch. We show how to derive the equations to study the second-order CMB anisotropies and provide analytical computations to evaluate their contamination to primordial NG (complemented with numerical examples). We also offer a brief summary of other secondary effects. This review requires basic knowledge of the theory of cosmological perturbations at the linear level.

  15. Non-Gaussianity and the Cosmic Microwave Background Anisotropies

    Directory of Open Access Journals (Sweden)

    N. Bartolo

    2010-01-01

    microwave background (CMB anisotropies. We first show how to set the initial conditions at second order for the CMB anisotropies when some primordial NG is present. However, there are many sources of NG in CMB anisotropies, beyond the primordial one, which can contaminate the primordial signal. We mainly focus on the NG generated from the post inflationary evolution of the CMB anisotropies at second order in perturbation theory at large and small angular scales, such as the ones generated at the recombination epoch. We show how to derive the equations to study the second-order CMB anisotropies and provide analytical computations to evaluate their contamination to primordial NG (complemented with numerical examples. We also offer a brief summary of other secondary effects. This paper requires basic knowledge of the theory of cosmological perturbations at the linear level.

  16. Design of a trial evaluating myocardial cell protection with cariporide, an inhibitor of the transmembrane sodium-hydrogen exchanger: the Guard During Ischemia Against Necrosis (GUARDIAN trial

    Directory of Open Access Journals (Sweden)

    Schroeder John S

    2000-08-01

    Full Text Available Synopsis Background Direct myocardial cell protection in patients with unstable angina or evolving myocardial infarction (MI could prevent cell necrosis or reduce its extent, and minimize the risk of MI and death associated with percutaneous coronary interventions (PCIs and coronary artery bypass surgery. The myocardial NHE plays a critical role in mediating the progression of ischemia to necrosis by promoting intracellular accumulation of sodium and calcium in exchange for hydrogen. Blockage of the system in various experimental models of ischemia and reperfusion had a strong antinecrotic effect. The present paper describes a trial that was intended to investigate the potential clinical benefit of cariporide, a potent and selective inhibitor of the NHE, in a large spectrum of at-risk patients. Trial design The GUARDIAN trial was a multicenter, double-blind, randomized, four-arm trial that compared three cariporide dosages with placebo in patients with unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI and in patients undergoing a high-risk PCI or coronary artery bypass surgery. A total of 11 590 patients with one of the three possible entry diagnoses were enroled in 23 countries. The trial was designed as a combined phase 2/phase 3 study. The primary objective was to evaluate the efficacy of cariporide in reducing all-cause mortality and/or MI across the various entry populations 36 days after randomization. Three different doses of cariporide were compared with placebo. Secondary end-points were death or non-fatal MI at 10 days and 6 months, and cardiac events related to left ventricular dysfunction. The extent of MI was also assessed by peak elevation in creatinine kinase (CK-MB and a ratio of peak elevation to normal values. The sample size was driven by a total event rate of 1200 patients experiencing a primary end-point, powered to detect a 25% risk reduction in any of the three treatment groups compared with

  17. Diagnostic value of exercise induced 18F-FDG myocardial metabolism scintigraphy in myocardial ischemia

    International Nuclear Information System (INIS)

    Shen Rui; He Zuoxiang; Shi Rongfang; Liu Xiujie; Tian Yueqin; Guo Feng; Wei Hongxing; Wu Yongjian; Qin Xuewen; Gao Runlin

    2006-01-01

    Objective: To evaluate the feasibility and diagnostic accuracy of exercise induced myocardial imaging with 18 F-fluorodeoxyglucose (FDG) in myocardial ischemia. Methods: Twenty-six patients with known or suspected coronary artery, disease (CAD) and with no prior myocardial infarction underwent simultaneous myocardial perfusion and metabolism imaging following intravenous injection of 99 Tc m -methoxy-isobutylisonitrile ( 99 Tc m -sestamibi) and 18 F-FDG at peak exercise. Subsequently rest perfusion imaging and coronary angiography (CAG) were performed in all patients. Exercise 18 F-FDG myocardial imaging was compared with 99 Tc m -sestamibi imaging and CAG. Results: In 22 patients with ≥50% narrowing over l coronary artery, 18 had perfusion abnormalities (sensitivity 82%), whereas 20 had abnormal myocardial 18 F-FDG uptake (sensitivity 91%, P>0.05). Patients with reversible (12 cases) or partial reversible (3 cases) perfusion abnormalities had increased myocardial 18 F-FDG uptake in abnormal perfusion segments. Compared with CAG, perfusion defect was seen in myocardial segments corresponding to 25 vascular territories of 51 vessels with ≥50% narrowing in 22 patients in 99 Tc m -sestamibi imaging (sensitivity 49%), whereas increased 18 F-FDG uptake was seen in 34 vascular territories (sensitivity 67%, P=0.008). Conclusions: Exercise induced myocardial ischemia can be imaged directly with 18 F-FDG. Combined exercise 18 F-FDG and 99 Tc m -sestamibi imaging provides a better assessment of exercise-induced myocardial ischemia as compared with exercise-rest perfusion imaging. (authors)

  18. Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping

    International Nuclear Information System (INIS)

    Baessler, Bettina; Treutlein, Melanie; Maintz, David; Bunck, Alexander C.; Schaarschmidt, Frank; Stehning, Christian; Schnackenburg, Bernhard; Michels, Guido

    2017-01-01

    To re-evaluate a recently suggested approach of quantifying myocardial oedema and increased tissue inhomogeneity in myocarditis by T2-mapping. Cardiac magnetic resonance data of 99 patients with myocarditis were retrospectively analysed. Thirthy healthy volunteers served as controls. T2-mapping data were acquired at 1.5 T using a gradient-spin-echo T2-mapping sequence. T2-maps were segmented according to the 16-segments AHA-model. Segmental T2-values, segmental pixel-standard deviation (SD) and the derived parameters maxT2, maxSD and madSD were analysed and compared to the established Lake Louise criteria (LLC). A re-estimation of logistic regression models revealed that all models containing an SD-parameter were superior to any model containing global myocardial T2. Using a combined cut-off of 1.8 ms for madSD + 68 ms for maxT2 resulted in a diagnostic sensitivity of 75% and specificity of 80% and showed a similar diagnostic performance compared to LLC in receiver-operating-curve analyses. Combining madSD, maxT2 and late gadolinium enhancement (LGE) in a model resulted in a superior diagnostic performance compared to LLC (sensitivity 93%, specificity 83%). The results show that the novel T2-mapping-derived parameters exhibit an additional diagnostic value over LGE with the inherent potential to overcome the current limitations of T2-mapping. (orig.)

  19. Noninvasive diagnostic test choices for the evaluation of coronary artery disease in women: a multivariate comparison of cardiac fluoroscopy, exercise electrocardiography and exercise thallium myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Hung, J.; Chaitman, B.R.; Lam, J.; Lesperance, J.; Dupras, G.; Fines, P.; Bourassa, M.G.

    1984-01-01

    Several diagnostic noninvasive tests to detect coronary and multivessel coronary disease are available for women. However, all are imperfect and it is not yet clear whether one particular test provides substantially more information than others. The aim of this study was to evaluate clinical findings, exercise electrocardiography, exercise thallium myocardial scintigraphy and cardiac fluoroscopy in 92 symptomatic women without previous infarction and determine which tests were most useful in determining the presence of coronary disease and its severity. Univariate analysis revealed two clinical, eight exercise electrocardiographic, seven myocardial scintigraphic and seven fluoroscopic variables predictive of coronary or multivessel disease with 70% or greater stenosis. The multivariate discriminant function analysis selected a reversible thallium defect, coronary calcification and character of chest pain syndrome as the variables most predictive of presence or absence of coronary disease. The ranked order of variables most predictive of multivessel disease were cardiac fluoroscopy score, thallium score and extent of ST segment depression in 14 electrocardiographic leads. Each provided statistically significant information to the model. The estimate of predictive accuracy was 89% for coronary disease and 97% for multivessel coronary disease. The results suggest that cardiac fluoroscopy or thallium scintigraphy provide significantly more diagnostic information than exercise electrocardiography in women over a wide range of clinical patient subsets

  20. Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping

    Energy Technology Data Exchange (ETDEWEB)

    Baessler, Bettina; Treutlein, Melanie; Maintz, David; Bunck, Alexander C. [University Hospital of Cologne, Department of Radiology, Cologne (Germany); Schaarschmidt, Frank [Leibniz Universitaet Hannover, Institute of Biostatistics, Faculty of Natural Sciences, Hannover (Germany); Stehning, Christian [Philips Research, Hamburg (Germany); Schnackenburg, Bernhard [Philips, Healthcare Germany, Hamburg (Germany); Michels, Guido [University Hospital of Cologne, Department III of Internal Medicine, Heart Centre, Cologne (Germany)

    2017-12-15

    To re-evaluate a recently suggested approach of quantifying myocardial oedema and increased tissue inhomogeneity in myocarditis by T2-mapping. Cardiac magnetic resonance data of 99 patients with myocarditis were retrospectively analysed. Thirthy healthy volunteers served as controls. T2-mapping data were acquired at 1.5 T using a gradient-spin-echo T2-mapping sequence. T2-maps were segmented according to the 16-segments AHA-model. Segmental T2-values, segmental pixel-standard deviation (SD) and the derived parameters maxT2, maxSD and madSD were analysed and compared to the established Lake Louise criteria (LLC). A re-estimation of logistic regression models revealed that all models containing an SD-parameter were superior to any model containing global myocardial T2. Using a combined cut-off of 1.8 ms for madSD + 68 ms for maxT2 resulted in a diagnostic sensitivity of 75% and specificity of 80% and showed a similar diagnostic performance compared to LLC in receiver-operating-curve analyses. Combining madSD, maxT2 and late gadolinium enhancement (LGE) in a model resulted in a superior diagnostic performance compared to LLC (sensitivity 93%, specificity 83%). The results show that the novel T2-mapping-derived parameters exhibit an additional diagnostic value over LGE with the inherent potential to overcome the current limitations of T2-mapping. (orig.)

  1. Pharmacologic Effects of Cannabidiol on Acute Reperfused Myocardial Infarction in Rabbits: Evaluated With 3.0T Cardiac Magnetic Resonance Imaging and Histopathology.

    Science.gov (United States)

    Feng, Yuanbo; Chen, Feng; Yin, Ting; Xia, Qian; Liu, Yewei; Huang, Gang; Zhang, Jian; Oyen, Raymond; Ni, Yicheng

    2015-10-01

    Cannabidiol (CBD) has anti-inflammatory effects. We explored its therapeutic effects on cardiac ischemia-reperfusion injury with an experimental imaging platform. Reperfused acute myocardial infarction (AMI) was induced in rabbits with a 90-minute coronary artery occlusion followed by 24-hour reperfusion. Before reperfusion, rabbits received 2 intravenous doses of 100 μg/kg CBD (n = 10) or vehicle (control, n = 10). Evans blue was intravenously injected for later detection of the AMI core. Cardiac magnetic resonance imaging was performed to evaluate cardiac morphology and function. After euthanasia, blood troponin I (cTnI) was assessed, and the heart was excised and infused with multifunctional red iodized oil dye. The heart was sliced for digital radiography to quantify the perfusion density rate, area at risk (AAR), and myocardial salvage index, followed by histomorphologic staining. Compared with controls, CBD treatment improved systolic wall thickening (P CBD therapy reduced AMI size and facilitated restoration of left ventricular function. We demonstrated that this experimental platform has potential theragnostic utility.

  2. Optimized Heart Sampling and Systematic Evaluation of Cardiac Therapies in Mouse Models of Ischemic Injury: Assessment of Cardiac Remodeling and Semi-Automated Quantification of Myocardial Infarct Size.

    Science.gov (United States)

    Valente, Mariana; Araújo, Ana; Esteves, Tiago; Laundos, Tiago L; Freire, Ana G; Quelhas, Pedro; Pinto-do-Ó, Perpétua; Nascimento, Diana S

    2015-12-02

    Cardiac therapies are commonly tested preclinically in small-animal models of myocardial infarction. Following functional evaluation, post-mortem histological analysis is essential to assess morphological and molecular alterations underlying the effectiveness of treatment. However, non-methodical and inadequate sampling of the left ventricle often leads to misinterpretations and variability, making direct study comparisons unreliable. Protocols are provided for representative sampling of the ischemic mouse heart followed by morphometric analysis of the left ventricle. Extending the use of this sampling to other types of in situ analysis is also illustrated through the assessment of neovascularization and cellular engraftment in a cell-based therapy setting. This is of interest to the general cardiovascular research community as it details methods for standardization and simplification of histo-morphometric evaluation of emergent heart therapies. © 2015 by John Wiley & Sons, Inc. Copyright © 2015 John Wiley & Sons, Inc.

  3. Correlation between left ventricular diastolic function before and after valve replacement surgery and myocardial ultrastructural changes in patients with left ventricular volume-overloaded valvular heart diseases; Evaluation with gated blood pool scintigraphy using [sup 99m]Tc

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Tomiro (Okayama Univ. (Japan). School of Medicine)

    1993-06-01

    Left ventricular (LV) diastolic functions in 23 patients with aortic regurgitation (AR) and 22 patients with mitral regurgitation (MR) were evaluated by gated blood pool scintigraphy. LV myocardial biopsy was performed during open heart surgery, and LV myocardial ultrastructural changes were evaluated by electron microscope. Correlation between LV diastolic function and myocardial ultrastructural changes was examined. It was suggested that preoperative LV diastolic dysfunction occurred earlier than LV systolic dysfunction in patients with AR and MR. LV early diastolic dysfunction was especially significant in patients with AR. LV systolic function was significantly improved postoperatively compared with LV diastolic function in patients with AR and MR. It was suggested that LV interstitial fibrosis caused LV diastolic dysfunction in patients with AR and MR, and insufficiency of myocardial thickening as compensation in patients with MR. It was presumed that LV diastolic dysfunction was irreversible in patients with AR and MR in the distant postoperative period due to persistence of the preoperative myocardial ultrastructural change, e.g., interstitial fibrosis. These LV diastolic indices measured by gated pool scintigraphy were useful in predicting LV ultrastructural changes and postoperative LV dysfunction in patients with LV volume-overloaded valvular heart disease. (author).

  4. Evaluating coronary reperfusion during acute myocardial infarction in a canine model by gadolinium-DTPA-enhanced magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, Kazuaki; Ishibashi, Yutaka; Shimada, Toshio (Shimane Medical Univ., Izumo (Japan)) (and others)

    1993-05-01

    In previous studies, magnetic resonance imaging (MRI) using contrast agents was found to be useful in distinguishing reperfused infarcts from nonreperfused infarcts. However, there have been only a few detailed studies using consecutive MR images for the assessment of myocardial reperfusion during an acute infarction and also no studies have been performed using a percutaneous transluminal coronary occlusion model (closed chest model). We induced acute myocardial infarction in dogs by occluding and then reperfusing the coronary artery with a balloon catheter. ECG-gated MR images were taken using the spin-echo technique before and after Gd-DTPA injection during both coronary artery occlusion and after reperfusion. We defined the intensity ratio (IR) as the signal intensity at the ischemic area divided by that at the nonischemic area on MR images and compared each image by the IR. Without Gd-DTPA, there was no difference between infarcted and normally perfused myocardium. Infarcted myocardium had a low signal intensity (IR=0.68[+-]0.14) soon after Gd-DTPA injection. This difference diminished with time. After reperfusion the infarcted myocardium had a high signal intensity (IR: 1.76[+-]0.34). We conclude that Gd-DTPA-enhanced MRI can distinguish reperfused from nonreperfused infarcts soon after Gd-DTPA administration. (author).

  5. Metabonomic Strategy to the Evaluation of Chinese Medicine Compound Danshen Dripping Pills Interfering Myocardial Ischemia in Rats

    Directory of Open Access Journals (Sweden)

    Xue Xin

    2013-01-01

    Full Text Available Coronary heart disease (CHD is one of the highest mortality diseases in the world. Traditional Chinese medicine compound Danshen dripping pills (CDDPs have currently made a great achievement in treating CHD. However, the therapeutic mechanism of CDDP is often poorly interpreted. In this study, a GC-MS-based metabonomic study was conducted to assess the holistic efficacy of CDDP for myocardial infarction in male Sprague-Dawley rats, which were divided into the control group, the sham group, the model group, the control + CDDP group, and the model + CDDP, with CDDP at a dose of 107 mg/kg·d (equal to 1.8 mL/kg·d. The metabonomic findings demonstrated great differences of metabolic pattern among sham, model, and the model + CDDP in the orthogonal partial least squares discriminant analysis (OPLS-DA models, which coordinated well with the assessment of plasma biochemistry and histopathological assay. Differentially expressed metabolites suggested that energy metabolism, glycolysis, and lipid metabolism might be disrupted by myocardial infarction. Both the potential metabolic biomarkers and the biochemical histopathological indices were regulated effectively by CDDP.

  6. Evaluation of the door-to-needle time in patients undergoing fibrinolytic therapy after acute myocardial infarction

    International Nuclear Information System (INIS)

    Jehangir, W.; Daood, M.S.; Khan, M.

    2009-01-01

    Early thrombolysis with fibrinolytic therapy has reduced mortality following acute myocardial infarction (AMI) with the major effect coming from early achievement of infarct-related artery potency. This study was carried out to determine the door-to-needle time in patients undergoing fibrinolytic therapy after acute myocardial infarction and to identify factors associated with a prolonged door-to-needle time. This was a cross sectional study in which patients who were thrombolysed for AMI with streptokinase at Punjab Institute of Cardiology, Lahore, from December 12, 2008 to February 18, 2009 were included. All patients admitted with AMI, who were candidates for fibrinolysis, were included. The time of infarction and time of arrival in hospital was determined with ECG changes and asking from patient and/or relatives. The reasons for delay of arrival were asked from patient and accompanying attendants where possible. A door-to-needle time of <30 min could be achieved in 110 of our 201 patients (54.72%). Mean door-to-needle time was 55.13 (+-71.04) minutes. A door-to-needle time of less than 30 minutes in 54.72% is comparable to most contemporary studies however there is a need to look into factors associated with delay. (author)

  7. Evaluating coronary reperfusion during acute myocardial infarction in a canine model by gadolinium-DTPA-enhanced magnetic resonance imaging

    International Nuclear Information System (INIS)

    Tanabe, Kazuaki; Ishibashi, Yutaka; Shimada, Toshio

    1993-01-01

    In previous studies, magnetic resonance imaging (MRI) using contrast agents was found to be useful in distinguishing reperfused infarcts from nonreperfused infarcts. However, there have been only a few detailed studies using consecutive MR images for the assessment of myocardial reperfusion during an acute infarction and also no studies have been performed using a percutaneous transluminal coronary occlusion model (closed chest model). We induced acute myocardial infarction in dogs by occluding and then reperfusing the coronary artery with a balloon catheter. ECG-gated MR images were taken using the spin-echo technique before and after Gd-DTPA injection during both coronary artery occlusion and after reperfusion. We defined the intensity ratio (IR) as the signal intensity at the ischemic area divided by that at the nonischemic area on MR images and compared each image by the IR. Without Gd-DTPA, there was no difference between infarcted and normally perfused myocardium. Infarcted myocardium had a low signal intensity (IR=0.68±0.14) soon after Gd-DTPA injection. This difference diminished with time. After reperfusion the infarcted myocardium had a high signal intensity (IR: 1.76±0.34). We conclude that Gd-DTPA-enhanced MRI can distinguish reperfused from nonreperfused infarcts soon after Gd-DTPA administration. (author)

  8. Evaluation of the quality of the radiopharmaceutical 99mTc-MIBI and its influence on image quality in myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Santos, Poliane Angelo de Lucena

    2013-01-01

    This study evaluated the quality of the 99m Tc-MIBI radiopharmaceutical from different manufacturers, used in three nuclear medicine services (NMS) in Recife-PE, through labeling procedure of each service. It was observed their biodistribution by quantifying the activity present in the organs of interest (heart / liver), the influence and interference in image quality and in myocardial scintigraphy diagnosis exam. In these NMS (A, B and C) were done quality controls in the eluates of 99 Mo/ 99m Tc generators (radionuclidic, chemical and radiochemical purity and pH) and of the 99m Tc-MIBI radiopharmaceutical (radiochemical purity and pH) used in myocardial scintigraphy exam. In the case of radiochemical purity (RCP), was used the thin layer chromatography technique; after the chromatographic ran on, the plates were analyzed both in the dose calibrator, and in scintillation camera of each NMS. The radiopharmaceutical biodistribution was evaluated through the activities present in the heart and liver images in 60 patients, using the technique of combined images counting. Five nuclear physicians analyzed 24 images through myocardial perfusion visual interpretation during stress, it was verified the agreement degree among them. The results of the quality control showed that all eluate samples were in agreement with the manufacturers in relation to radionuclidic purity and pH. In relation to chemical purity, 10% of the services samples B and C showed Al +3 values above 10 ppm. In the RCP, it was observed that using the scintillation camera, only 22% of the samples would be discarded, while with dose calibrator would be 78%, indicating that the scintillation camera is more sensitive in chromatographic pale analysis. For the labeled radiopharmaceutical, the services B and C presented respectively one and three samples with RCP percentage below 90%. However, C service presented the lowest medium to liver/heart proportions, showing that this factor does not depends on the

  9. Myocardial perfusion in silent myocardial ischemia

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa

    1989-01-01

    To investigate myocardial perfusion in silent myocardial ischemia, we performed exercise stress myocardial tomography with thallium-201 (Tl) in 85 patients with coronary artery disease (CAD). Exercise stress myocardial tomography was obtained both immediately after exercise and three hours later. Patients were classified into two groups according to the presence (Symptomatic Group, n=36) or absence (Silent Group, n=49) of chest pain during exercise stress. Clinical features (age, gender and history of myocardial infarction) and arteriographically determined severity of CAD were the same in both groups. The extent of myocardial ischemia (% Ischemia) estimated by exercise stress myocardial tomography was the same in each group (30±10 % in Silent Group, 28±12 % in Symptomatic Group, NS). The severity of exercise-induced myocardial ischemia was expressed as a minimal value of myocardial Tl washout rate (minimal WOR) of each patient. Although exercise heart rate was identical in both groups, minimal WOR in Silent Group was significantly higher than that of Symptomatic Group (4±10% vs -16±14%, p<0.001). The study in patients who exhibited both silent and symptomatic ischemia showed the same results. These findings suggest that the severity of ischemia is a fundamental factor in determining the presence or absence of pain during exercise induced ischemia. (author)

  10. Accordion-like honeycombs for tissue engineering of cardiac anisotropy

    Science.gov (United States)

    Engelmayr, George C.; Cheng, Mingyu; Bettinger, Christopher J.; Borenstein, Jeffrey T.; Langer, Robert; Freed, Lisa E.

    2008-12-01

    Tissue-engineered grafts may be useful in myocardial repair; however, previous scaffolds have been structurally incompatible with recapitulating cardiac anisotropy. Here, we use microfabrication techniques to create an accordion-like honeycomb microstructure in poly(glycerol sebacate), which yields porous, elastomeric three-dimensional (3D) scaffolds with controllable stiffness and anisotropy. Accordion-like honeycomb scaffolds with cultured neonatal rat heart cells demonstrated utility through: (1) closely matched mechanical properties compared to native adult rat right ventricular myocardium, with stiffnesses controlled by polymer curing time; (2) heart cell contractility inducible by electric field stimulation with directionally dependent electrical excitation thresholds (pthe formation of grafts with aligned heart cells and mechanical properties more closely resembling native myocardium.

  11. The cardiomyopathy in Friedreich's ataxia: isotopic ventriculography and myocardial imaging with thallium-201

    International Nuclear Information System (INIS)

    Therriault, L.; Lamoureux, G.; Cote, M.; Plourde, G.; Lemieux, B.

    1984-01-01

    Myocardial scanning after the intravenous administration of Thallium 201 was used to evaluate regional myocardial perfusion in 14 patients with Friedreich's ataxia. Isotopic ventriculography was also used to assess left ventricular contractility. Myocardial images in patients with Friedreich's ataxia were found to be precociously abnormal irrespective of the degree of neurological impairment or of the severity of myocardial hypertrophy

  12. Myocardial perfusion assessed by contrast echocardiography and single photon emission computed tomography in the evaluation of patients with acute chest pain and normal electrocardiogram

    International Nuclear Information System (INIS)

    Soares, J. Jr.; Ferreira, S.M.A.; Matias, W. Jr.; Giorgi, M.C.P.; Izaki, M.; Luz, P.L.; Ramires, J.A.F.; Meneghetti, J.C.

    2002-01-01

    Aim : Evaluation of diagnostic accuracy of myocardial contrast echocardiography (MCE) in comparison with single-photon emission computed tomography (SPECT) for the detection of myocardial ischemia in patients with acute chest pain. Material and Methods : Eighteen patients (pts) with chest pain lasting ≥30 minutes, occurring within 6 hours of emergency room presentation and a normal or no diagnostic electrocardiogram were studied. Pts underwent rest MCE and SPECT. For both exams myocardial perfusion was assessed in the same 7 segments (apical, anterior, inferior, anteroseptal, inferoseptal, lateral and posterior) of left ventricle. A total of 126 segments were analyzed. Images were classified as positive for ischemia if they had a perfusion defect. Coronary angiography was performed if MCE or SPECT images were classified as positive for ischemia or by clinical indication. Otherwise the patients underwent stress SPECT. Significant coronary artery disease (CAD) was defined as ≥70% stenosis in a major coronary artery or its branches. Final diagnosis of an acute coronary event (ACE) was established in the presence of positive findings in MCE or SPECT in addition to significant CAD in the corresponding territory. Kappa statistics were calculated to evaluate the concordance between MCE and SPECT. κ values of ≤0.4, >0.4 and >0.7 indicate fair, good and excellent agreement, respectively. Results: Thirteen out of 18 pts underwent coronary angiography (seven pts had positive findings on SPECT, 2 on MCE, 2 on both exams and 1 had clinical indication). Significant CAD was detected on six. Five pts underwent stress SPECT and no perfusion defect was detected. Therefore, six pts (33.3%) had an ACE and 12 (66.6%) had not. There were no statistical differences between groups according to age, gender, duration of pain, free pain interval, presence of risk factors and antecedents. Concordance between MCE and SPECT for evaluation of perfusion defects showed a ? coefficient of 0

  13. Radioimmunoassay of myosin heavy beta chains in human serum for the evaluation of the size of myocardial infarction: correlation with myocardial Tl-201 SPECT and cardiac angioscintigraphy. Le dosage des chaines lourdes beta de la myosine serique dans l'approche de la taille de l'infarctus du myocarde: correlation avec la tomoscintigraphie myocardique au Tl-201 et l'angioscintigraphie cardiaque

    Energy Technology Data Exchange (ETDEWEB)

    Facello, A.; Gries, P.; Demangeat, C.; Brunot, B.; Roul, G.; Demangeat, J.L.; Moulichon, M.; Bareiss, P.; Sacrez, A.; Constantinesco, A. (Centre Hospitalier Universitaire Hautepierre, 67 - Strasbourg (FR))

    1990-01-01

    To determine the relationship between serum levels of myosin heavy beta chains assessed by an IRMA technique and other radionuclide and enzymatic parameters in the evaluation of the size of myocardial infarction, we studied 22 patients with acute myocardial infarction. Blood samples taken daily between 1st to 13th day of evolution allow the determination of peak and integral of myosine release that showed a good correlation (p<0.01) with myocardial underperfusion score in T1-201 SPECT, left ventricular ejection fractions at 1st day and at the pre-discharge study, just as CPK peak. This new assay is an interesting mean to evaluate the size of myocardial infarction.

  14. Ventricular and myocardial scintiscanning: Methodical fundamentals

    International Nuclear Information System (INIS)

    Standke, R.; Hoer, G.; Maul, F.D.

    1984-01-01

    Nuclear cardiology is concerned with non invasive procedures to quantitate global and regional left ventricular function (Radionuclide ventriculography), also the imaging of vitally perfused myocardium (Myocardial scintigraphy) is achieved. A gammacamera and a minicomputer are necessary. Radionuclide ventriculography enables the analysis of global and regional time dependent left ventricular volume curves and hence the evaluation of contraction and contractility of the heart muscle. The basis is a sequence of scans covering an average heartcycle. This sequence may be produced either by first pass or equilibrium technique. Myocardial scintigraphy at rest images vital myocardium, scans immediately after exercise represent the interference of myocardial perfusion and muscle mass. The regional difference (Redistribution) between normalized exercise- and rest scans provide quantitative parameters to detect impairment of exercise-induced myocardial perfusion anomalies. The procedures of sectorial analysis of left ventricular function and myocardial perfusion are presented. (orig.) [de

  15. Daytime Thermal Anisotropy of Urban Neighbourhoods: Morphological Causation

    Directory of Open Access Journals (Sweden)

    E. Scott Krayenhoff

    2016-01-01

    Full Text Available Surface temperature is a key variable in boundary-layer meteorology and is typically acquired by remote observation of emitted thermal radiation. However, the three-dimensional structure of cities complicates matters: uneven solar heating of urban facets produces an “effective anisotropy” of surface thermal emission at the neighbourhood scale. Remotely-sensed urban surface temperature varies with sensor view angle as a consequence. The authors combine a microscale urban surface temperature model with a thermal remote sensing model to predict the effective anisotropy of simplified neighbourhood configurations. The former model provides detailed surface temperature distributions for a range of “urban” forms, and the remote sensing model computes aggregate temperatures for multiple view angles. The combined model’s ability to reproduce observed anisotropy is evaluated against measurements from a neighbourhood in Vancouver, Canada. As in previous modeling studies, anisotropy is underestimated. Addition of moderate coverages of small (sub-facet scale structure can account for much of the missing anisotropy. Subsequently, over 1900 sensitivity simulations are performed with the model combination, and the dependence of daytime effective thermal anisotropy on diurnal solar path (i.e., latitude and time of day and blunt neighbourhood form is assessed. The range of effective anisotropy, as well as the maximum difference from nadir-observed brightness temperature, peak for moderate building-height-to-spacing ratios (H/W, and scale with canyon (between-building area; dispersed high-rise urban forms generate maximum anisotropy. Maximum anisotropy increases with solar elevation and scales with shortwave irradiance. Moreover, it depends linearly on H/W for H/W < 1.25, with a slope that depends on maximum off-nadir sensor angle. Decreasing minimum brightness temperature is primarily responsible for this linear growth of maximum anisotropy. These

  16. Long-term prognostic importance of hyperkinesia following acute myocardial infarction. TRACE Study Group. TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Kjøller, E; Køber, L; Jørgensen, S

    1999-01-01

    The long-term prognostic importance of hyperkinesia is unknown following an acute myocardial infarction (AMI). The American Society of Echocardiography recommends that hyperkinesia should not be included in calculation of wall motion index (WMI). The objective of the present study was to determine...... if hyperkinesia should be included in WMI when it is estimated for prognostic purposes following an AMI. Six thousand, six hundred seventy-six consecutive patients were screened 1 to 6 days after AMI in 27 Danish hospitals. WMI was measured in 6,232 patients applying the 9-segment model and the following scoring...... system: 3 for hyperkinesia, 2 for normokinesia, 1 for hypokinesia, 0 for akinesia, and -1 for dyskinesia. All patients were followed with respect to mortality for at least 3 years. WMI was calculated in 2 different ways: 1 including hyperkinetic segments (hyperkinetic-WMI) and the other excluding...

  17. Classification of myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Hosbond, Susanne Elisabeth

    2013-01-01

    The classification of myocardial infarction into 5 types was introduced in 2007 as an important component of the universal definition. In contrast to the plaque rupture-related type 1 myocardial infarction, type 2 myocardial infarction is considered to be caused by an imbalance between demand...

  18. Synthesis and Preclinical Evaluation of Radioiodinated Hypericin Dicarboxylic Acid as a Necrosis Avid Agent in Rat Models of Induced Hepatic, Muscular, and Myocardial Necroses.

    Science.gov (United States)

    Li, Jindian; Zhang, Jian; Yang, Shengwei; Jiang, Cuihua; Zhang, DongJian; Jin, Qiaomei; Wang, Qin; Wang, Cong; Ni, Yicheng; Yin, Zhiqi; Song, Shaoli

    2016-01-04

    Myocardial infarction (MI) leads to substantial morbidity and mortality around the world. Accurate assessment of myocardial viability is essential to assist therapies and improve patient outcomes. (131)I-hypericin dicarboxylic acid ((131)I-HDA) was synthesized and evaluated as a potential diagnostic agent for earlier assessment of myocardium viability compared to its preceding counterpart (131)I-hypericin ((131)I-Hyp) with strong hydrophobic property, long plasma half-life, and high uptake in mononuclear phagocyte system (MPS). Herein, HDA was synthesized and characterized, and self-aggregation constant Kα was analyzed by spectrophotometry. Plasma half-life was determined in healthy rats by γ-counting. (131)I-HDA and (131)I-Hyp were prepared with iodogen as oxidant. In vitro necrosis avidity of (131)I-HDA and (131)I-Hyp was evaluated in necrotic cells induced by hyperthermia. Biodistribution was determined in rat models of induced necrosis using γ-counting, autoradiography, and histopathology. Earlier imaging of necrotic myocardium to assess myocardial viability was performed in rat models of reperfused myocardium infarction using single photon emission computed tomography/computed tomography (SPECT/CT). As a result, the self-aggregation constant Kα of HDA was lower than that of Hyp (105602 vs 194644, p HDA displayed a shorter blood half-life compared with (131)I-Hyp (9.21 vs 31.20 h, p HDA relative to that with (131)I-Hyp (5.48 vs 4.63, p HDA showed a higher necrotic-viable myocardium ratio (7.32 vs 3.20, p HDA achieved imaging of necrotic myocardium at 6 h postinjection (p.i.) with SPECT/CT, earlier than what (131)I-Hyp did. Therefore, (131)I-HDA may serve as a promising necrosis-avid diagnostic agent for earlier imaging of necrotic myocardium compared with (131)I-Hyp. This may support further development of radiopharmaceuticals ((123)I and (99m)Tc) based on HDA for SPECT/CT of necrotic myocardium.

  19. Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping.

    Science.gov (United States)

    Baeßler, Bettina; Schaarschmidt, Frank; Treutlein, Melanie; Stehning, Christian; Schnackenburg, Bernhard; Michels, Guido; Maintz, David; Bunck, Alexander C

    2017-12-01

    To re-evaluate a recently suggested approach of quantifying myocardial oedema and increased tissue inhomogeneity in myocarditis by T2-mapping. Cardiac magnetic resonance data of 99 patients with myocarditis were retrospectively analysed. Thirthy healthy volunteers served as controls. T2-mapping data were acquired at 1.5 T using a gradient-spin-echo T2-mapping sequence. T2-maps were segmented according to the 16-segments AHA-model. Segmental T2-values, segmental pixel-standard deviation (SD) and the derived parameters maxT2, maxSD and madSD were analysed and compared to the established Lake Louise criteria (LLC). A re-estimation of logistic regression models revealed that all models containing an SD-parameter were superior to any model containing global myocardial T2. Using a combined cut-off of 1.8 ms for madSD + 68 ms for maxT2 resulted in a diagnostic sensitivity of 75% and specificity of 80% and showed a similar diagnostic performance compared to LLC in receiver-operating-curve analyses. Combining madSD, maxT2 and late gadolinium enhancement (LGE) in a model resulted in a superior diagnostic performance compared to LLC (sensitivity 93%, specificity 83%). The results show that the novel T2-mapping-derived parameters exhibit an additional diagnostic value over LGE with the inherent potential to overcome the current limitations of T2-mapping. • A novel quantitative approach to myocardial oedema imaging in myocarditis was re-evaluated. • The T2-mapping-derived parameters maxT2 and madSD were compared to traditional Lake-Louise criteria. • Using maxT2 and madSD with dedicated cut-offs performs similarly to Lake-Louise criteria. • Adding maxT2 and madSD to LGE results in further increased diagnostic performance. • This novel approach has the potential to overcome the limitations of T2-mapping.

  20. Fundamental and clinical evaluation of Fourier analysis for the detection of regional wall contraction abnormalities in the patients with myocardial infarction

    International Nuclear Information System (INIS)

    Murata, H.; Toyama, H.; Tabuchi, H.; Muraki, T.; Ohtake, E.; Chiba, K.; Yamada, H.

    1982-01-01

    The purpose of the present study are to evaluate fundamentally the method of Fourier analysis and to detect regional wall motion abnormality of the infarcted lesions by Fourier analysis. Fourier analyses were performed using the data obtained by first pass method in right anterior oblique projection (RAO) and by equilibrium method in left anterior oblique projection (LAO), and amplitude and phase were calculated. Amplitude and phase values needed to be corrected by R-R interval. On the detection of myocardial infarction, Fourier analyses in RAO and in LAO had same value for anterior infarctions. The analysis in RAO was more sensitive to detect infero-posterior lesions. On the other hand, the analysis in LAO was more sensitive for septal and lateral lesions

  1. Influence of a history of arterial hypertension and pretreatment blood pressure on the effect of angiotensin converting enzyme inhibition after acute myocardial infarction. Trandolapril Cardiac Evaluation Study

    DEFF Research Database (Denmark)

    Gustafsson, F; Køber, L; Torp-Pedersen, C

    1998-01-01

    OBJECTIVE: To evaluate the influence of a history of arterial hypertension and the level of pretreatment blood pressure on the efficacy of the angiotensin converting enzyme (ACE) inhibitor trandolapril on mortality and morbidity in patients with acute myocardial infarction (AMI) and left...... ventricular dysfunction. METHODS: Data from the Trandolapril Cardiac Event study, in which 1749 patients with an enzyme verified AMI and echocardiographic evidence of left ventricular dysfunction were randomized in a double-blind manner to treatment with trandolapril or placebo, were retrospectively analysed....... Follow up time was 24-50 months (mean 26 months). RESULTS: Four hundred patients (23%) had a history of arterial hypertension. A total of 173 (43%) patients with a history of hypertension died during follow up versus 500 (37%) patients in the normotensive group. Treatment with trandolapril...

  2. Myocardial blood flow quantification for evaluation of coronary artery disease by positron emission tomography, cardiac magnetic resonance imaging, and computed tomography.

    Science.gov (United States)

    Waller, Alfonso H; Blankstein, Ron; Kwong, Raymond Y; Di Carli, Marcelo F

    2014-05-01

    The noninvasive detection of the presence and functional significance of coronary artery stenosis is important in the diagnosis, risk assessment, and management of patients with known or suspected coronary artery disease. Quantitative assessment of myocardial perfusion can provide an objective and reproducible estimate of myocardial ischemia and risk prediction. Positron emission tomography, cardiac magnetic resonance, and cardiac computed tomography perfusion are modalities capable of measuring myocardial blood flow and coronary flow reserve. In this review, we will discuss the technical aspects of quantitative myocardial perfusion imaging with positron emission tomography, cardiac magnetic resonance imaging, and computed tomography, and its emerging clinical applications.

  3. Evaluation of the impact of genetic polymorphisms in glutathione-related genes on the association between methylmercury or n-3 polyunsaturated long chain fatty acids and risk of myocardial infarction: a case-control study

    Directory of Open Access Journals (Sweden)

    Norberg Margareta

    2011-04-01

    Full Text Available Abstract Background The n-3 polyunsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid, which are present in fish, are protective against myocardial infarction. However, fish also contains methylmercury, which influences the risk of myocardial infarction, possibly by generating oxidative stress. Methylmercury is metabolized by conjugation to glutathione, which facilitates elimination. Glutathione is also an antioxidant. Individuals with certain polymorphisms in glutathione-related genes may tolerate higher exposures to methylmercury, due to faster metabolism and elimination and/or better glutathione-associated antioxidative capacity. They would thus benefit more from the protective agents in fish, such as eicosapentaenoic+docosahexaenoic acid and selenium. The objective for this study was to elucidate whether genetic polymorphisms in glutathione-related genes modify the association between eicosapentaenoic+docosahexaenoic acid or methylmercury and risk of first ever myocardial infarction. Methods Polymorphisms in glutathione-synthesizing (glutamyl-cysteine ligase catalytic subunit, GCLC and glutamyl-cysteine ligase modifier subunit, GCLM or glutathione-conjugating (glutathione S-transferase P, GSTP1 genes were genotyped in 1027 individuals from northern Sweden (458 cases of first-ever myocardial infarction and 569 matched controls. The impact of these polymorphisms on the association between erythrocyte-mercury (proxy for methylmercury and risk of myocardial infarction, as well as between plasma eicosapentaenoic+docosahexaenoic acid and risk of myocardial infarction, was evaluated by conditional logistic regression. The effect of erythrocyte-selenium on risk of myocardial infarction was also taken into consideration. Results There were no strong genetic modifying effects on the association between plasma eicosapentaenoic+docosahexaenoic acid or erythrocyte-mercury and risk of myocardial infarction risk. When eicosapentaenoic

  4. Myocardial imaging. Coxsackie myocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Wells, R.G.; Ruskin, J.A.; Sty, J.R.

    1986-09-01

    A 3-week-old male neonate with heart failure associated with Coxsackie virus infection was imaged with Tc-99m PYP and TI-201. The abnormal imaging pattern suggested myocardial infarction. Autopsy findings indicated that the cause was myocardial necrosis secondary to an acute inflammatory process. Causes of abnormal myocardial uptake of Tc-99m PYP in pediatrics include infarction, myocarditis, cardiomyopathy, bacterial endocarditis, and trauma. Myocardial imaging cannot provide a specific cause diagnosis. Causes of myocardial infarction in pediatrics are listed in Table 1.

  5. Myocardial imaging. Coxsackie myocarditis

    International Nuclear Information System (INIS)

    Wells, R.G.; Ruskin, J.A.; Sty, J.R.

    1986-01-01

    A 3-week-old male neonate with heart failure associated with Coxsackie virus infection was imaged with Tc-99m PYP and TI-201. The abnormal imaging pattern suggested myocardial infarction. Autopsy findings indicated that the cause was myocardial necrosis secondary to an acute inflammatory process. Causes of abnormal myocardial uptake of Tc-99m PYP in pediatrics include infarction, myocarditis, cardiomyopathy, bacterial endocarditis, and trauma. Myocardial imaging cannot provide a specific cause diagnosis. Causes of myocardial infarction in pediatrics are listed in Table 1

  6. Anisotropy signature in extended images from reverse-time migration

    KAUST Repository

    Sava, Paul

    2012-11-04

    Reverse-time migration can accurately image complex geologic structures in anisotropic media. Extended images at selected locations in the earth, i.e. at common-image-point gathers (CIPs), carry enough information to characterize the angle-dependent illumination and to provide measurements for migration velocity analysis. Furthermore, inaccurate anisotropy leaves a distinctive signature in CIPs, which can be used to evaluate anisotropy through techniques similar to the ones used in conventional wavefield tomography.

  7. Anisotropy signature in extended images from reverse-time migration

    KAUST Repository

    Sava, Paul; Alkhalifah, Tariq Ali

    2012-01-01

    Reverse-time migration can accurately image complex geologic structures in anisotropic media. Extended images at selected locations in the earth, i.e. at common-image-point gathers (CIPs), carry enough information to characterize the angle-dependent illumination and to provide measurements for migration velocity analysis. Furthermore, inaccurate anisotropy leaves a distinctive signature in CIPs, which can be used to evaluate anisotropy through techniques similar to the ones used in conventional wavefield tomography.

  8. Microstructure, Slip Systems and Yield Stress Anisotropy in Plastic Deformation

    DEFF Research Database (Denmark)

    Winther, Grethe; You, Ze Sheng; Lu, Lei

    The highly anisotropic microstructures in nanotwinned copper produced by electrodeposition provide an excellent opportunity to evaluate models for microstructurally induced mechanical anisotropy. A crystal plasticity model originally developed for the integration of deformation induced dislocatio...... boundaries with texture is applied to account for the effects of texture as well as twin and grain boundaries, providing good qualitative agreement with experimental yield stress and yield stress anisotropy data....

  9. Evaluation of endothelium-dependent myocardial perfusion reserve in healthy smokers; cold pressor test using H215O PET

    International Nuclear Information System (INIS)

    Hwang, Kyung Hoon; Lee, Dong Soo; Lee, Byeong Il; Lee, Jae Sung; Lee, Ho Young; Chung, June Key; Lee, Myung Chul

    2004-01-01

    Much evidence suggests long-term cigarette smoking alters coronary vascular endothelial response. In this study, we applied nonnegative matrix factorization (NMF), an unsupervised learning algorithm, to CO-less H 2 15 O-PET to investigate coronary endothelial dysfunction caused by smoking noninvasively. This study enrolled eighteen young male volunteers consisting of 9 smokers (23.8±1.1 yr; 6.6±2.5 pack-years) and 9 nonsmokers (23.8±2.9 yr). They do not have any cardiovascular risk factor or disease history. Myocardial H 2 15 O-PET was performed at rest, during cold (5.deg.C) pressor stimulation and during adenosine infusion. Left ventricular blood pool and myocardium were segmented on dynamic PET data by NMF method. Myocardial blood flow (MBF) was calculated from input and tissue functions by a single compartmental model with correction of partial volume and spillover effects. There were no significant difference in resting MBF between the two groups (Smokers: 1.43 0.41ml/g/min and non-smokers: 1.37±0.41 ml/g/min; p = NS). during cold pressor stimulation, MBF in smokers was significantly lower than that in non-smokers (1.25±0.34 ml/g/min vs 1.59±0.29 ml/g/min ; p = 0.019). The difference in the ratio of cold pressor MBF to resting MBF between the two groups was also significant (p=0.024; 90±24% in smokers and 122±28% in non-smokers.). During adenosine infusion, however, hyperemic MBF did not differ significantly between smokers and non-smokers (5.81±1.99 ml/g/min vs 5.11±1.31 ml/g/min ; p=NS). In smokers, MBF during cold pressor stimulation was significantly lower compared with nonsmokers, reflecting smoking-induced endothelial dysfunction. However, there was no significant difference in MBF during adenosine-induced hyperemia between the two groups

  10. Non-invasive evaluation for pulmonary circulatory impairment during exercise in patients with chronic lung disease; With thallium-201 myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Hiroshi [Kobe Univ. (Japan). School of Medicine

    1990-06-01

    Thallium-201 myocardial scintigraphy was performed at rest and during exercise on sixteen patients with chronic lung disease to evaluate the secondary pulmonary hypertension during exercise with non-invasive technique. An inverse significant correlation was found between thallium activity ratio (TAR) of left ventricle plus ventricular septum to right ventricle and both of pulmonary vascular resistance and right to left ventricular work index ratio during exercise. The patients were divided into three groups according to mean pulmonary arterial pressure (P-bar{sub PA}) at rest and during exercise: the first group consisted of six patients with pulmonary hypertension during exercise (P-bar{sub PA}: below 25 mmHg at rest and above 30 mmHg during exercise), the second group consisted of four patients with pulmonary hypertension at rest (P-bar{sub PA} above 25 mmHg at rest), and the third group consisted of six patients without pulmonary hypertension (P-bar{sub PA} below 25 mmHg at rest, below 30 mmHg during exercise). In the first group, TAR during exercise was lowered than at rest in four patients, and in the second group TAR during exercise was lowered than at rest in all, while in the third group TAR during exercise was increased than at rest in five patients. These results suggest that thallium-201 myocardial scintigraphy can reflect pulmonary hemodynamics during exercise in patients with chronic lung disease and it is of great use to predict the patients with pulmonary hypertension during exercise. (author).

  11. Myocardial ischemia in Kawasaki disease

    International Nuclear Information System (INIS)

    Fukuda, Tsuyoshi

    1993-01-01

    The detection of myocardial ischemia is essential for evaluation of patients with Kawasaki disease, especially who have had coronary artery lesions. To evaluate the clinical efficacy of Tl-201 single photon emission computed tomography (SPECT) after dipyridamole infusion (maximum dose 0.70 mg/kg) for detecting myocardial ischemia, 44 patients with Kawasaki disease aged 7.7±4.8 years at the study and 10 age matched controls were observed. In the Kawasaki disease group, significant coronary artery stenosis was observed in 14, coronary aneurysm without stenosis in 18, the regression of the coronary aneurysms in 2 and without coronary lesions in 10 patients. In 24 of 44 patients, treadmill exercise stress test was also performed at the same period. Myocardial ischemic changes were observed in 11 patients, all combined with significant coronary artery stenosis. The sensitivity of SPECT for detection of overall coronary stenosis was 79%, coronary that of treadmill exercise test was only 33% (p<0.001). Furthermore, among the patients having significant coronary stenosis, the severity score was significantly elevated in patients who had electrocardiographic abnormal Q wave compared to those without abnormal Q wave (51.0±38.8 versus 20.0±12.1, p<0.05). These data suggest that the pharmacological stress scintigraphy using dipyridamole injection provides not only the accurate detection but quantitative evaluation of myocardial ischemia in these patients. This noninvasive technique may become one of the most useful index for detection and follow-up of myocardial ischemia in Kawasaki disease. (author)

  12. Non invasive evaluation of the coronary atherosclerosis illness in patients with silent ischemia: utility of the SPECT of myocardial perfusion. Electric, angiographic and image correlation

    International Nuclear Information System (INIS)

    Puente B, A.; Roffe G, F.; Aceves C, J.; Gomez A, E.

    2005-01-01

    The objective of the work was to determine the utility of the SPECT (Single Photon Emission Computerized Tomography) of myocardial perfusion for the ischemia detection in asymptomatic patients with Coronary Atherosclerosis Illness. It was concluded that the SPECT of myocardial perfusion has a high sensitivity (97%) for the silent ischemia diagnosis

  13. Evaluation of risk factors in acute myocardial infarction patients admitted to the coronary care unit, Tripoli Medical Centre, Libya.

    Science.gov (United States)

    Abduelkarem, A R; El-Shareif, H J; Sharif, S I

    2012-04-01

    The aim of this study was to provide an overview of the risk factors for acute myocardial infarction in patients attending Tripoli Medical Centre, Libya. Records were reviewed for 622 patients with a mean age of 58.3 (SD 12.9) years. Diabetes mellitus (48.2%), hypertension (35.7%) and smoking (50.6%) were among the risk factors reported. There were 110 patients (17.7%) who died during hospitalization, mainly suffering cardiogenic shock (48.0%). The rate of use of thrombolytic therapy was low in patients who were female (40.4% versus 58.4% for males), older age (31.6% for those > 85 years versus 63.3% for patients < 55 years), diabetics (45.3% versus 62.0% for non-diabetic patients) and hypertensives (47.3% versus 57.8% for non-hypertensive patients). Prevention strategies should be implemented in order to improve the long-term prognosis and decrease overall morbidity and mortality from coronary artery disease in Libyan patients.

  14. Dipyridamole 201T1 myocardial perfusion tomography and bull's--eye analysis for quantitative evaluation of CAD

    International Nuclear Information System (INIS)

    Jiang Maosong; Tang Xi

    1992-01-01

    To assess the ability of quantitative analysis of dipyridamole 201 T1 tomography for detecting and localizing coronary artery disease (CAD), 55 patients with angiographically proved CAD ( = 50% stenosis) were studied. All patients underwent dipyridamole 201 T1 myocardial perfusion tomography and coronary arteriography. The overall sensitivity for detection of CAD by Bull's-eye analysis was 89% (50 patients) and 92% (51 patients) with visual analysis. The sensitivity for detecting individual vessel involvement with the Bull'-eye analysis was 88% for LAD. 81% for RCA and 67% for LCX. With visual analysis, the results were 88%, 83% and 58% respectively. The overall rate of detection was 87% in lesions greater than or equal to 75% stenosis vs 59% in those under 75% stenosis (P 201 T1 tomography using Bull's-eye display is a highly accurate reproducible technique for the detection of patients with CAD and the localization of individual coronary vessel, and it offers the potential to quantify the percentage of the abnormally perfused myocardium

  15. Role of adenosine 99MTc sestamibi myocardial perfusion spect in evaluation of symptomatic hypertensives with recent onset left bundle branch block

    International Nuclear Information System (INIS)

    Padma, S.; Sundaram, P.S.; Zachariah, M.; Hariads, K.K.

    2004-01-01

    Objectives: Adenosine pharmacological stress Myocardial Perfusion Imaging (AMPI) is the preferred imaging modality for IHD evaluation in pts with Left Bundle Branch Block (LBBB). Good prognosis has been reported in recent onset LBBB pts with normal MPI. Our aim was to evaluate the utility and analyze the predictive value of SestaMIBI AMPI in symptomatic recent onset LBBB hypertensives for coronary artery disease evaluation. Methods: 29 hypertensive pts, age range 36-72yrs, mean 54+ 6 yrs, M:F- 21:8 with recent onset complete LBBB, under evaluation for typical/atypical angina who had AMPI between Nov 02-Nov 03, were retrospectively analyzed. LBBB was diagnosed ECG wise if there is prolonged QRS complex i.e. 0.125sec or more in sinus/supraventricular rhythm, a QS or rS complex in lead 1, and an R-wave peak time of 0.06sec in leads 1, V5 or V6 with no Q wave in same lead. Pts with prior Myocardial Infarct / revasularisation, pacemaker induced LBBB were excluded. Single day 6 min. Adenosine infusion Stress-rest 99m Tc MIBI gated MPI was performed with a dual head variable angle Gamma Camera at 76-degree angle. Coronary Angiogram (CAG) correlation was available in 24 pts. Results: Myocardial perfusion SPECT images were assessed visually and by a 20-segment model. Location, extent and severity of the LV perfusion defects were evaluated. 6/29 pts (20.7%) had normal stress-rest perfusion in all LV segments.12 (41.4%) had isolated septal fixed defect with normal perfusion in rest of the segments.3 pts (10.3%)showed isolated reversible septal defects while 8(27.6%) had reversible septal defects with reversible defects in other LV segments also. Pts with fixed septal perfusion defect showed moderate to good septal wall thickening in gated SPECT images. While all pts with multiple reversible perfusion defects had angiographically proven coronary artery disease (i.e. 3pts had LAD lesion, 2 had Triple vessel and 3 showed double vessel lesions), 1 out of 3 pts with isolated

  16. Myocardial imaging with cesium-130

    International Nuclear Information System (INIS)

    Harper, P.V.; Resnekov, L.; Stark, V.; Odeh, N.

    1984-01-01

    Recently comparative studies using nitrogen-13 ammonia and cesium-130 have shown strikingly different myocardial localization patterns in the same subjects with ischemic heart disease. Initial localization of ammonia, an avidly extracted agent, reflects the perfusion pattern in viable myocardial tissue. The myocardial localization of cesium ion, taking place more slowly over 15 to 20 minutes, is apparently much less flow dependent, causing uptake defects shown with ammonia to be largely filled in. Cesium thus appears to provide information on the extent of the viable myocardial mass, apart from perfusion. Cesium-130 (t1/2 30 m) decays by positron emission and electron capture. The whole body radiation absorbed dose, assuming uniform distribution, is 24 mrad/mCi. While abundant production of Cs-130 results from proton bombardment of natural xenon [Xe-130(rho,n)Cs-130] at 15 MeV, small amounts of Cs-129, -131, and -132 are also produced, and enriched Xe-130 is not available. Alternatively almost completely uncontaminated Cs-130 is available by alpha bombardment of natural I-127. Anhydrous sodium iodide is dissolved in acetone and a thin layer (≅20 mg per centimeter squared) is evaporated onto the gold plated tip of the internal target backing which is oscillated vertically to spread out the area upon which the beam is incident. The target surface is inclined 2.5 degrees to the beam giving a power density of about 400 watts per centimeter squared at 100μA which is adequately handled by water cooling. A 30-minute bombardment yields 4 to 5 mCi of Cs-130 which is dissolved directly from the target. This approach appears to offer a new and helpful method for evaluating ischemic heart disease by permitting evaluation of viable myocardial mass

  17. Quantitative aspects of myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Vogel, R.A.

    1980-01-01

    Myocardial perfusion measurements have traditionally been performed in a quantitative fashion using application of the Sapirstein, Fick, Kety-Schmidt, or compartmental analysis principles. Although global myocardial blood flow measurements have not proven clinically useful, regional determinations have substantially advanced our understanding of and ability to detect myocardial ischemia. With the introduction of thallium-201, such studies have become widely available, although these have generally undergone qualitative evaluation. Using computer-digitized data, several methods for the quantification of myocardial perfusion images have been introduced. These include orthogonal and polar coordinate systems and anatomically oriented region of interest segmentation. Statistical ranges of normal and time-activity analyses have been applied to these data, resulting in objective and reproducible means of data evaluation

  18. Myocardial perfusion scintigraphy - possibilities of diagnosing CAD

    International Nuclear Information System (INIS)

    Tsonevska, A.

    1998-01-01

    A reviewing the diagnostic methods used in the intricate process of evaluating CAD patients in a attempt to establish the role played by radionuclide methods in the diagnostic strategy is done. The perfusion cardiotropic radiopharmaceuticals used and the various methods of evaluating myocardial are discussed. Although 210 Tl-chloride is the most widely used myocardial perfusion agent, recently 99m Tc-MIBI is proposed as an alternative because of its advantages. Myocardial perfusion assessment is done by various techniques depending on the specific aim, each of them having its proper advantages and shortcomings. The inference is reached that regardless of the routine practical implementation of myocardial perfusion scintigraphy and comprehensive studies along this line in course, there are problems still not well enough clarified awaiting solution

  19. Dosimetry in myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Toledo, Janine M.; Trindade, Bruno; Ribeiro, Tarcisio P.C. [Universidade Federal de Minas Gerais (DEN/UFMG), Belo Horizonte (Brazil). Dept. de Engenharia Nuclear. Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares

    2011-07-01

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  20. Dosimetry in myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Toledo, Janine M.; Trindade, Bruno; Ribeiro, Tarcisio P.C.

    2011-01-01

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  1. The metabolic syndrome and risk of myocardial infarction in familial hypertension (hypertension heredity in Malmö evaluation study).

    Science.gov (United States)

    Fedorowski, Artur; Burri, Philippe; Hulthén, Lennart; Melander, Olle

    2009-01-01

    The aim of this study was to examine whether three main definitions of the metabolic syndrome (MetS)--WHO, National Cholesterol Education Program--Adult Treatment Panel III and International Diabetes Federation--identify the same individuals and are able to predict incident myocardial infarction (MI) in families with essential hypertension. The tested definitions were prospectively related to data on MI in a cohort of approximately 1700 individuals with overt essential hypertension and their normotensive first-degree relatives. At baseline, 616 participants had MetS, yet only 209 of them (33.9%) were identified by all definitions, and compatibility rate for each pair of definitions was approximately 50%. During follow-up (Tmean approximately 6.6 years) 53 participants developed MI and they were generally older and more dysmetabolic than the rest of the cohort. There were also more men, smokers and diabetic individuals in this group. After adjustment for all conventional cardiovascular risk factors, including hypertension and diabetes, only the National Cholesterol Education Program definition could predict the increased risk of MI [odds ratio (OR) = 2.2, confidence interval (CI) = 1.2-4.0, P = 0.01]. Among individual MetS components, incident MI was independently associated with three of them: low high-density lipoprotein-cholesterol (OR = 2.03, CI = 1.09-3.78, P = 0.025) insulin resistance (OR = 2.02, CI = 1.08-3.78, P = 0.028) and increased albumin excretion rate (OR = 1.24, CI = 0.99-1.55, P = 0.060). The presence of MetS in hypertensive and genetically hypertension prone individuals may signal the increased risk of future MI. However, only the National Cholesterol Education Program criteria appear to have a sufficient predictive accuracy.

  2. Stroke and myocardial infarction: a comparative systematic evaluation of gender-specific analysis, funding and authorship patterns in cardiovascular research.

    Science.gov (United States)

    Oertelt-Prigione, Sabine; Wiedmann, Silke; Endres, Matthias; Nolte, Christian H; Regitz-Zagrosek, Vera; Heuschmann, Peter

    2011-01-01

    Major gender differences exist in cardiovascular diseases and lead to different outcomes in women and men. However, attention and incorporation of sex-/gender-specific research might vary among disciplines. We therefore conducted a systematic review comparing publication characteristics and trends between stroke and myocardial infarction (MI) with respect to sex- and gender-related aspects. A systematic literature search was performed in PubMed to identify gender-/sex-related articles published for stroke and MI between 1977 and 2008. A specifically designed text mining program was used, and all literature was rated by two independent investigators. Publications were classified according to type of research performed, publication year, funding, geographical location, and gender of first and last authors. 962 articles were retrieved and limited to 405 (42%) gender-relevant publications; 131 on stroke and 274 on MI. Type of performed research differed, especially in disease management, which received little attention (17%) in stroke, while representing the major focus in MI (40%). In both areas, clinical presentation received little attention (3 and 5%). Although publications progressively increased in both fields, an 8- to 10-year time gap emerged for stroke compared to MI. Last authors in both areas were predominantly men, but female last authorship is increasing more significantly over time in the field of stroke. Research on sex and gender differences in MI and stroke is largely underfunded, particularly by the EU. The data demonstrate how sex-/gender-specific research differs between specialties, most likely due to the diverse interest, funding opportunities and authorship distributions identified. Copyright © 2011 S. Karger AG, Basel.

  3. The evaluation of B-type Natriuretic Peptide and Troponin I in acute myocardial infarction and unstable angina

    Directory of Open Access Journals (Sweden)

    Nafija Serdarevic

    2014-09-01

    Full Text Available Introduction: The diagnostic utility of B-type natriuretic peptide (BNP has prompted interest in its use as an aid in the detection of early heart failure and assessment of diseases. The first objective of this study was measurement of BNP and troponin I (TnI blood levels in patients with acute myocardial infarction (AMI and unstable angina. The second objective of this study was to find a correlation between TnI and BNP in blood.Methods: The concentrations of BNP and TnI in 150 blood levels were determined using CMIA (chemiluminescent microparticle immunoassay Architect and 2000 (Abbott diagnostics. The retrospective study included 100 patients who were hospitalized at the Department of Internal Medicine of the University Clinical Center Sarajevo and 50 healthy control. The reference blood range of BNP is 0-100 pg/mL and TnI is 0.00-0.4 ng/mL.Results: In the patients with AMI the mean value of BNP is 764.48 ± 639.52 pg/mL and TnI is 2.50 ± 2.28ng/mL. The patients with unstable angina have BNP 287.18 ± 593.20 pg/mL and TnI 0.10 ± 0.23 ng/mL. Our studies have shown that the correlation between BNP and TnI was statistically significant for p< 0.05 using Student t test with correlation coefficient r = 0.36. Conclusions: BNP and TnI levels can help to identify the patients with a high risk for cardiovascular diseases.

  4. Opium decreases the age at myocardial infarction and sudden cardiac death: a long- and short-term outcome evaluation.

    Science.gov (United States)

    Roohafza, Hamidreza; Talaei, Mohammad; Sadeghi, Masoumeh; Haghani, Poone; Shokouh, Pedram; Sarrafzadegan, Nizal

    2013-03-01

      Opium dependence is a recognized individual and public health threat, but little is known about its association with acute myocardial infarction (AMI) or sudden cardiac death (SCD). In a cross-sectional study followed by a one-year matched longitudinal cohort, all 569 men hospitalized with AMI in all Cardiac Care Units (CCU) of Isfahan, Iran, were recruited in a six-month period. In addition, 123 out-of-hospital deaths were included that were diagnosed as SCD at the same duration. Among those discharged alive, 126 opium dependents were matched with 126 nondependents (mostly nonusers) according to age and smoking status, and were followed for one year. Opium dependence was measured using the ICD10 criteria and Severity of Dependence Scale (SDS) questionnaire. The method was validated by morphine blood levels. Biochemical measurements, blood pressure, blood cell counts, anthropometrics, and ejection fraction were measured at baseline and repeated at the end of follow-up.  There were 118 (17.1%) patients with an average of 17.4 ± 10.4 years of abuse who met the criteria for opium dependency. Opium dependence decreased the age at event by 3.6 (95% CI: 1.2 - 6.0) years and was independent of smoking (P = 0.003). In terms of cardiovascular risk factors such as ejection fraction, in addition to post-AMI mortality and morbidity, no significant associations were noted at baseline or after one year of follow-up. The odds ratio of sustained smoking after AMI was 1.92 (95% CI: 1.04 - 3.52) in opium dependents (P = 0.033). Despite public opinion, opium did not improve cardiovascular risk factors, or post-AMI mortality and morbidity. Conversely, there were irrefutable findings regarding the detrimental effects of opium dependence.

  5. Evaluation of damage accumulation behavior and strength anisotropy of NITE SiC/SiC composites by acoustic emission, digital image correlation and electrical resistivity monitoring

    International Nuclear Information System (INIS)

    Nozawa, Takashi; Ozawa, Kazumi; Asakura, Yuuki; Kohyama, Akira; Tanigawa, Hiroyasu

    2014-01-01

    Understanding the cracking process of the composites is essential to establish the design basis for practical applications. This study aims to investigate the damage accumulation process and its anisotropy for nano-infiltration transient eutectic sintered (NITE) SiC/SiC composites by various characterization techniques such as the acoustic emission (AE), digital image correlation (DIC) and electrical resistivity (ER) measurements. Cracking behavior below the proportional limit stress (PLS) was specifically addressed. Similar to the other generic SiC/SiC composites, the 1st AE event was identified below the PLS for NITE SiC/SiC composites with a dependency of fabric orientation. The DIC results support that the primary failure mode depending on fiber orientation affected more than the other minor modes did. Detailed AE waveform analysis by wavelet shows a potential to classify the failure behavior depending on architecture. Cracking below the PLS is a potential concern in component deign but the preliminary ER measurements imply that the impact of cracking below the PLS on composite function was limited

  6. Automated quantitative coronary computed tomography correlates of myocardial ischaemia on gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Graaf, Michiel A. de; Boogers, Mark J.; Veltman, Caroline E.; El-Naggar, Heba M.; Bax, Jeroen J.; Delgado, Victoria; Broersen, Alexander; Kitslaar, Pieter H.; Dijkstra, Jouke; Kroft, Lucia J.; Younis, Imad Al; Reiber, Johan H.; Scholte, Arthur J.

    2013-01-01

    Automated software tools have permitted more comprehensive, robust and reproducible quantification of coronary stenosis, plaque burden and plaque location of coronary computed tomography angiography (CTA) data. The association between these quantitative CTA (QCT) parameters and the presence of myocardial ischaemia has not been explored. The aim of the present investigation was to evaluate the association between QCT parameters of coronary artery lesions and the presence of myocardial ischaemia on gated myocardial perfusion single-photon emission CT (SPECT). Included in the study were 40 patients (mean age 58.2 ± 10.9 years, 27 men) with known or suspected coronary artery disease (CAD) who had undergone multidetector row CTA and gated myocardial perfusion SPECT within 6 months. From the CTA datasets, vessel-based and lesion-based visual analyses were performed. Consecutively, lesion-based QCT was performed to assess plaque length, plaque burden, percentage lumen area stenosis and remodelling index. Subsequently, the presence of myocardial ischaemia was assessed using the summed difference score (SDS ≥2) on gated myocardial perfusion SPECT. Myocardial ischaemia was seen in 25 patients (62.5 %) in 37 vascular territories. Quantitatively assessed significant stenosis and quantitatively assessed lesion length were independently associated with myocardial ischaemia (OR 7.72, 95 % CI 2.41-24.7, p 2 = 20.7) and lesion length (χ 2 = 26.0) to the clinical variables and the visual assessment (χ 2 = 5.9) had incremental value in the association with myocardial ischaemia. Coronary lesion length and quantitatively assessed significant stenosis were independently associated with myocardial ischaemia. Both quantitative parameters have incremental value over baseline variables and visually assessed significant stenosis. Potentially, QCT can refine assessment of CAD, which may be of potential use for identification of patients with myocardial ischaemia. (orig.)

  7. Myocardial perfusion imaging with dual energy CT

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Kwang Nam [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); De Cecco, Carlo N. [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Caruso, Damiano [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiological Sciences, Oncology and Pathology, University of Rome “Sapienza”, Rome (Italy); Tesche, Christian [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich (Germany); Spandorfer, Adam; Varga-Szemes, Akos [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States)

    2016-10-15

    Highlights: • Stress dual-energy sCTMPI offers the possibility to directly detect the presence of myocardial perfusion defects. • Stress dual-energy sCTMPI allows differentiating between reversible and fixed myocardial perfusion defects. • The combination of coronary CT angiography and dual-energy sCTMPI can improve the ability of CT to detect hemodynamically relevant coronary artery disease. - Abstract: Dual-energy CT (DECT) enables simultaneous use of two different tube voltages, thus different x-ray absorption characteristics are acquired in the same anatomic location with two different X-ray spectra. The various DECT techniques allow material decomposition and mapping of the iodine distribution within the myocardium. Static dual-energy myocardial perfusion imaging (sCTMPI) using pharmacological stress agents demonstrate myocardial ischemia by single snapshot images of myocardial iodine distribution. sCTMPI gives incremental values to coronary artery stenosis detected on coronary CT angiography (CCTA) by showing consequent reversible or fixed myocardial perfusion defects. The comprehensive acquisition of CCTA and sCTMPI offers extensive morphological and functional evaluation of coronary artery disease. Recent studies have revealed that dual-energy sCTMPI shows promising diagnostic accuracy for the detection of hemodynamically significant coronary artery disease compared to single-photon emission computed tomography, invasive coronary angiography, and cardiac MRI. The aim of this review is to present currently available DECT techniques for static myocardial perfusion imaging and recent clinical applications and ongoing investigations.

  8. Nitrogen-13-labeled ammonia for myocardial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, W.F.; Fill, H.R.; Harper, P.V.

    1977-01-01

    Cyclotron-produced nitrogen-13 (half-life 10 min), as labeled ammonia (/sup 13/NH/sub 4//sup +/), has been evaluated as a myocardial perfusion imaging agent. The regional myocardial uptake of /sup 13/NH/sub 4//sup +/ has been shown to be proportional to regional tissue perfusion in animal studies. Intravenously administered /sup 13/NH/sub 4//sup +/ is rapidly cleared from the circulation, being extracted by the liver (15 percent), lungs, myocardium (2 percent--4 percent), brain, kidney, and bladder. Myocardial ammonia is metabolized mainly to glutamine via the glutamine synthetase pathway. Pulmonary uptake is substantial, but usually transient, except in smokers where clearance may be delayed. The positron annihilation irradiation (511 keV) of /sup 13/N may be imaged with a scintillation camera, using either a specially designed tungsten collimator or a pinhole collimator. After early technical problems with collimation and the production method of /sup 13/NH/sub 4//sup +/ were overcome, reproducible high quality myocardial images were consistently obtained. The normal myocardial image was established to be of a homogeneous ''doughnut'' configuration. Imaging studies performed in patients with varying manifestations of ischemic and valvular heart disease showed a high incidence of localized perfusion defects, especially in patients with acute myocardial infarction. Sequential studies at short intervals in patients with acute infarction showed correlation between alterations in regional perfusion and the clinical course of the patient. It is concluded that myocardial imaging with /sup 13/NH/sub 4//sup +/ and a scintillation camera provides a valid and noninvasive means of assessing regional myocardial perfusion. This method is especially suitable for sequential studies of acute cardiac patients at short intervals. Coincidence imaging of the 511 keV annihilation irradiation provides a tomographic and potentially quantitative assessment of the

  9. The role of diffusion tensor imaging and fractional anisotropy in the evaluation of patients with idiopathic normal pressure hydrocephalus: a literature review.

    Science.gov (United States)

    Siasios, Ioannis; Kapsalaki, Eftychia Z; Fountas, Kostas N; Fotiadou, Aggeliki; Dorsch, Alexander; Vakharia, Kunal; Pollina, John; Dimopoulos, Vassilios

    2016-09-01

    OBJECTIVE Diffusion tensor imaging (DTI) for the assessment of fractional anisotropy (FA) and involving measurements of mean diffusivity (MD) and apparent diffusion coefficient (ADC) represents a novel, MRI-based, noninvasive technique that may delineate microstructural changes in cerebral white matter (WM). For example, DTI may be used for the diagnosis and differentiation of idiopathic normal pressure hydrocephalus (iNPH) from other neurodegenerative diseases with similar imaging findings and clinical symptoms and signs. The goal of the current study was to identify and analyze recently published series on the use of DTI as a diagnostic tool. Moreover, the authors also explored the utility of DTI in identifying patients with iNPH who could be managed by surgical intervention. METHODS The authors performed a literature search of the PubMed database by using any possible combinations of the following terms: "Alzheimer's disease," "brain," "cerebrospinal fluid," "CSF," "diffusion tensor imaging," "DTI," "hydrocephalus," "idiopathic," "magnetic resonance imaging," "normal pressure," "Parkinson's disease," and "shunting." Moreover, all reference lists from the retrieved articles were reviewed to identify any additional pertinent articles. RESULTS The literature search retrieved 19 studies in which DTI was used for the identification and differentiation of iNPH from other neurodegenerative diseases. The DTI protocols involved different approaches, such as region of interest (ROI) methods, tract-based spatial statistics, voxel-based analysis, and delta-ADC analysis. The most studied anatomical regions were the periventricular WM areas, such as the internal capsule (IC), the corticospinal tract (CST), and the corpus callosum (CC). Patients with iNPH had significantly higher MD in the periventricular WM areas of the CST and the CC than had healthy controls. In addition, FA and ADCs were significantly higher in the CST of iNPH patients than in any other patients with other

  10. Comparison of Automated 4D-MSPECT and Visual Analysis for Evaluating Myocardial Perfusion in Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Chien-Chin Hsu

    2008-09-01

    Full Text Available The aim of this study was to assess the reproducibility and diagnostic performance for coronary artery disease (CAD of an automated software package, 4D-MSPECT, and compare the results with a visual approach. We enrolled 60 patients without previously known CAD, who underwent dual-isotope rest Tl-201/stress Tc-99m sestamibi myocardial perfusion imaging and subsequent coronary angiography within 3 months. The automated summed stress score (A-SSS, summed rest score (A-SRS and summed difference score (A-SDS were obtained using a 17-segment five-point scale model with 4D-MSPECT. For intraobserver and interobserver variability assessment, automated scoring was done by a nuclear medicine physician twice and by a nuclear medicine technologist. The visual summed stress score (V-SSS, summed rest score (V-SRS, and summed difference score (V-SDS were obtained by consensus of two nuclear medicine physicians. The intraobserver and interobserver agreements of automated segmental scores were excellent. The intraobserver and interobserver summed scores also correlated well. Agreements between visual and automated segmental scores were moderate (weighted κ of 0.55 and 0.50 for stress and rest images, respectively. Correlations between automated and visual summed scores were high, with correlation coefficients of 0.89, 0.85 and 0.82 for SSS, SRS and SDS, respectively (all p < 0.001. The receiver operating characteristic area under the curve for diagnosis of CAD by V-SSS, V-SDS, A-SSS and A-SDS were 0.78 ± 0.06, 0.87 ± 0.05, 0.84 ± 0.05 and 0.90 ± 0.04, respectively. A-SDS had better diagnostic performance than A-SSS and V-SSS (p = 0.043 and p = 0.032, respectively, whereas there was no statistically significant difference between A-SDS and V-SDS (p = 0.56. Using V-SDS ≥ 2 as a diagnostic threshold, the sensitivity, specificity, and accuracy for CAD were 83.7%, 76.5% and 81.7%, respectively. Using A-SDS ≥ 3 as a diagnostic threshold, the sensitivity

  11. Model of coordination melting of crystals and anisotropy of physical and chemical properties of the surface

    Science.gov (United States)

    Bokarev, Valery P.; Krasnikov, Gennady Ya

    2018-02-01

    Based on the evaluation of the properties of crystals, such as surface energy and its anisotropy, the surface melting temperature, the anisotropy of the work function of the electron, and the anisotropy of adsorption, were shown the advantages of the model of coordination melting (MCM) in calculating the surface properties of crystals. The model of coordination melting makes it possible to calculate with an acceptable accuracy the specific surface energy of the crystals, the anisotropy of the surface energy, the habit of the natural crystals, the temperature of surface melting of the crystal, the anisotropy of the electron work function and the anisotropy of the adhesive properties of single-crystal surfaces. The advantage of our model is the simplicity of evaluating the surface properties of the crystal based on the data given in the reference literature. In this case, there is no need for a complex mathematical tool, which is used in calculations using quantum chemistry or modeling by molecular dynamics.

  12. Comparison of blood biochemics between acute myocardial infarction models with blood stasis and simple acute myocardial infarction models in rats

    International Nuclear Information System (INIS)

    Qu Shaochun; Yu Xiaofeng; Wang Jia; Zhou Jinying; Xie Haolin; Sui Dayun

    2010-01-01

    Objective: To construct the acute myocardial infarction models in rats with blood stasis and study the difference on blood biochemics between the acute myocardial infarction models with blood stasis and the simple acute myocardial infarction models. Methods: Wistar rats were randomly divided into control group, acute blood stasis model group, acute myocardial infarction sham operation group, acute myocardial infarction model group and of acute myocardial infarction model with blood stasis group. The acute myocardial infarction models under the status of the acute blood stasis in rats were set up. The serum malondialdehyde (MDA), nitric oxide (NO), free fatty acid (FFA), tumor necrosis factor-α (TNF-α) levels were detected, the activities of serum superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and the levels of prostacycline (PGI2), thromboxane A 2 (TXA 2 ) and endothelin (ET) in plasma were determined. Results: There were not obvious differences in MDA, SOD, GSH-Px and FFA between the acute myocardial infarction models with blood stasis in rats and the simple acute myocardial infarction models (P 2 and NO, and the increase extents of TXA 2 , ET and TNF-α in the acute myocardial infarction models in rats with blood stasis were higher than those in the simple acute myocardial infarction models (P 2 and NO, are significant when the acute myocardial infarction models in rats with blood stasis and the simple acute myocardial infarction models are compared. The results show that it is defective to evaluate pharmacodynamics of traditional Chinese drug with only simple acute myocardial infarction models. (authors)

  13. A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Carlsen, J E

    1995-01-01

    myocardial infarctions confirmed by enzyme studies. A total of 2606 patients had echocardiographic evidence of left ventricular systolic dysfunction (ejection fraction, ....86; 95 percent confidence interval, 0.66 to 1.13; P = 0.29). CONCLUSIONS. Long-term treatment with trandolapril in patients with reduced left ventricular function soon after myocardial infarction significantly reduced the risk of overall mortality, mortality from cardiovascular causes, sudden death...

  14. Anisotropy in the deep Earth

    Science.gov (United States)

    Romanowicz, Barbara; Wenk, Hans-Rudolf

    2017-08-01

    Seismic anisotropy has been found in many regions of the Earth's interior. Its presence in the Earth's crust has been known since the 19th century, and is due in part to the alignment of anisotropic crystals in rocks, and in part to patterns in the distribution of fractures and pores. In the upper mantle, seismic anisotropy was discovered 50 years ago, and can be attributed for the most part, to the alignment of intrinsically anisotropic olivine crystals during large scale deformation associated with convection. There is some indication for anisotropy in the transition zone, particularly in the vicinity of subducted slabs. Here we focus on the deep Earth - the lower mantle and core, where anisotropy is not yet mapped in detail, nor is there consensus on its origin. Most of the lower mantle appears largely isotropic, except in the last 200-300 km, in the D″ region, where evidence for seismic anisotropy has been accumulating since the late 1980s, mostly from shear wave splitting measurements. Recently, a picture has been emerging, where strong anisotropy is associated with high shear velocities at the edges of the large low shear velocity provinces (LLSVPs) in the central Pacific and under Africa. These observations are consistent with being due to the presence of highly anisotropic MgSiO3 post-perovskite crystals, aligned during the deformation of slabs impinging on the core-mantle boundary, and upwelling flow within the LLSVPs. We also discuss mineral physics aspects such as ultrahigh pressure deformation experiments, first principles calculations to obtain information about elastic properties, and derivation of dislocation activity based on bonding characteristics. Polycrystal plasticity simulations can predict anisotropy but models are still highly idealized and neglect the complex microstructure of polyphase aggregates with strong and weak components. A promising direction for future progress in understanding the origin of seismic anisotropy in the deep mantle

  15. Surface energy anisotropy of tungsten

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, R; Grenga, H E [Georgia Inst. of Tech., Atlanta (USA). School of Chemical Engineering

    1976-10-01

    Field-ion microscopy was used to study the faceting behavior and/or surface energy anisotropy of tungsten in vacuum and in hydrogen. In vacuum below 1700 K the activation energy for (110) facet growth agreed with values previously reported for surface diffusion on tungsten. The observed anisotropy values at 0.5 Tsub(m), where Tsub(m) is the absolute melting temperature of tungsten (approximately 3680 K), were different from those previously reported at higher temperatures and more nearly agreed with broken bond calculations based on Mie potential using m=5, n=8, and a 1.5% lattice expansion. Hydrogen appeared to have a negligible effect on surface energy anisotropy, but did preferentially increase surface diffusion rates on (310) regions.

  16. Evaluating microvascular obstruction after acute myocardial infarction using cardiac magnetic resonance imaging and 201-thallium and 99m-technetium pyrophosphate scintigraphy

    International Nuclear Information System (INIS)

    Onishi, Takayuki; Kobayashi, Isshi; Onishi, Yuko; Kawashima, Tomoyuki; Muramoto, Hirotaka; Nakamura, Hiroaki; Nagata, Yasutoshi; Umezawa, Shigeo; Niwa, Akihiro

    2010-01-01

    Few studies have compared the ability of cardiac magnetic resonance (CMR) with that of scintigraphy using 201-thallium (201-Tl) and 99m-technetium pyrophosphate (99m-Tc PYP) to evaluate microvascular obstructions (MOs). In the present study the relationship between the scintigraphic and CMR characteristics of MOs after acute myocardial infarction (MI) was examined. The 14 patients (age 69±8 years, 11 males) underwent 201-Tl/99m-Tc PYP single photon emission computed tomography (SPECT) 7±3 days, initial CMR 16±12 days, and follow-up CMR 193±20 days after a reperfused first acute MI. Each image was analyzed using a 17-segment model. Segmental extent of delayed enhancement (DE), wall motion (WM) and degree of 201-Tl uptake were scored in 238 segments. Of 91 MI segments, MO was recognized in 22 (25%) segments on CMR. WM was significantly better in proportion to 201-Tl uptake (P=0.01) in MO segments. All 8 MO segments with WM improvement at follow-up had 99m-Tc PYP uptake, although only 3 (21%) of 14 MO segments that did not show WM improvement at follow-up had 99m-Tc PYP uptake (P=0.001). 99m-Tc PYP and 201-Tl scintigraphy have the potential to predict WM status and improvement of the MO region after reperfused acute MI. (author)

  17. Myocardial function and perfusion in the CREST syndrome variant of progressive systemic sclerosis. Exercise radionuclide evaluation and comparison with diffuse scleroderma

    International Nuclear Information System (INIS)

    Follansbee, W.P.; Curtiss, E.I.; Medsger, T.A. Jr.; Owens, G.R.; Steen, V.D.; Rodnan, G.P.

    1984-01-01

    Myocardial function and perfusion were evaluated in 22 patients with progressive systemic sclerosis with the CREST syndrome using exercise and radionuclide techniques, pulmonary function testing, and chest roentgenography. The results were compared with a similar study of 26 patients with progressive systemic sclerosis with diffuse scleroderma. The prevalence of thallium perfusion abnormalities was similar in the groups with CREST syndrome and diffuse scleroderma, (64 percent versus 77 percent), but the defects were significantly smaller in the CREST syndrome (p less than 0.01). Reperfusion thallium defects in the absence of extramural coronary artery disease were seen in 38 percent of patients with diffuse scleroderma. This finding was not seen in any of the patients with the CREST syndrome. In diffuse scleroderma, abnormalities of both right and left ventricular function were related to larger thallium perfusion defects. In the CREST syndrome, abnormalities of left ventricular function were minor, were seen only during exercise, and were unrelated to thallium perfusion defects. Abnormal resting right ventricular function was seen in 36 percent of the patients with the CREST syndrome and was associated with an isolated decrease in diffusing capacity of carbon monoxide. It is concluded that the cardiac manifestations of the CREST syndrome are distinct from those found in diffuse scleroderma. Unlike diffuse scleroderma, abnormalities of left ventricular function in the CREST syndrome are minor and are unrelated to abnormalities of coronary perfusion. Right ventricular dysfunction in the CREST syndrome appears to be primarily related to pulmonary vascular disease

  18. Pharmacoeconomic impact evaluation of statin adherence in high-risk unselected post myocardial infarction population: an administrative database-guided analysis.

    Science.gov (United States)

    Summaria, Francesco; Ciaralli, Fabrizio; Mustilli, Marina; Sette, Antonella; Lanzillo, Chiara; Vasselli, Loredana

    2013-01-01

    The compliance to statins in secondary prevention is very low, increasing health-care costs principally for rehospitalization. To evaluate the cost of lack of persistence to statin therapy together with identification and cost-estimation of poor compliance. Retrospective observational study starting from administrative database analysis of statin prescription after myocardial infarction. Among 463 patients enrolled, 25.1% were never treated, 70.8% received statins regularly; 14.9% received only 1-2 prescriptions (spot prescription), and 12% were occasional users. Among the 288 nonoccasional users, we found a compliance rate of 80% only in the 59.7%. The cost analysis shows that 59.787,72 euros (23.4%) have been spent for patients with compliance of less than 80% (ineffective adherence). As the lower compliance affects the health-care costs, the identification of occasional users and spot prescriptions of the nonoccasional users, has a potential role in reducing medical expense with limited increase in costs.

  19. Momentum anisotropy at freeze out

    International Nuclear Information System (INIS)

    Feld, S.; Borghini, N.; Lang, C.

    2017-01-01

    The transition from a hydrodynamical modeling to a particle-based approach is a crucial element of the description of high-energy heavy-ion collisions. Assuming this “freeze out” happens instantaneously at each point of the expanding medium, we show that the local phase-space distribution of the emitted particles is asymmetric in momentum space. This suggests the use of anisotropic hydrodynamics for the last stages of the fluid evolution. We discuss how observables depend on the amount of momentum-space anisotropy at freeze out and how smaller or larger anisotropies allow for different values of the freeze-out temperature. (paper)

  20. Tl myocardial SPECT demonstrates importance of collateral circulation in patients with myocardial infarction

    International Nuclear Information System (INIS)

    Hattori, Fukunori

    1997-01-01

    The influence of collateral circulation on the preservation of myocardial viability and the efficacy of drug therapy and PTCA were evaluated by exercise 201 Tl myocardial SPECT before and after treatment. Thirty-five patients with a history of myocardial infarction resulting from total or subtotal obstruction of the responsible coronary artery were divided into four groups, according to the method of the treatment and the degree of collateral blood flow. Patients in groups A and B received drug therapy and displayed developed and undeveloped collateral circulation, respectively. Groups C and D received PTCA and displayed developed and undeveloped collateral circulation, respectively. Tl myocardial SPECT was performed before treatment to record the extent of redistribution to the occluded region, the degree of myocardial viability and the nature and extent of the ischemic lesion. In group A, myocardial perfusion improved, although redistribution remained in all cases, while in group B, 4 of 7 cases improved after drug therapy. In group C, myocardial perfusion improved in all cases, and redistribution disappeared in 7 of 12 cases. 5 of 6 cases improved in group D after PTCA. After drug therapy, the %Tl uptake in the infarcted region improved significantly in initial and delayed images of patients in group A. The differences in initial and delayed images in group B before and after drug therapy were not significant. In contrast, groups C and D both registered significant improvement in initial and delayed images after PTCA. The washout rate improved significantly in groups A, C and D after their respective treatments. These results suggest that developed collateral circulation helps to preserve myocardial viability in cases of myocardial infarction. Myocardial perfusion improved after drug therapy in cases with developed collateral circulation, and in patients with developed and undeveloped collateral circulation receiving PTCA. (K.H.)

  1. Usefulness of 123I-BMIPP myocardial scintigraphy for evaluation of the left ventricular function in patients with chronic heart failure

    International Nuclear Information System (INIS)

    Watanabe, Kouki; Tsuruoka, Takashi; Sekiya, Michihito; Funada, Junichi; Miyagawa, Masao; Kumano, Seishi.

    1996-01-01

    We examined the relationship between free fatty acid metabolism using 123 I beta-methyl-iodophenyl-pentadecanoic acid (BMIPP) and cardiac function in patients with chronic heart failure (CHF). Cardiac free fatty acid metabolism was evaluated by the heart to mediastinum ratio (H/M), the heart to lung ratio (H/Lu), the heart to liver ratio (H/Li) and the myocardial uptake ratio (MUR) obtained from the planar imaging. Cardiac function was evaluated by the percent of fractional shortening (%FS) and the amount of left ventricular mass (LVmass) calculated with echocardiography. The study included 34 male and 14 female subjects of CHF with mean age of 61±9 years; dilated cardiomyopathy (DCM): n=17, ischemic heart disease (IHD): n=16, valvular disease: n=5, hypertrophic cardiomyopathy: n=4, hypertension: n=4, amyloidosis: n=2. The correlations between indices of BMIPP uptake and those of echocardiography were as follows: H/M vs. %FS (r=0.67, p<0.01), H/Lu vs. %FS (r=0.49, p<0.01), H/Li vs. %FS (r=0.12, p=0.42), MUR vs. %FS (r=0.03, p=0.86) and MUR/LVmass vs. %FS (r=0.59, p<0.01). The correlation coefficient between H/M and MUR/LVmass in patients with IHD was higher than that in patients with DCM. In conclusion, BMIPP, in particular, is a useful tool for evaluating cardiac function in patients with CHF. (author)

  2. System dynamics modeling in the evaluation of delays of care in ST-segment elevation myocardial infarction patients within a tiered health system.

    Directory of Open Access Journals (Sweden)

    Luciano de Andrade

    Full Text Available Mortality rates amongst ST segment elevation myocardial infarction (STEMI patients remain high, especially in developing countries. The aim of this study was to evaluate the factors related with delays in the treatment of STEMI patients to support a strategic plan toward structural and personnel modifications in a primary hospital aligning its process with international guidelines.The study was conducted in a primary hospital localized in Foz do Iguaçu, Brazil. We utilized a qualitative and quantitative integrated analysis including on-site observations, interviews, medical records analysis, Qualitative Comparative Analysis (QCA and System Dynamics Modeling (SD. Main cause of delays were categorized into three themes: a professional, b equipment and c transportation logistics. QCA analysis confirmed four main stages of delay to STEMI patient's care in relation to the 'Door-in-Door-out' time at the primary hospital. These stages and their average delays in minutes were: a First Medical Contact (From Door-In to the first contact with the nurse and/or physician: 7 minutes; b Electrocardiogram acquisition and review by a physician: 28 minutes; c ECG transmission and Percutaneous Coronary Intervention Center team feedback time: 76 minutes; and d Patient's Transfer Waiting Time: 78 minutes. SD baseline model confirmed the system's behavior with all occurring delays and the need of improvements. Moreover, after model validation and sensitivity analysis, results suggested that an overall improvement of 40% to 50% in each of these identified stages would reduce the delay.This evaluation suggests that investment in health personnel training, diminution of bureaucracy, and management of guidelines might lead to important improvements decreasing the delay of STEMI patients' care. In addition, this work provides evidence that SD modeling may highlight areas where health system managers can implement and evaluate the necessary changes in order to improve the

  3. Usefulness of {sup 123}I-BMIPP myocardial scintigraphy for evaluation of the left ventricular function in patients with chronic heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Kouki; Tsuruoka, Takashi [Minamiuwa Ehime Prefectural Hospital, Johen (Japan); Sekiya, Michihito; Funada, Junichi; Miyagawa, Masao; Kumano, Seishi

    1996-07-01

    We examined the relationship between free fatty acid metabolism using {sup 123}I beta-methyl-iodophenyl-pentadecanoic acid (BMIPP) and cardiac function in patients with chronic heart failure (CHF). Cardiac free fatty acid metabolism was evaluated by the heart to mediastinum ratio (H/M), the heart to lung ratio (H/Lu), the heart to liver ratio (H/Li) and the myocardial uptake ratio (MUR) obtained from the planar imaging. Cardiac function was evaluated by the percent of fractional shortening (%FS) and the amount of left ventricular mass (LVmass) calculated with echocardiography. The study included 34 male and 14 female subjects of CHF with mean age of 61{+-}9 years; dilated cardiomyopathy (DCM): n=17, ischemic heart disease (IHD): n=16, valvular disease: n=5, hypertrophic cardiomyopathy: n=4, hypertension: n=4, amyloidosis: n=2. The correlations between indices of BMIPP uptake and those of echocardiography were as follows: H/M vs. %FS (r=0.67, p<0.01), H/Lu vs. %FS (r=0.49, p<0.01), H/Li vs. %FS (r=0.12, p=0.42), MUR vs. %FS (r=0.03, p=0.86) and MUR/LVmass vs. %FS (r=0.59, p<0.01). The correlation coefficient between H/M and MUR/LVmass in patients with IHD was higher than that in patients with DCM. In conclusion, BMIPP, in particular, is a useful tool for evaluating cardiac function in patients with CHF. (author)

  4. Myocardial perfusion modeling using MRI

    DEFF Research Database (Denmark)

    Larsson, H B; Fritz-Hansen, T; Rostrup, Egill

    1996-01-01

    In the present study, it is shown that it is possible to quantify myocardial perfusion using magnetic resonance imaging in combination with gadolinium diethylenetriaminopentaacetic acid (Gd-DTPA). Previously, a simple model and method for measuring myocardial perfusion using an inversion recovery...... turbo-FLASH (fast low-angle shot) sequence and Gd-DTPA has been presented. Here, an extension of the model is presented taking into account fast and slow water exchange between the compartments, enabling the calculation of the unidirectional influx constant (Ki) for Gd-DTPA, the distribution volume...... of Gd-DTPA (lambda), the vascular blood volume (Vb), and the time delay through the coronary arteries (delta T). The model was evaluated by computer simulation and used on experimental results from seven healthy subjects. The results in the healthy volunteers for a region of interest placed...

  5. Assessment of myocardial viability by exercise stress myocardial tomography with 201Tl

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa

    1992-01-01

    Exercise stress (Ex) and redistribution (RD) myocardial tomography with Tl-201 has been widely used for evaluating myocardial viability. But recent studies have demonstrated that reinjection (ReI) study following RD study is necessary for detecting reversible ischemic myocardium. On the other hand, decreased myocardial washout of Tl-201 after Ex is an indicator of myocardial ischemia. So we have studied the usefulness of myocardial Tl-201 washout rate (WOR) for the evaluation of myocardial viability by comparing it with ReI images. Ex and RD myocardial tomographies were obtained immediately after Ex and 3 hours later. After RD study a small amount of Tl-201 was injected and ReI imaging was repeated. We studied 64 myocardial segments (in 58 patients with coronary artery disease) in which Ex-induced perfusion defects persisted in RD images. According to the changes of perfusion defects between Ex, RD and ReI images, they were classified into 3 types: Type I; perfusion defect on the RD image was identical to ReI image (75%). Type I was divided into 2 subgroups whether perfusion defect at Ex was unchanged (Ia, 42%) or improved (Ib, 33%) on the RD image. Type II; perfusion defect at Ex was reduced on the RD image and it improved furthermore at ReI image (17%). Type III; perfusion defect was the same at Ex and RD but it was reduced on the ReI image (8%). WOR less than 30% was defined as abnormal when Ex heart rate exceeded 120 bpm and lung-myocardial Tl-201 uptake ratio was less than 0.45. The differentiation between Type Ia and Type III is of great importance. History of myocardial infarction, effort angina and Ex induced ST depression could not differentiate these 2 groups. WOR abnormality was observed in all of Type III, but WOR was normal in Type Ia. In conclusion, WOR abnormality in Ex-RD myocardial imaging is useful for evaluating myocardial viability. ReI imaging is necessary for the precise evaluation of viable muscle mass and for inadequate Ex. (author)

  6. Anisotropy of the Elastic Properties of Normal and Pathological Myocardium: Angular Dependence of Ultrasonic Backscatter, Attenuation, and Velocity.

    Science.gov (United States)

    Verdonk, Edward Dennis

    The focus of this thesis is the measurement of anisotropies in the ultrasonic parameters of soft tissues. The goal is to contribute to a better understanding of the physics which underlies the interaction of ultrasonic waves with inhomogeneous and anisotropic media. Broadband measurements using a piezoelectric transducer are reported for investigations of excised specimens of human and canine myocardial tissue. Emphasis is placed on identifying the effect that the muscle fiber orientation, relative to the direction of insonification, has on the propagation and scattering properties of ultrasonic waves. Results of the anisotropy of backscatter, the anisotropy of attenuation, and the anisotropy of quasilongitudinal velocity are presented for data obtained in 2^ circ increments through the full 360 ^circ relative to the myofibers. Measured velocities are used in conjunction with measured specimen densities to determine the elastic stiffness constants c_{11} and c_ {33} and to estimate specific mechanical moduli for thin layers of myocardium.

  7. Flow stress anisotropy in aluminium

    DEFF Research Database (Denmark)

    Juul Jensen, D.; Hansen, N.

    1990-01-01

    The plastic anisotropy of cold-rolled high purity aluminum (99.996%) and commercially pure aluminum (99.6%) has been investigated. Sample parameters were the initial grain size and the degree of plastic strain (ϵ < 3.00). Flow stresses (0.2% offset) were measured at room temperature by uniaxial t...

  8. The Cosmic Microwave Background Anisotropy

    Science.gov (United States)

    Bennett, C. L.

    1994-12-01

    The properties of the cosmic microwave background radiation provide unique constraints on the history and evolution of the universe. The first detection of anisotropy of the microwave radiation was reported by the COBE Team in 1992, based on the first year of flight data. The latest analyses of the first two years of COBE data are reviewed in this talk, including the amplitude of the microwave anisotropy as a function of angular scale and the statistical nature of the fluctuations. The two-year results are generally consistent with the earlier first year results, but the additional data allow for a better determination of the key cosmological parameters. In this talk the COBE results are compared with other observational anisotropy results and directions for future cosmic microwave anisotropy observations will be discussed. The National Aeronautics and Space Administration/Goddard Space Flight Center (NASA/GSFC) is responsible for the design, development, and operation of the Cosmic Background Explorer (COBE). Scientific guidance is provided by the COBE Science Working Group.

  9. Periodontitis and myocardial hypertrophy.

    Science.gov (United States)

    Suzuki, Jun-Ichi; Sato, Hiroki; Kaneko, Makoto; Yoshida, Asuka; Aoyama, Norio; Akimoto, Shouta; Wakayama, Kouji; Kumagai, Hidetoshi; Ikeda, Yuichi; Akazawa, Hiroshi; Izumi, Yuichi; Isobe, Mitsuaki; Komuro, Issei

    2017-04-01

    There is a deep relationship between cardiovascular disease and periodontitis. It has been reported that myocardial hypertrophy may be affected by periodontitis in clinical settings. Although these clinical observations had some study limitations, they strongly suggest a direct association between severity of periodontitis and left ventricular hypertrophy. However, the detailed mechanisms between myocardial hypertrophy and periodontitis have not yet been elucidated. Recently, we demonstrated that periodontal bacteria infection is closely related to myocardial hypertrophy. In murine transverse aortic constriction models, a periodontal pathogen, Aggregatibacter actinomycetemcomitans markedly enhanced cardiac hypertrophy with matrix metalloproteinase-2 activation, while another pathogen Porphyromonas gingivalis (P.g.) did not accelerate these pathological changes. In the isoproterenol-induced myocardial hypertrophy model, P.g. induced myocardial hypertrophy through Toll-like receptor-2 signaling. From our results and other reports, regulation of chronic inflammation induced by periodontitis may have a key role in the treatment of myocardial hypertrophy. In this article, we review the pathophysiological mechanism between myocardial hypertrophy and periodontitis.

  10. Left ventricular contractile function after distal protection in primary percutaneous coronary intervention Results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial

    DEFF Research Database (Denmark)

    Kofoed, K F; Kelbæk, H; Thuesen, L

    2011-01-01

    Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function.......Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function....

  11. Anisotropy of acoustic properties in paratellurite

    International Nuclear Information System (INIS)

    Parygin, Vladimir N.

    1996-01-01

    One of the peculiarities of the TeO 2 crystal consists of its strong acoustic anisotropy. This anisotropy demonstrates itself by acoustic energy walk-off and anisotropic distortion of an acoustic beam. Four constants completely characterise the acoustic anisotropy of the medium. In this paper these constants are calculated for various directions of the acoustic beam in crystal. (authors)

  12. Effect of recombinant tissue-type plasminogen activator on acute myocardial infarction; Limitation of infarct size and preservation of left ventricular function evaluated by radionuclide methods

    Energy Technology Data Exchange (ETDEWEB)

    Fukuyama, Takaya; Inou, Tetsuji; Ashihara, Toshiaki; Ogata, Ikuo; Nabeyama, Shouzou; Yamada, Akira; Murakami, Satoshi; Kodama, Mayuko; Matsui, Kanji (Matsuyama Red Cross Hospital, Ehime (Japan))

    1989-12-01

    Radionuclide studies were performed in 18 patients with acute myocardial infarction receiving i.v. injection of recombinant tissue-type plasminogen activator (rt-PA) within 12 hr after an attack. Thallium-201 single photon emission computed tomography revealed that infarct size decreased by 42% in the rt-PA treated group, as compared with 25% in the control group. Left ventricular ejection fraction, as found on first-pass radionuclide angiography with Tc-99m PYP, was significantly higher in the rt-PA treated group than the control group (49% vs 38%). Radionuclide imagings were helpful in confirming myocardial salvage after rt-PA intravenous therapy. It was also considered necessary to perform rt-PA therapy as early as possible after an acute myocardial attack. (N.K.).

  13. Evaluation of acute ischemia in pre-procedure ECG predicts myocardial salvage after primary PCI in STEMI patients with symptoms >12hours

    DEFF Research Database (Denmark)

    Fakhri, Yama; Busk, Martin; Schoos, Mikkel Malby

    2016-01-01

    -presenters). The Anderson-Wilkin's score (AW-score) estimates the acuteness of myocardial ischemia from the electrocardiogram (ECG) in STEMI patients. We hypothesized that the AW-score is superior to symptom duration in identifying substantial salvage potential in late-presenters. METHODS: The AW-score (range 1......-4) was obtained from the pre-pPCI ECG in 55 late-presenters and symptoms 12-72 hours. Myocardial perfusion imaging was performed to assess area at risk before pPCI and after 30days to assess myocardial salvage index (MSI). We correlated both the AW-score and pain-to-balloon with MSI and determined the salvage...

  14. VIABILIDAD MIOCÁRDICA Y LOS PRINCIPALES MÉTODOS PARA SU DETECCIÓN / Myocardial viability and the main methods for its evaluation

    Directory of Open Access Journals (Sweden)

    Iguer F Aladro Miranda

    2009-09-01

    Full Text Available The reduction of mortality due to ischemic heart disease is one of the objectives of the Health Systems in the developed nations, and in Cuba as well. After an acute myocardial infarction, or after a chronic obstruction of a coronary artery, a contractile dysfunction of the cardiac muscle appears. This dysfunction can be partially or totally reversible. With a surgical and percutaneous myocardialrevascularization it is possible to restore the flow of blood to the ischemic area; however, these procedures would be in vain if the reperfused muscle is not viable. That is why the tests which assess the myocardial viability are so important and represent an indispensable tool to guarantee the success. During the last years some concepts have been modified, some diagnosis techniques have been developed; and the therapeutics, both medical and surgical, is in a process of evolution. The most useful diagnosis methods to determine myocardial viability are commented in this article.

  15. Intracoronary and systemic melatonin to patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Halladin, Natalie L; Busch, Sarah Ekeløf; Jensen, Svend Eggert

    2014-01-01

    -point is the Myocardial Salvage Index assessed by cardiovascular magnetic resonance imaging on day 4 (± 1) after pPCI. The secondary end-points are high-sensitivity troponin, creatinekinase myocardial band and clinical events. CONCLUSION: The aim of the IMPACT trial is to evaluate the effect of melatonin on reperfusion...

  16. Magnetic anisotropy of lecithin membranes. A new anisotropy susceptometer

    OpenAIRE

    Scholz, F.; Boroske, E.; Helfrich, W.

    1984-01-01

    Cylindrical giant vesicles prepared from egg lecithin and 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) are oriented in an external magnetic field and observed by phase contrast microscopy. The anisotropic part of the diamagnetic susceptibility of the lecithin membrane is determined from the distribution of angles between the magnetic field and the long cylinder axis due to thermal fluctuations. The anisotropy of DMPC is found to be larger by a factor of 2 than that of egg lecithin. This...

  17. Anisotropy effect on strengths of metamorphic rocks

    Directory of Open Access Journals (Sweden)

    Ahmet Özbek

    2018-02-01

    Full Text Available This paper aims to study the effect of anisotropy on strengths of several metamorphic rocks of southern (Çine submassif of Menderes metamorphic massif in southwest Turkey. Four different metamorphic rocks including foliated phyllite, schist, gneiss and marble (calcschist were selected and examined. Discontinuity surveys were made along lines for each rock and evaluated with DIPS program. L-type Schmidt hammer was applied in the directions parallel and perpendicular to foliation during the field study. Several hand samples and rock blocks were collected during the field study for measurements of dry and saturated densities, dry and saturated unit weights and porosity, and for petrographic analysis and strength determination in laboratory. L- and N-type Schmidt hammers were applied in the directions perpendicular (anisotropy angle of 0° and parallel (anisotropy angle of 90° to the foliation on selected blocks of phyllite, schist, gneiss and marble (calcschist. The phyllite and schist have higher porosity and lower density values than the other rocks. However, coarse crystalline gneiss and marble (calcschist have higher rebound values and strengths, and they are classified as strong–very strong rocks. Generally, the rebound values in the direction perpendicular to the foliation are slightly higher than that in the direction parallel to foliation. Rebound values of N-type Schmidt hammer are higher than the L-type values except for phyllite. Sometimes, the rebound values of laboratory and field applications gave different results. This may result from variable local conditions such as minerals differentiation, discontinuities, water content, weathering degree and thickness of foliated structure.

  18. [Door-to-balloon time and in-hospital mortality in patients with ST-evaluation myocardial infarction: a network experience in a province in northwest Tuscany, Italy].

    Science.gov (United States)

    Paradossi, Umberto; Palmieri, Cataldo; Trianni, Giuseppe; Ravani, Marcello; Vaghetti, Marco; Rizza, Antonio; Gianetti, Jacopo; Cardullo, Simona; Chabane, Hakim; Maffei, Stefano; Berti, Sergio

    2010-05-01

    A network system for ST-elevation myocardial infarction (STEMI) patients offers a quick diagnosis and a rapid transfer to a specialized center for primary percutaneous coronary intervention. The aim of our study was to evaluate the relationship between door-to-balloon time and in-hospital mortality in our network of STEMI patients. Our Hub & Spoke network in the province of Massa-Carrara in the northwest of Tuscany Region, Italy, began in April 2006. This program involved 5 Spoke and 1 Hub centers, 1 medical helicopter, 3 advanced life support ambulances with direct transmission of the ECG and vital parameters to our cath lab on call 24h a day for primary percutaneous coronary intervention. Data regarding clinical, echocardiographic and hemodynamic parameters, the door-to-balloon (DTB) time and their impact on mortality were analyzed. Up to January 2008, 312 STEMI patients were enrolled (242 male, mean age 66.6 +/- 12.3 years). The DTB time was 93 min (79-117, 25th-75th percentile, respectively). The gold standard of a DTB mountain area. Patients from the coast (n = 238) had a DTB time lower than patients from the mountain area (89.5 vs 122.5 min, p < 0.0001), and the risk of in-hospital mortality was significantly and independently correlated with the increase in DTB time (p = 0.04). CONCLUSIONS; Our data confirm the correlation between DTB time and in-hospital mortality. More efforts are necessary to reduce the time to treatment and mortality rates.

  19. Cardiac magnetic resonance based evaluation of aortic stiffness and epicardial fat volume in patients with hypertension, diabetes mellitus, and myocardial infarction.

    Science.gov (United States)

    Homsi, Rami; Sprinkart, Alois M; Gieseke, Juergen; Meier-Schroers, Michael; Yuecel, Seyrani; Fischer, Stefan; Nadal, Jennifer; Dabir, Darius; Luetkens, Julian A; Kuetting, Daniel L; Schild, Hans H; Thomas, Daniel K

    2018-01-01

    Background Aortic stiffness and epicardial fat relate to cardiovascular risk. Their relationship with each other and their role with hypertension, diabetes mellitus (DM), and myocardial infarction (MI) can be evaluated by cardiac magnetic resonance (CMR). Purpose To explore an association between aortic stiffness and epicardial as well as paracardial fat volume (EFV and ParaFV, respectively) in hypertensive patients and to relate the results to the presence of DM and MI. Material and Methods A total of 156 hypertensive and 20 non-hypertensive participants were examined at 1.5 Tesla. A 2D-velocity-encoded sequence was acquired to assess aortic pulse wave velocity (PWV in m/s) as a measure of aortic stiffness. A 3D-Dixon sequence was used to determine EFV and ParaFV. Results PWV correlated with EFV (R = 0.474; P hypertensive controls compared to hypertensive patients. EFV and PWV were significantly higher in diabetic hypertensive patients without MI (n = 19; PWV: 10.4 ± 2.9; EFV: 92.5 ± 19.3) compared to hypertension-only patients (n = 84 [no DM or MI]; EFV: 64.8 ± 25.1, PWV: 9.0 ± 2.6; P hypertensive patients. Both were increased in the presence of DM; however, only EFV was increased in the presence of MI. This may relate to the PWV lowering effect of the antihypertensive medication used by hypertensive patients and underscores the benefit of EFV assessment in this regard.

  20. Cell tracking and therapy evaluation of bone marrow monocytes and stromal cells using SPECT and CMR in a canine model of myocardial infarction

    Directory of Open Access Journals (Sweden)

    Merrifield Peter

    2009-04-01

    Full Text Available Abstract Background The clinical application of stem cell therapy for myocardial infarction will require the development of methods to monitor treatment and pre-clinical assessment in a large animal model, to determine its effectiveness and the optimum cell population, route of delivery, timing, and flow milieu. Objectives To establish a model for a in vivo tracking to monitor cell engraftment after autologous transplantation and b concurrent measurement of infarct evolution and remodeling. Methods We evaluated 22 dogs (8 sham controls, 7 treated with autologous bone marrow monocytes, and 7 with stromal cells using both imaging of 111Indium-tropolone labeled cells and late gadolinium enhancement CMR for up to12 weeks after a 3 hour coronary occlusion. Hearts were also examined using immunohistochemistry for capillary density and presence of PKH26 labeled cells. Results In vivo Indium imaging demonstrated an effective biological clearance half-life from the injection site of ~5 days. CMR demonstrated a pattern of progressive infarct shrinkage over 12 weeks, ranging from 67–88% of baseline values with monocytes producing a significant treatment effect. Relative infarct shrinkage was similar through to 6 weeks in all groups, following which the treatment effect was manifest. There was a trend towards an increase in capillary density with cell treatment. Conclusion This multi-modality approach will allow determination of the success and persistence of engraftment, and a correlation of this with infarct size shrinkage, regional function, and left ventricular remodeling. There were overall no major treatment effects with this particular model of transplantation immediately post-infarct.

  1. The Systematic Evaluation of Identifying the Infarct Related Artery Utilizing Cardiac Magnetic Resonance in Patients Presenting with ST-Elevation Myocardial Infarction.

    Directory of Open Access Journals (Sweden)

    Carine E Hamo

    Full Text Available Identification of the infarct-related artery (IRA in patients with STEMI using coronary angiography (CA is often based on the ECG and can be challenging in patients with severe multi-vessel disease. The current study aimed to determine how often percutaneous intervention (PCI is performed in a coronary artery different from the artery supplying the territory of acute infarction on cardiac magnetic resonance imaging (CMR.We evaluated 113 patients from the Reduction of infarct Expansion and Ventricular remodeling with Erythropoetin After Large myocardial infarction (REVEAL trial, who underwent CMR within 4±2 days of revascularization. Blinded reviewers interpreted CA to determine the IRA and CMR to determine the location of infarction on a 17-segment model. In patients with multiple infarcts on CMR, acuity was determined with T2-weighted imaging and/or evidence of microvascular obstruction.A total of 5 (4% patients were found to have a mismatch between the IRA identified on CMR and CA. In 4/5 cases, there were multiple infarcts noted on CMR. Thirteen patients (11.5% had multiple infarcts in separate territories on CMR with 4 patients (3.5% having multiple acute infarcts and 9 patients (8% having both acute and chronic infarcts.In this select population of patients, the identification of the IRA by CA was incorrect in 4% of patients presenting with STEMI. Four patients with a mismatch had an acute infarction in more than one coronary artery territory on CMR. The role of CMR in patients presenting with STEMI with multi-vessel disease on CA deserves further investigation.

  2. Predicting response to cardiac resynchronization therapy with cross-correlation analysis of myocardial systolic acceleration: a new approach to echocardiographic dyssynchrony evaluation

    DEFF Research Database (Denmark)

    Olsen, Niels Thue; Mogelvang, Rasmus; Jons, Christian

    2009-01-01

    BACKGROUND: We tested the ability of cross-correlation analysis of myocardial systolic acceleration (XCA), a new marker of dyssynchrony based on tissue Doppler echocardiography, to predict long-term outcome of cardiac resynchronization therapy (CRT) and to discriminate between control patients...... and patients with dyssynchrony. METHODS: XCA was performed by off-line analysis of digitally stored myocardial velocity curves in 44 patients treated with CRT and followed for 13 +/- 2 months. We tested the ability of preimplant XCA to identify long-term responders to CRT (defined by a decrease in left...

  3. Clinical evaluation of 99mTc-CPI myocardial perfusion single photon emission computerized tomography in the diagnosis of coronary heart disease

    International Nuclear Information System (INIS)

    Peng Changping

    1991-01-01

    Two normal subjects, 5 patients with old myocardial infarction (OMI) and 4 patients with angina pectoris were examined by rest single photon emission computerized tomography revealed that the right ventricular was not imaged, the left ventricular was well exposed in the normal subjects. All the 9 patients had defects in the left ventricle. comparison of SPECT with 99m Tc-CPI with selective coronary arteriography (SCA), echocardiography (UCG), dynamic electrocardiography (DCG) and electrocardiographic (ECG)-exercise test in the diagnosis of myocardial ischemia or necrosis has demonstrated the former to be more significantly sensitive than the latter four. Good agreement between SPECT and SCA has been confirmed

  4. Consequences of elastic anisotropy in patterned substrate heteroepitaxy.

    Science.gov (United States)

    Dixit, Gopal Krishna; Ranganathan, Madhav

    2018-06-13

    The role of elastic anisotropy on quantum dot formation and evolution on a pre-patterned substrate is evaluated within the framework of a continuum model. We first extend the formulation for surface evolution to take elastic anisotropy into account. Using a small slope approximation, we derive the evolution equation and show how it can be numerically implemented up to linear and second order for stripe and egg-carton patterned substrates using an accurate and efficient procedure. The semi--infinite nature of the substrate is used to solve the elasticity problem subject to other boundary conditions at the free surface and at the film--substrate interface. The positioning of the quantum dots with respect to the peaks and valleys of the pattern is explained by a competition between the length scale of the pattern and the wavelength of the Asaro--Tiller--Grinfeld instability, which is also affected by the elastic anisotropy. The alignment of dots is affected by a competition between the elastic anisotropy of the film and the pattern orientation. A domain of pattern inversion, wherein the quantum dots form exclusively in the valleys of the patterns is identified as a function of the average film thickness and the elastic anisotropy, and the time--scale for this inversion as function of height is analyzed. © 2018 IOP Publishing Ltd.

  5. Anisotropy of domain wall resistance

    Science.gov (United States)

    Viret; Samson; Warin; Marty; Ott; Sondergard; Klein; Fermon

    2000-10-30

    The resistive effect of domain walls in FePd films with perpendicular anisotropy was studied experimentally as a function of field and temperature. The films were grown directly on MgO substrates, which induces an unusual virgin magnetic configuration composed of 60 nm wide parallel stripe domains. This allowed us to carry out the first measurements of the anisotropy of domain wall resistivity in the two configurations of current perpendicular and parallel to the walls. At 18 K, we find 8.2% and 1.3% for the domain wall magnetoresistance normalized to the wall width (8 nm) in these two respective configurations. These values are consistent with the predictions of Levy and Zhang.

  6. Rationale and radiopharmaceuticals for myocardial imaging

    International Nuclear Information System (INIS)

    Poe, N.D.

    1976-01-01

    Static radionuclide imaging procedures are now available for evaluating regional myocardial perfusion and for detecting acute myocardial infarction. Thallium-201, a radiopharmaceutical which possesses many of the characteristics of potassium analogs, at present is receiving the greatest attention as a regional blood flow indicator. Ischemic lesions appear as areas of decreased tracer uptake. Unfortunately, this agent is expensive, is in limited supply and has a photopeak which is low for optimum imaging. Positive infarct images can be obtained with various technetium-99m chelates. Pyrophosphate appears to be the best of the technetium compounds studied to date although the mechanism of uptake of the chelates has not yet been fully elucidated. Therefore, quantitative measurements of infarct size are not justified. As perfusion imaging and infarct imaging provide useful, complementary data, a dual tracer approach to evaluating patients with suspected coronary artery disease and/or myocardial infarction is probably justifiable

  7. Evaluating the normal individual cardiac function in different imaging phases post exercise and rest by gated SPECT myocardial perfusion

    International Nuclear Information System (INIS)

    Hua, W.; Li, S.J.; Liu, J.Z.; Li, X.F.; Jin, C.R.; Hu, G.; Wang, J.

    2007-01-01

    Full text: Objectives: To evaluate the normal individual cardiac function in the different imaging phases post-exercise and rest by GSPECT. Methods: 46 normal individuals underwent exercise/rest GSPECT using 99mTc-MIBI by 2- day program. Sequential imaging was started 15, 35 and 120 minutes after exercise and rest imaging was performed the following day. The left ventricular EF and EDV, ESV values were calculated with the Cedars-Sinai program. Results: The EF values of post- exercise at 15, 35, and 120m was 64.48±7.43%, 65.02±7.66%, and 60.98±7.28% respectively, and the rest EF value was 61.46±7.23%. The post exercise EF at 15m and 35m was higher than EF at post- exercise 120m and rest, but there is a significant difference only between post exercise 35m and rest (P< 0.05), and all post exercise EF did not increase at least 5% from EF at-rest. The EDV and ESV values did not have statistically significant differences at 15, 35,120m post-exercise and rest. The heart rate at 15,35m post- exercise was higher significantly than at rest. Conclusions: The different imaging phases after exercise with 99mTc-MIBI GSPECT affects LVEF in normal individuals, the 35m post- exercise EF is highest. (author)

  8. Type I supernovae and angular anisotropy of the Hubble constant

    International Nuclear Information System (INIS)

    Le Denmat, Gerard; Vigier, J.-P.

    1975-01-01

    The observation of type I supernovae in distant galaxies yields an homogeneous sample of sources to evaluate their true distance. An examination of their distribution in the sky provides a significant confirmation of the angular anisotropy of the Hubble constant already observed by Rubin, Rubin and Ford [fr

  9. Evaluation of risk scores for risk stratification of acute coronary syndromes in the Myocardial Infarction National Audit Project (MINAP) database.

    Science.gov (United States)

    Gale, C P; Manda, S O M; Weston, C F; Birkhead, J S; Batin, P D; Hall, A S

    2009-03-01

    To compare the discriminative performance of the PURSUIT, GUSTO-1, GRACE, SRI and EMMACE risk models, assess their performance among risk supergroups and evaluate the EMMACE risk model over the wider spectrum of acute coronary syndrome (ACS). Observational study of a national registry. All acute hospitals in England and Wales. 100 686 cases of ACS between 2003 and 2005. Model performance (C-index) in predicting the likelihood of death over the time period for which they were designed. The C-index, or area under the receiver-operating curve, range 0-1, is a measure of the discriminative performance of a model. The C-indexes were: PURSUIT C-index 0.79 (95% confidence interval 0.78 to 0.80); GUSTO-1 0.80 (0.79 to 0.81); GRACE in-hospital 0.80 (0.80 to 0.81); GRACE 6-month 0.80 (0.79 to 0.80); SRI 0.79 (0.78 to 0.80); and EMMACE 0.78 (0.77 to 0.78). EMMACE maintained its ability to discriminate 30-day mortality throughout different ACS diagnoses. Recalibration of the model offered no notable improvement in performance over the original risk equation. For all models the discriminative performance was reduced in patients with diabetes, chronic renal failure or angina. The five ACS risk models maintained their discriminative performance in a large unselected English and Welsh ACS population, but performed less well in higher-risk supergroups. Simpler risk models had comparable performance to more complex risk models. The EMMACE risk score performed well across the wider spectrum of ACS diagnoses.

  10. Exercise testing and thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Poyatos, M.E.; Suarez, L.; Lerman, J.; Guibourg, H.; Camps, J.; Perosio, A.

    1986-10-01

    In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Pre-excitation persisted in 39.5% of patients with type A and in 88.8% with type B (p less than 0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p less than 0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p less than 0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patients showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients n which the PE disappears suddenly, at a given heart rate.

  11. Exercise testing and thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome

    International Nuclear Information System (INIS)

    Poyatos, M.E.; Suarez, L.; Lerman, J.; Guibourg, H.; Camps, J.; Perosio, A.

    1986-01-01

    In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Pre-excitation persisted in 39.5% of patients with type A and in 88.8% with type B (p less than 0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p less than 0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p less than 0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patients showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients n which the PE disappears suddenly, at a given heart rate

  12. [Cosmic Microwave Background (CMB) Anisotropies

    Science.gov (United States)

    Silk, Joseph

    1998-01-01

    One of the main areas of research is the theory of cosmic microwave background (CMB) anisotropies and analysis of CMB data. Using the four year COBE data we were able to improve existing constraints on global shear and vorticity. We found that, in the flat case (which allows for greatest anisotropy), (omega/H)0 less than 10(exp -7), where omega is the vorticity and H is the Hubble constant. This is two orders of magnitude lower than the tightest, previous constraint. We have defined a new set of statistics which quantify the amount of non-Gaussianity in small field cosmic microwave background maps. By looking at the distribution of power around rings in Fourier space, and at the correlations between adjacent rings, one can identify non-Gaussian features which are masked by large scale Gaussian fluctuations. This may be particularly useful for identifying unresolved localized sources and line-like discontinuities. Levin and collaborators devised a method to determine the global geometry of the universe through observations of patterns in the hot and cold spots of the CMB. We have derived properties of the peaks (maxima) of the CMB anisotropies expected in flat and open CDM models. We represent results for angular resolutions ranging from 5 arcmin to 20 arcmin (antenna FWHM), scales that are relevant for the MAP and COBRA/SAMBA space missions and the ground-based interferometer. Results related to galaxy formation and evolution are also discussed.

  13. Absorb bioresorbable vascular scaffold versus everolimus-eluting metallic stent in ST-segment elevation myocardial infarction: 1-year results of a propensity score matching comparison: the BVS-EXAMINATION Study (bioresorbable vascular scaffold-a clinical evaluation of everolimus eluting coronary stents in the treatment of patients with ST-segment elevation myocardial infarction).

    Science.gov (United States)

    Brugaletta, Salvatore; Gori, Tommaso; Low, Adrian F; Tousek, Petr; Pinar, Eduardo; Gomez-Lara, Josep; Scalone, Giancarla; Schulz, Eberhard; Chan, Mark Y; Kocka, Viktor; Hurtado, Jose; Gomez-Hospital, Juan Antoni; Münzel, Thomas; Lee, Chi-Hang; Cequier, Angel; Valdés, Mariano; Widimsky, Petr; Serruys, Patrick W; Sabaté, Manel

    2015-01-01

    The purpose of this study was to compare the 1-year outcome between bioresorbable vascular scaffold (BVS) and everolimus-eluting metallic stent (EES) in ST-segment elevation myocardial infarction (STEMI) patients. The Absorb BVS (Abbott Vascular, Santa Clara, California) is a polymeric scaffold approved for treatment of stable coronary lesions. Limited and not randomized data are available on its use in ST-segment elevation myocardial infarction (STEMI) patients. This study included 290 consecutive STEMI patients treated by BVS, compared with either 290 STEMI patients treated with EES or 290 STEMI patients treated with bare-metal stents (BMS) from the EXAMINATION (A Clinical Evaluation of Everolimus Eluting Coronary Stents in the Treatment of Patients With ST-segment Elevation Myocardial Infarction) trial, by applying propensity score matching. The primary endpoint was a device-oriented endpoint (DOCE), including cardiac death, target vessel myocardial infarction, and target lesion revascularization, at 1-year follow-up. Device thrombosis, according to the Academic Research Consortium criteria, was also evaluated. The cumulative incidence of DOCE did not differ between the BVS and EES or BMS groups either at 30 days (3.1% vs. 2.4%, hazard ratio [HR]: 1.31 [95% confidence interval (CI): 0.48 to 3.52], p = 0.593; vs. 2.8%, HR: 1.15 [95% CI: 0.44 to 2.30], p = 0.776, respectively) or at 1 year (4.1% vs. 4.1%, HR: 0.99 [95% CI: 0.23 to 4.32], p = 0.994; vs. 5.9%, HR: 0.50 [95% CI: 0.13 to 1.88], p = 0.306, respectively). Definite/probable BVS thrombosis rate was numerically higher either at 30 days (2.1% vs. 0.3%, p = 0.059; vs. 1.0%, p = 0.324, respectively) or at 1 year (2.4% vs. 1.4%, p = 0.948; vs. 1.7%, p = 0.825, respectively), as compared with EES or BMS. At 1-year follow-up, STEMI patients treated with BVS showed similar rates of DOCE compared with STEMI patients treated with EES or BMS, although rate of scaffolds thrombosis, mostly clustered in the early phase

  14. 99Tcm-MIBI and 18F-FDG DISA imaging in the evaluation of CABG combined with autologous bone marrow mononuclear cell transplantation in patients with myocardial infarction

    International Nuclear Information System (INIS)

    Zhang Fuqiang; Chen Xianying; Zhang Guoxu; Wang Zhiguo; Ma Dongchu; Wang Huishan

    2009-01-01

    Objective: Autologous bone marrow mononuclear cell transplantation is a treatment modality under investigation for severe coronary heart disease. Its beneficial effects on ventricular function, myocardial perfusion and metabolism remain to be evaluated. The present study proposed a 18 F-fluorodeoxyglucose (FDG) and 99 Tc m -methoxyisobutylisinitrile (MIBI) dual-isotope simultaneous acquisition (DISA) imaging technique to assess the effects of coronary artery bypass grafting (CABG) combined with autologous bone marrow mononuclear cell transplantation in patients with old myocardial infarction (OMI). Methods: Twenty patients with OMI, whose diagnosis was confirmed with angiography. were divided into a convention. al CABG group (group A, n=11) and CABG+ autologous bone marrow mononuclear cell transplantation group (group B, n=9). All subjects underwent gated cardiac DISA tomography at one week preoperatively and four months postoperatively. The segmental myocardial uptake of the tracers was scored as 3, 2, 1 and 0. Paired-samples t test was used to compare data of the two groups. Results In group A, there were 52 perfusion/metabolism mismatched segments, 99 Tc m -MIBI and 18 F-FDG uptake scores of these segments in-creased from preoperatively 1.48 ± 0.75( 99 Tc m -MIBI)and 1.90 ± 0.75( 18 F-FDG) to postoperatively 1.75 ± 0.68 and 2.13 ± 0.74 (t=3.25 and 2.37, both P 0.05). However, in group B, there was significant increase of the myocardial uptake scores both in mismatched segments and matched segments. In the 45 mismatched segments of this group,preoperative and postoperative 99 Tc m -MIBI/ 18 F-FDG uptake scores were 1.24 ± 0.68/1.71 ± 0.76 and 1.53 ± 0.66/2.00 ± 0.64, respectively (t=2.93 and 2.56. both P 99 Tc m -MIBI/ 18 F-FDG uptake scores were 0.94 ± 0.75/1.50 ± 0.74 and 1.22 ± 0.76/1.78 ± 0.64. respectively (t=2.71 and 3.37. both P 0.05). Conclusions: CABG combined with autologous bone marrow mononuclear cell transplantation may improve myocardial

  15. Safety and tolerability of adenosine stress myocardial perfusion scintigraphy in the evaluation of coronary artery disease in the elderly patients - A case control study

    International Nuclear Information System (INIS)

    Gnanasegaran, G.; Malcolm, M.; Rossiter, A.; McCool, D.; Hilson, A.J.W.; Buscombe, J.R.

    2006-01-01

    Elderly patients referred for evaluation of chest pain are often unable to undertake adequate exercise for exercise stress testing. The aim of this retrospective study was to analyze haemodynamic effects and assess the safety of adenosine stress myocardial perfusion scintigraphy (MPS) in the elderly. Records of 380 Patients (Age range=30-93 years) were reviewed. These were divided into two groups, Group-A with 190 patients who were above 65 years of age and Group-B with 190 patients who were equal or below the age of 65 years, and who had undergone adenosine stress MPS. The two groups were matched for major risk factors and clinical presentations. Symptoms (flushing, headache, chest pain, dyspnoea, neck pain) were recorded throughout the adenosine infusion. Baseline blood pressure, heart rate and ECG were recorded and monitored throughout the study. A total of 167 out of 380 patients (44%) had side effects, 86 of them belonged to Group-A and 81 of them belonged to Group-B. Flushing occurred in 33% of patients in Group-A and 43% of patients in Group-B. Seventeen percent of patients in Group-A had chest pain, while this was encountered in 27% of patients in Group-B. Dyspnoea was recorded in 32% of patients from Group-A, while it was encountered in 21% of patients belonging to Group-B. Neck pain was experienced by 8.4% in Group-A and 15% in Group-B. All of these findings were statistically significant (p<0.05). Several other side effects were also encountered which included headache (Group-A: 14% and Group-B: 21%), abdominal discomfort (Group-A: 19% and Group-B: 23%), Nausea and/or vomiting (Group-A: 4.7% and Group-B: 7.3%). ECG changes were noted in both groups (Group-A: 14% and Group-B: 12%). None of these were found to be statistically significant. Based on this retrospective study, the authors concluded that Adenosine stress MPS is a safe method for the evaluation of coronary artery disease (CAD) in elderly patients and is well tolerated. Most side effects were

  16. Evaluation of the global MODIS 30 arc-second spatially and temporally complete snow-free land surface albedo and reflectance anisotropy dataset

    Science.gov (United States)

    Sun, Qingsong; Wang, Zhuosen; Li, Zhan; Erb, Angela; Schaaf, Crystal B.

    2017-06-01

    Land surface albedo is an essential variable for surface energy and climate modeling as it describes the proportion of incident solar radiant flux that is reflected from the Earth's surface. To capture the temporal variability and spatial heterogeneity of the land surface, satellite remote sensing must be used to monitor albedo accurately at a global scale. However, large data gaps caused by cloud or ephemeral snow have slowed the adoption of satellite albedo products by the climate modeling community. To address the needs of this community, we used a number of temporal and spatial gap-filling strategies to improve the spatial and temporal coverage of the global land surface MODIS BRDF, albedo and NBAR products. A rigorous evaluation of the gap-filled values shows good agreement with original high quality data (RMSE = 0.027 for the NIR band albedo, 0.020 for the red band albedo). This global snow-free and cloud-free MODIS BRDF and albedo dataset (established from 2001 to 2015) offers unique opportunities to monitor and assess the impact of the changes on the Earth's land surface.

  17. Stress myocardial scintigraphy in coronary artery disease

    International Nuclear Information System (INIS)

    Hata, Noritake; Koumi, Shin-ichi; Yasutake, Masahiro; Imaizumi, Takahiro; Saito, Tsutomu; Kishida, Hiroshi; Hayakawa, Hirokazu

    1991-01-01

    To evaluate the clinical significance of asymptomatic ischemic heart disease, exercise electrocardiography and stress myocardial scintigraphy were performed. These were correlated with symptoms during exercise tests and histories of myocardial infarction (MI). The study subjects consisted of 70 patients with coronary artery disease, including 34 with MI, and 36 without MI but with angina pectoris. Stress tests were performed using bicycle ergometer under electrocardiographic monitoring throughout the test. Transient myocardial ischemia was confirmed by perfusion defects on thallium myocardial imaging demonstrated immediately after exercise, but not 3 hours after the stress test. Asymptomatic ST depression was observed in 18 of 34 patients with MI (53%) and in 21 of the 36 patients with angina (58%); however, transient myocardial perfusion defects were confimred in 61% of the patients with MI (11 of 18 patients), but in only 33% of those with angina (7 of 21 patients). The difference was statistically significant (p<0.05). It was suggested that there are some differences in the clinical significance of asymptomatic ST depression between the patients with MI and those without MI but with angina pectoris. (author)

  18. Gated SPECT evaluation of myocardial perfusion defects and left ventricular function in chronic atrial fibrillation (CAF) patients - a prevalence study between a General Hospital (GH) and a referral Cardiology Hospital (CH)

    International Nuclear Information System (INIS)

    Rocha, G.; Guimaraes, M.; Marroni, B.; Zagoury, E.; Sprinz, C.; Andrea, S.; Louzada, A.; Ludwig, R.; Graef, C.

    2002-01-01

    Aims: to evaluate myocardial perfusion defects (MPD) prevalence and left ventricular function in CAF patients from a distinct referral basis (a GH and CH populations). Materials and Methods: a retrospective cross-sectional survey including 171 CAF (43 from GH and 128 from CH) and 5415 control patients (2222 from GH and 3193 from CH) submitted to rest/stress myocardial perfusion gated SPECT with Tc99m-MIBI. The following items were collected from CAF patients: the percentage of patients with MPD, the type (fixed, reversible or mixed) and number of segments with MPD and left ventricular ejection fraction (LVEF). The control patients percentage of MPD, their type and number were also collected. Results: CAF from GH and CH were not significantly different in the number of patients with MPD, mean number of segments affected, and LVEF. In GH patients, the CAF group had more segments with MPD (2,4x1,6 p<0,01) and lower LVEF (37%x52% p<0,01) than control group. CAF patients from CH also showed lower LVEF (40%x58% p<0,01) and more fixed MPD (40%x18% p<0,01) than their control group population. Conclusion: our data showed similar prevalence of MPD and reduced LVEF values between CAF patients from a GH and referral CH. The CAF group from CH seemed to have more fixed MPD perhaps reflecting more severe coronary artery disease population or referral bias. The data appears to support the evaluation of myocardial ischemia as a part of CAF possible etiologies. Caution is advised in LVEF evaluation of CAF patients due to increased variability of R-R interval

  19. Scintigraphic demonstration of acute myocardial infarcts

    International Nuclear Information System (INIS)

    Holman, B.L.; Lesch, M.

    1976-01-01

    The feasibility of acute infarct scintigraphy for the clinical evaluation of patients with known or suspected acute myocardial infarction is established. Further development of this methodologic approach may result in even better agents for the visualization of infarcts. Radiotracers with high affinity for the infarct, rapid blood clearance, and low concentrations in surrounding organs, such as liver and bone, would be more suitable than available radiopharmaceuticals for acute myocardial infarct scintigraphy. Ultimately, labeling these tracers and ultra-short-lived radionuclides will enable rapid sequential imaging to assess changes in the extent of infarction and to determine the efficacy of therapies aimed at limiting infarct size

  20. Exercise induced ST elevation and residual myocardial ischemia in previous myocardial infarction

    International Nuclear Information System (INIS)

    Shimonagata, Tsuyoshi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Saito, Muneyasu; Sumiyoshi, Tetsuya

    1987-01-01

    The purpose of this study was to evaluate the clinical significance of stress induced ST elevation on infarcted area in 65 patients with previous myocardial infarction (single vessel disease) who had stress thallium scan. Stress induced ST changes on infarcted area were compared with quantitative assessment of myocardial ischemia (thallium ischemic score; TIS) and extent of myocardial infarction (defect score; DS) derived from circumferential profile analysis. In patients with previous myocardial infarction in less than 3 month from the onset (n = 36), left ventricular ejection fraction (LVEF) and extent of abnormal LV wall motion were not significantly different between patients with stress induced ST elevation ( ≥ 2 mm, n = 26) and those with stress induced ST elevation ( < 2 mm, n = 10), while, in patients with previous myocardial infarction in more than 3 month (n = 29), patients with stress induced ST elevation ( ≥ 2 mm, n = 15) showed left ventricular dyskinesis more frequently than those with ST elevation ( < 2 mm, n = 14). In addition, the former showed significantly higher DS and significantly lower TIS than the latter. In patients with previous myocardial infarction in less than 3 month, patients with ST elevation ( ≥ 2 mm, n = 15) with prominent upright T wave (n = 15) had transient thallium defect in infarcted area in 73 % and they had significantly higher LVEF and TIS than those with ST elevation ( < 2 mm, n = 11). These results indicated that ST elevation in infarcted area reflect different significance according to the recovery of injured myocardium and stress induced ST elevation with prominent upright T wave in infarcted area reflect residual myocardial ischemia in less than 3 month from the onset of myocardial infarction. (author)

  1. Evaluation of related factors, prediction and treatment drugs of no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction after direct PCI.

    Science.gov (United States)

    Li, Hui; Fu, Du-Guan; Liu, Fu-Yuan; Zhou, Heng; Li, Xiao-Mei

    2018-04-01

    This study determined the related factors of no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction (STEMI) after direct percutaneous coronary intervention (PCI), and evaluated related factor scores in predicting the occurrence of no-reflow phenomenon and drug treatments. A total of 203 patients with acute STEMI receiving PCI who were admitted to the Department of Cardiovascularology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine (Xiangyang, China) from January 2015 to December 2016 were selected. The clinical and image data were analyzed to determine the related factors of no-reflow phenomenon after operation, and related factor scores were quantified to predict the occurrence of no-reflow phenomenon. Three drugs (diltiazem, nitroglycerin and tirofiban needles) were continuously injected in coronary arteries of patients with no-reflow phenomenon, and the effects of these drugs were analyzed. There were 38 patients (18.7%) with no-reflow phenomenon. The correlation analysis showed that 10 factors were associated with no-reflow phenomenon, in which five factors were identified as risk factors, including IRA open-up time ≥8 h, SBP 18 mg/l, thrombus loads, length of the culprit vessel ≥20 mm. The score analysis of related factors of 38 patients with no-reflow phenomenon was conducted. Three points were set for five risk factors each, and 1 point was set for the other five factors each. It was found that the score was approximately normally distributed. The average was 11.5±1.57 points and the lower limit of 95% confidence interval was >8.93 points. The effective rates of three drugs were different (P<0.05), and the pairwise comparison showed their effective rates were not fully identical (P<0.05). The results showed that: i) Τhere are 10 related factors, including five risk factors; ii) related factors with the score ≥9 points can be used for clinical prediction of STEMI after direct PCI; and iii) it is

  2. Do inter-hospital comparisons of in-hospital, acute myocardial infarction case-fatality rates serve the purpose of fostering quality improvement? An evaluative study

    Directory of Open Access Journals (Sweden)

    Molenberghs Geert

    2010-12-01

    Full Text Available Abstract Background In-hospital case-fatality rates in patients, admitted for acute myocardial infarction (AMI-CFRs, are internationally used as a quality indicator. Attempting to encourage the hospitals to assume responsibility, the Belgian Ministry of Health decided to stimulate initiatives of quality improvement by means of a limited set of indicators, among which AMI-CFR, to be routinely analyzed. In this study we aimed, by determining the existence of inter-hospital differences in AMI-CFR, (1 to evaluate to which extent Belgian discharge records allow the assessment of quality of care in the field of AMI, and (2 to identify starting points for quality improvement. Methods Hospital discharge records from all the Belgian short-term general hospitals in the period 2002-2005. The study population (N = 46,287 included patients aged 18 years and older, hospitalized for AMI. No unique patient identifier being present, we tried to track transferred patients. We assessed data quality through a comparison of MCD with data from two registers for acute coronary events and through transfer and sensitivity analyses. We compared AMI-CFRs across hospitals, using multivariable logistic regression models. In the main model hospitals, Charlson's co-morbidity index, age, gender and shock constituted the covariates. We carried out two types of analyses: a first one wherein transferred-out cases were excluded, to avoid double counting of patients when computing rates, and a second one with exclusion of all transferred cases, to allow the study of patients admitted into, treated in and discharged from the same hospital. Results We identified problems regarding both the CFR's numerator and denominator. Sensitivity analyses revealed differential coding and/or case management practices. In the model with exclusion of transfer-out cases, the main determinants of AMI-CFR were cardiogenic shock (ORadj 23.0; 95% CI [20.9;25.2], and five-year age groups ORadj 1.23; 95

  3. Do inter-hospital comparisons of in-hospital, acute myocardial infarction case-fatality rates serve the purpose of fostering quality improvement? An evaluative study.

    Science.gov (United States)

    Aelvoet, Willem; Terryn, Nathalie; Molenberghs, Geert; De Backer, Guy; Vrints, Christiaan; van Sprundel, Marc

    2010-12-08

    In-hospital case-fatality rates in patients, admitted for acute myocardial infarction (AMI-CFRs), are internationally used as a quality indicator. Attempting to encourage the hospitals to assume responsibility, the Belgian Ministry of Health decided to stimulate initiatives of quality improvement by means of a limited set of indicators, among which AMI-CFR, to be routinely analyzed. In this study we aimed, by determining the existence of inter-hospital differences in AMI-CFR, (1) to evaluate to which extent Belgian discharge records allow the assessment of quality of care in the field of AMI, and (2) to identify starting points for quality improvement. Hospital discharge records from all the Belgian short-term general hospitals in the period 2002-2005. The study population (N = 46,287) included patients aged 18 years and older, hospitalized for AMI. No unique patient identifier being present, we tried to track transferred patients. We assessed data quality through a comparison of MCD with data from two registers for acute coronary events and through transfer and sensitivity analyses. We compared AMI-CFRs across hospitals, using multivariable logistic regression models. In the main model hospitals, Charlson's co-morbidity index, age, gender and shock constituted the covariates. We carried out two types of analyses: a first one wherein transferred-out cases were excluded, to avoid double counting of patients when computing rates, and a second one with exclusion of all transferred cases, to allow the study of patients admitted into, treated in and discharged from the same hospital. We identified problems regarding both the CFR's numerator and denominator.Sensitivity analyses revealed differential coding and/or case management practices. In the model with exclusion of transfer-out cases, the main determinants of AMI-CFR were cardiogenic shock (OR(adj) 23.0; 95% CI [20.9;25.2]), and five-year age groups OR(adj) 1.23; 95% CI [1.11;1.36]). Sizable inter-hospital and inter

  4. The diagnostic performance of CT-derived fractional flow reserve for evaluation of myocardial ischaemia confirmed by invasive fractional flow reserve: a meta-analysis.

    Science.gov (United States)

    Li, S; Tang, X; Peng, L; Luo, Y; Dong, R; Liu, J

    2015-05-01

    To review the literature on the diagnostic accuracy of CT-derived fractional flow reserve (FFRCT) for the evaluation of myocardial ischaemia in patients with suspected or known coronary artery disease, with invasive fractional flow reserve (FFR) as the reference standard. A PubMed, EMBASE, and Cochrane cross-search was performed. The pooled diagnostic accuracy of FFRCT, with FFR as the reference standard, was primarily analysed, and then compared with that of CT angiography (CTA). The thresholds to diagnose ischaemia were FFR ≤0.80 or CTA ≥50% stenosis. Data extraction, synthesis, and statistical analysis were performed by standard meta-analysis methods. Three multicentre studies (NXT Trial, DISCOVER-FLOW study and DeFACTO study) were included, examining 609 patients and 1050 vessels. The pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR) for FFRCT were 89% (85-93%), 71% (65-75%), 70% (65-75%), 90% (85-93%), 3.31 (1.79-6.14), 0.16 (0.11-0.23), and 21.21 (9.15-49.15) at the patient-level, and 83% (78-63%), 78% (75-81%), 61% (56-65%), 92% (89-90%), 4.02 (1.84-8.80), 0.22 (0.13-0.35), and 19.15 (5.73-63.93) at the vessel-level. At per-patient analysis, FFRCT has similar sensitivity but improved specificity, PPV, NPV, LR+, LR-, and DOR versus those of CTA. At per-vessel analysis, FFRCT had a slightly lower sensitivity, similar NPV, but improved specificity, PPV, LR+, LR-, and DOR compared with those of CTA. The area under the summary receiver operating characteristic curves for FFRCT was 0.8909 at patient-level and 0.8865 at vessel-level, versus 0.7402 for CTA at patient-level. FFRCT, which was associated with improved diagnostic accuracy versus CTA, is a viable alternative to FFR for detecting coronary ischaemic lesions. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  5. Coronary risk factors and myocardial blood flow in patients evaluated for coronary artery disease: a quantitative [15O]H2O PET/CT study

    International Nuclear Information System (INIS)

    Danad, Ibrahim; Appelman, Yolande E.; Haan, Stefan de; Allaart, Cornelis P.; Rossum, Albert C. van; Knaapen, Paul; Raijmakers, Pieter G.; Harms, Hendrik J.; Hoekstra, Otto S.; Lammertsma, Adriaan A.; Lubberink, Mark; Oever, Mijntje L.P. van den; Kuijk, Cornelis van

    2012-01-01

    There has been increasing interest in quantitative myocardial blood flow (MBF) imaging over the last years and it is expected to become a routinely used technique in clinical practice. Positron emission tomography (PET) using [ 15 O]H 2 O is the established gold standard for quantification of MBF in vivo. A fundamental issue when performing quantitative MBF imaging is to define the limits of MBF in a clinically suitable population. The aims of the present study were to determine the limits of MBF and to determine the relationship among coronary artery disease (CAD) risk factors, gender and MBF in a predominantly symptomatic patient cohort without significant CAD. A total of 128 patients (mean age 54 ± 10 years, 50 men) with a low to intermediate pretest likelihood of CAD were referred for noninvasive evaluation of CAD using a hybrid PET/computed tomography (PET/CT) scanner. MBF was quantified with [ 15 O]H 2 O at rest and during adenosine-induced hyperaemia. Obstructive CAD was excluded in these patients by means of invasive or CT-based coronary angiography. Global average baseline MBF values were 0.91 ± 0.34 and 1.09 ± 0.30 ml.min -1 .g -1 (range 0.54-2.35 and 0.59-2.75 ml.min -1 .g -1 ) in men and women, respectively (p -1 .g -1 in men and women, respectively; p = 0.08). Global average hyperaemic MBF values were 3.44 ± 1.20 ml.min -1 .g -1 in the whole study population, and 2.90 ± 0.85 and 3.78 ± 1.27 ml.min -1 .g -1 (range 1.52-5.22 and 1.72-8.15 ml.min -1 .g -1 ) in men and women, respectively (p < 0.001). Multivariate analysis identified male gender, age and body mass index as having an independently negative impact on hyperaemic MBF. Gender, age and body mass index substantially influence reference values and should be corrected for when interpreting hyperaemic MBF values. (orig.)

  6. The diagnostic performance of CT-derived fractional flow reserve for evaluation of myocardial ischaemia confirmed by invasive fractional flow reserve: a meta-analysis

    International Nuclear Information System (INIS)

    Li, S.; Tang, X.; Peng, L.; Luo, Y.; Dong, R.; Liu, J.

    2015-01-01

    Aim: To review the literature on the diagnostic accuracy of CT-derived fractional flow reserve (FFR CT ) for the evaluation of myocardial ischaemia in patients with suspected or known coronary artery disease, with invasive fractional flow reserve (FFR) as the reference standard. Materials and methods: A PubMed, EMBASE, and Cochrane cross-search was performed. The pooled diagnostic accuracy of FFR CT , with FFR as the reference standard, was primarily analysed, and then compared with that of CT angiography (CTA). The thresholds to diagnose ischaemia were FFR ≤0.80 or CTA ≥50% stenosis. Data extraction, synthesis, and statistical analysis were performed by standard meta-analysis methods. Results: Three multicentre studies (NXT Trial, DISCOVER-FLOW study and DeFACTO study) were included, examining 609 patients and 1050 vessels. The pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR−), and diagnostic odds ratio (DOR) for FFR CT were 89% (85–93%), 71% (65–75%), 70% (65–75%), 90% (85–93%), 3.31 (1.79–6.14), 0.16 (0.11–0.23), and 21.21 (9.15–49.15) at the patient-level, and 83% (78–63%), 78% (75–81%), 61% (56–65%), 92% (89–90%), 4.02 (1.84–8.80), 0.22 (0.13–0.35), and 19.15 (5.73–63.93) at the vessel-level. At per-patient analysis, FFR CT has similar sensitivity but improved specificity, PPV, NPV, LR+, LR−, and DOR versus those of CTA. At per-vessel analysis, FFR CT had a slightly lower sensitivity, similar NPV, but improved specificity, PPV, LR+, LR−, and DOR compared with those of CTA. The area under the summary receiver operating characteristic curves for FFR CT was 0.8909 at patient-level and 0.8865 at vessel-level, versus 0.7402 for CTA at patient-level. Conclusions: FFR CT , which was associated with improved diagnostic accuracy versus CTA, is a viable alternative to FFR for detecting coronary ischaemic lesions

  7. Automated quantitative coronary computed tomography correlates of myocardial ischaemia on gated myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Graaf, Michiel A. de; Boogers, Mark J.; Veltman, Caroline E. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); The Interuniversity Cardiology Institute of The Netherlands, Utrecht (Netherlands); El-Naggar, Heba M.; Bax, Jeroen J.; Delgado, Victoria [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); Broersen, Alexander; Kitslaar, Pieter H.; Dijkstra, Jouke [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Kroft, Lucia J. [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Younis, Imad Al [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands); Reiber, Johan H. [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Medis medical imaging systems B.V., Leiden (Netherlands); Scholte, Arthur J. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands)

    2013-08-15

    Automated software tools have permitted more comprehensive, robust and reproducible quantification of coronary stenosis, plaque burden and plaque location of coronary computed tomography angiography (CTA) data. The association between these quantitative CTA (QCT) parameters and the presence of myocardial ischaemia has not been explored. The aim of the present investigation was to evaluate the association between QCT parameters of coronary artery lesions and the presence of myocardial ischaemia on gated myocardial perfusion single-photon emission CT (SPECT). Included in the study were 40 patients (mean age 58.2 {+-} 10.9 years, 27 men) with known or suspected coronary artery disease (CAD) who had undergone multidetector row CTA and gated myocardial perfusion SPECT within 6 months. From the CTA datasets, vessel-based and lesion-based visual analyses were performed. Consecutively, lesion-based QCT was performed to assess plaque length, plaque burden, percentage lumen area stenosis and remodelling index. Subsequently, the presence of myocardial ischaemia was assessed using the summed difference score (SDS {>=}2) on gated myocardial perfusion SPECT. Myocardial ischaemia was seen in 25 patients (62.5 %) in 37 vascular territories. Quantitatively assessed significant stenosis and quantitatively assessed lesion length were independently associated with myocardial ischaemia (OR 7.72, 95 % CI 2.41-24.7, p < 0.001, and OR 1.07, 95 % CI 1.00-1.45, p = 0.032, respectively) after correcting for clinical variables and visually assessed significant stenosis. The addition of quantitatively assessed significant stenosis ({chi} {sup 2} = 20.7) and lesion length ({chi} {sup 2} = 26.0) to the clinical variables and the visual assessment ({chi} {sup 2} = 5.9) had incremental value in the association with myocardial ischaemia. Coronary lesion length and quantitatively assessed significant stenosis were independently associated with myocardial ischaemia. Both quantitative parameters have

  8. Anisotropy signature in reverse-time migration extended images

    KAUST Repository

    Sava, Paul C.; Alkhalifah, Tariq Ali

    2014-01-01

    Reverse-time migration can accurately image complex geologic structures in anisotropic media. Extended images at selected locations in the Earth, i.e., at common-image-point gathers, carry rich information to characterize the angle-dependent illumination and to provide measurements for migration velocity analysis. However, characterizing the anisotropy influence on such extended images is a challenge. Extended common-image-point gathers are cheap to evaluate since they sample the image at sparse locations indicated by the presence of strong reflectors. Such gathers are also sensitive to velocity error that manifests itself through moveout as a function of space and time lags. Furthermore, inaccurate anisotropy leaves a distinctive signature in common-image-point gathers, which can be used to evaluate anisotropy through techniques similar to the ones used in conventional wavefield tomography. It specifically admits a V-shaped residual moveout with the slope of the "V" flanks depending on the anisotropic parameter η regardless of the complexity of the velocity model. It reflects the fourth-order nature of the anisotropy influence on moveout as it manifests itself in this distinct signature in extended images after handling the velocity properly in the imaging process. Synthetic and real data observations support this assertion.

  9. Anisotropy signature in reverse-time migration extended images

    KAUST Repository

    Sava, Paul C.

    2014-11-04

    Reverse-time migration can accurately image complex geologic structures in anisotropic media. Extended images at selected locations in the Earth, i.e., at common-image-point gathers, carry rich information to characterize the angle-dependent illumination and to provide measurements for migration velocity analysis. However, characterizing the anisotropy influence on such extended images is a challenge. Extended common-image-point gathers are cheap to evaluate since they sample the image at sparse locations indicated by the presence of strong reflectors. Such gathers are also sensitive to velocity error that manifests itself through moveout as a function of space and time lags. Furthermore, inaccurate anisotropy leaves a distinctive signature in common-image-point gathers, which can be used to evaluate anisotropy through techniques similar to the ones used in conventional wavefield tomography. It specifically admits a V-shaped residual moveout with the slope of the "V" flanks depending on the anisotropic parameter η regardless of the complexity of the velocity model. It reflects the fourth-order nature of the anisotropy influence on moveout as it manifests itself in this distinct signature in extended images after handling the velocity properly in the imaging process. Synthetic and real data observations support this assertion.

  10. Evaluation of 201Tl stress-redistribution imaging for the detection of myocardial ischemia and assessment of its therapeutic effect (40 cases attached)

    International Nuclear Information System (INIS)

    Lin Jinghui

    1989-01-01

    The characteristics of 201 Tl stress-redistribution imagings of 21 normal controls and 19 myocardial ischemia were reported. Normal variability of myocardial images and its influencing factors were discussed as well. All of 40 cases were also undergoing coronary arteriography (CAG), and exercise ECG. Taken the stenosis of coronary artery > 50% by CAG as the criterion of diagnosis of CHD, the sensitivity and specificity of 201 Tl image were 94.7% and 100%, while as exercise ECG were 66.6% and 80.9% respectively. 2 patients with bypass surgery and 6 patients with PTCA were examined pre- and postoperatively by 201 Tl images. The results indicated that this technique was noninvasive and reliable also for the assessment of their therapeutic effect and follow up studies

  11. Age-distribution, risk factors and mortality in smokers and non-smokers with acute myocardial infarction: a review. TRACE study group. Danish Trandolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Ottesen, M M; Jørgensen, S; Kjøller, E

    1999-01-01

    Smoking is a risk factor for acute myocardial infarction; paradoxically, many studies have shown a lower post-infarct mortality among smokers. There are some important differences between smokers and non-smokers, which might explain the observed difference in mortality: smokers have less...... multivessel disease and atherosclerosis but are more thrombogenic; thrombolytic therapy seems to be more effective among smokers; smoking might result in an increased out-of-hospital mortality rate, by being more arrhythmogenic; and smokers are on average a decade younger than non-smokers at the time...... of infarction, and have less concomitant disease. Adjusting for these differences in regression analyses shows that smoking is not an independent risk factor for mortality after acute myocardial infarction. The difference in age and risk factors are responsible for the lower mortality among smokers....

  12. Anisotropy of the cosmic background radiation

    International Nuclear Information System (INIS)

    Silk, J.

    1988-01-01

    The characteristics of the cosmic microwave background radiation (CBR) are reviewed, focusing on intrinsic anisotropies caused by primordial matter fluctuations. The basic elements of the CBR are outlined and the contributions to anisotropy at different angular scales are discussed. Possible fluctuation spectra that can generate the observed large-scale structure of the universe through gravitational instability and nonlinear evolution are examined and compared with observational searches for cosmic microwave anisotropies. 21 refs

  13. Quantitative evaluation of renal dynamic scan with 99mTc-MAG3 assessment of interoposterior myocardial infarction using ECG gated SPECT with 99mTc-MIBI

    International Nuclear Information System (INIS)

    Cho, Keiichi; Kumita, Shinichiro; Mizumura, Sunao

    1997-01-01

    Simultaneous assessment of regional myocardial perfusion and local contraction ability of interoposterior myocardial infarction was examined by ECG gated SPECT. In thirteen cases of acute interoposterior myocardial infarction, the above-mentioned data were obtained by 180deg data acquisition method using L-shaped 2 detecting element type gamma camera. Mean and standard deviation of %Uptake and wall thickening (WT) in inferior wall were as follows: Infarction case; 57±9.2%/23±11.3%, normal case; 71±8.2%/61±10.2%. The significant depression (p<0.01/p<0.001) of both data were found in the infarction case. The both data in posterior wall were as follows: Infarction case; 55±10.7%/16±8.9%, normal case; 64±9.7%/41±15.0%. The significant depression (p<0.05/p<0.001) were also found in the infarction case. In both inferior wall and posterior wall, the AUC of ROC curve of WT was greater than that of %Uptake, and diagnostic ability of this method was favorable. The best sensitivity/specificity rate and the threshold were as follows: %Uptake of inferior wall 77/65, -0.5SD, WT of inferior wall 100/100, -2SD, %Uptake of posterior wall 62/82, -1SD, WT of posterior wall 85/88, -4SD. Accordingly, in diagnosis of interoposterior myocardial infarction, assessment of focus cardiac function, for example WT, is necessary as well as %Uptake. (K.H.)

  14. Two-dimensional tracking and TDI are consistent methods for evaluating myocardial longitudinal peak strain in left and right ventricle basal segments in athletes

    OpenAIRE

    Lstefani, L.Stefani; Ltoncelli, L.Toncelli; Mgianassi, M.Gianassi; Pmanetti, P.Manetti; Vdi, V.Di Tante; Mrvono, M.R.Vono; Amoretti, A.Moretti; Bcappelli, B.Cappelli; Gpedrizzetti, G.Pedrizzetti; Ggalanti, G.Galanti

    2007-01-01

    Abstract Background Myocardial contractility can be investigated using longitudinal peak strain. It can be calculated using the Doppler-derived TDI method and the non-Doppler method based on tissue tracking on B-mode images. Both are validated and show good reproducibility, but no comparative analysis of their results has yet been conducted. This study analyzes the results obtained from the basal segments of the ventricular chambers in a group of athletes. Methods 30 regularly-trained athlete...

  15. Myocardial scintigraphy with thallium-201

    Energy Technology Data Exchange (ETDEWEB)

    Lichte, H [Zentralkrankenhaus Gauting (Germany, F.R.). Nuklearmedizinische Abt.

    1977-04-01

    Myocardial scintigraphy with /sup 201/thallium is a non-invasive method for detection of myocardial infarction and coronary heart disease. Redistribution-analysis as a sequential-scintigraphy of an exercise-scan permits to distinguish between myocardial scars and coronary vessel disease.

  16. Radiosynthesis and preclinical evaluation of [{sup 18}F] 4-(2-fluoroethoxy)-2H-chromen-2-one as a novel myocardial perfusion imaging agent

    Energy Technology Data Exchange (ETDEWEB)

    Bhusari, Arun M.; Degani, Mariam S. [Institute of Chemical Technology, Mumbai (India). Dept. of Pharmaceutical Sciences and Technology; Lakshminarayanan, N.; Pawar, Yogita P.; Moghe, Surendra H.; Rajan, M.G.R. [Bhabha Atomic Research Centre, Mumbai (India). Radiation Medicine Center

    2017-07-01

    Recently we developed [{sup 18}F] 4-(2-fluoroethoxy)-2H-chromen-2-one as a novel {sup 18}F myocardial perfusion imaging radiotracer. It was synthesized in good radiochemical yield (>90%). The total time from radiosynthesis to its purification was less than 40 min, with excellent radiochemical purity (≥99%). It showed good stability over a period of 5 h at room temperature. The partition coefficient (log P) of radiotracer was found to be 2.70, suggesting the lipophilic nature of radiotracer. Ex vivo biodistribution study of radiotracer in normal Wistar rats for 30 min post-injection, demonstrated a good heart uptake (>1.3% ID/g) and favorable pharmacokinetics. Additionally, the radiotracer showed significant excretion (>11% ID) by liver, which is indicative of its rapid clearance. Further, in vivo biodistribution study of radiotracer in New Zealand White rabbit provided the clear PET/CT images of cardiomyocytes and myocardial perfusion. All these experimental findings suggest that [{sup 18}F] 4-(2-fluoroethoxy)-2H-chromen-2-one could be used as a potential hit for myocardial perfusion imaging.

  17. Determinants of delay between symptoms and hospital admission in 5978 patients with acute myocardial infarction. The TRACE Study Group. Trandolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Ottesen, M M; Køber, L; Jørgensen, S

    1996-01-01

    of 6676 consecutive patients with enzyme-confirmed acute myocardial infarction, admitted alive to 27 Danish hospitals over a 26 month period from 1990 to 1992, were studied. Due to missing information on delay or in-hospital acute myocardial infarction 698 patients were excluded, leaving 5978 patients...... associated with male gender (odds ratio (OR) = 0.809, P = 0.003), increased age (P = 0.0001), diabetes mellitus (OR = 1.269, P = 0.03), left ventricular systolic function (wall motion index) (P = 0.02), onset from midnight to 0600h (OR = 1.434, P = 0.0001), onset on a weekday (OR = 0.862, P = 0.04), history...... depressions (OR = 0.847, P = 0.01). All these variables, except history of diabetes mellitus, angina pectoris, and chest pain as an initial symptom were also associated with a delay of more than 6 h. Thrombolytic therapy was administered to 55.8% of patients admitted within 2 h of an acute myocardial...

  18. Magnetic anisotropy of Ni/Cr multilayers

    International Nuclear Information System (INIS)

    Kang, S.; Xia, H.

    1997-01-01

    The magnetic anisotropy of Ni/Cr multilayers has been investigated by using vibrating sample magnetometer (VSM) and ferromagnetic resonance techniques (FMR). The FMR spectra are obtained as a function of the orientation of the applied magnetic field from in-plane to out-of-plane. The results are fitted theoretically to determine the magnetic anisotropy. From VSM and FMR, a positive value for Ni/Cr interface anisotropy is obtained, which favours a perpendicular easy axis. The possible mechanism for the perpendicular anisotropy has been discussed and it may be attributed to the magnetostriction, caused by intrinsic stress due to lattice mismatch. (orig.). With 005 figs., 001 tabs

  19. Increase in mean platelet volume in patients with myocardial bridge.

    Science.gov (United States)

    Bilen, Emine; Tanboga, Ibrahim Halil; Kurt, Mustafa; Kocak, Umran; Ayhan, Huseyin; Keles, Telat; Bozkurt, Engin

    2013-01-01

    Myocardial bridge is associated with atherosclerosis altered in shear stress and endothelial dysfunction. Mean platelet volume (MPV), a determinant of platelet activation, is shown to be related with atherosclerosis and endothelial dysfunction. In this study, we aimed to evaluate platelet function assessed by MPV in patients with myocardial bridge. Forty-two patients with myocardial bridge in the left anterior descending artery (LAD) and 43 age- and gender-matched healthy participants were included in the study. Myocardial bridging was defined as an intramyocardial systolic compression or milking of a segment of an epicardial coronary artery on angiography. For the entire study population, MPV was measured using an automatic blood counter. The study population consisted of 42 patients with myocardial bridge (52.7 ± 10.2, 76.2% male) and 43 age- and sex-matched healthy control participants (52.1 ± 10.4, 74.4% male). Compared to the control group, MPV value was significantly higher in patients with myocardial bridge (8.9 ± 1.24 vs 8.3 ± 0.78; P = .01). Further, there were no significant differences between groups regarding hemoglobin level, platelet count, fasting blood glucose, and creatinine levels. Our study findings indicated that myocardial bridge is associated with elevated MPV values. Our results might partly explain the increased cardiovascular events in patients with myocardial bridge.

  20. Effect of Kaempferol Pretreatment on Myocardial Injury in Rats.

    Science.gov (United States)

    Vishwakarma, Anamika; Singh, Thakur Uttam; Rungsung, Soya; Kumar, Tarun; Kandasamy, Arunvikram; Parida, Subhashree; Lingaraju, Madhu Cholenahalli; Kumar, Ajay; Kumar, Asok; Kumar, Dinesh

    2018-01-20

    The present study was undertaken to evaluate the effect of kaempferol in isoprenaline (ISP)-induced myocardial injury in rats. ISP was administered subcutaneously for two subsequent days to induce myocardial injury. Assessment of myocardial injury was done by estimation of hemodynamic functions, myocardial infarcted area, cardiac injury markers, lipid profile, oxidative stress, pro-inflammatory cytokines and histopathology of heart and liver. Rats pretreated with kaempferol showed reduction in the myocardial infarcted area and heart rate. However, no improvement was observed in change in body weight, mean arterial, systolic and diastolic blood pressure. Kaempferol showed significant decrease in serum LDH, CK-MB, troponin-I and lipid profile. However, highest dose of kaempferol did not reduce the serum triglyceride level. Further, antioxidant enzymes, SOD and catalase, were also higher. However, reduced glutathione, serum SGOT and creatinine did not show any improvement. Kaempferol showed reduction in MDA level. Kaempferol at highest dose showed reduction in pro-MMP-2 expression and MMP-9 level. mRNA expression level of TNF-α was not different in kaempferol-pretreated myocardial injured rats with ISP-alone group. Pretreatment with kaempferol at highest dose showed mild mononuclear infiltration and degenerative changes in heart tissue section of myocardial injured rats. Rats pretreated with kaempferol at higher concentration showed normal cordlike arrangement of hepatocytes with moderate swelling of hepatocytes (vacuolar degeneration) around the central vein. Study suggests that kaempferol attenuated lipid profile, infarcted area and oxidative stress in ISP-induced myocardial injury in rats.

  1. Azimuthal anisotropy measurements by STAR

    Science.gov (United States)

    Yi, Li

    2014-06-01

    The recent study of centrality and transverse momentum (pT) dependence of inclusive charged hardron elliptic anisotropy (v2) at midrapidity (|η|<1.0) in Au+Au collision at √{sNN}=7.7,11.5,19.6,27, and 39 GeV in STAR Beam Energy Scan program is presented. We show that the observed increase of inclusive v2 is mainly due to the average pT increase with energy. In Au+Au 200 GeV collisions, the triangular anisotropy (v3) measurements highly depend on measurement methods; v3 is strongly dependent on Δη. The difference between two- and four-particle cumulants v2{2} and v2{4} for Au+Au and Cu+Cu collision at √{sNN}=62.4 and 200 GeV is used to explore flow fluctuations. Furthermore, by exploiting the symmetry of average flow in pseudorapidity η about midrapidity, the Δη-dependent and independent components are separated using v2{2} and v2{4}.

  2. Azimuthal anisotropy measurements by STAR

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Li

    2014-06-15

    The recent study of centrality and transverse momentum (p{sub T}) dependence of inclusive charged hardron elliptic anisotropy (v{sub 2}) at midrapidity (|η|<1.0) in Au+Au collision at √(s{sub NN})=7.7,11.5,19.6,27, and39 GeV in STAR Beam Energy Scan program is presented. We show that the observed increase of inclusive v{sub 2} is mainly due to the average p{sub T} increase with energy. In Au+Au 200 GeV collisions, the triangular anisotropy (v{sub 3}) measurements highly depend on measurement methods; v{sub 3} is strongly dependent on Δη. The difference between two- and four-particle cumulants v{sub 2}{2} and v{sub 2}{4} for Au+Au and Cu+Cu collision at √(s{sub NN})=62.4 and 200 GeV is used to explore flow fluctuations. Furthermore, by exploiting the symmetry of average flow in pseudorapidity η about midrapidity, the Δη-dependent and independent components are separated using v{sub 2}{2} and v{sub 2}{4}.

  3. Azimuthal anisotropy measurements by STAR

    International Nuclear Information System (INIS)

    Yi, Li

    2014-01-01

    The recent study of centrality and transverse momentum (p T ) dependence of inclusive charged hardron elliptic anisotropy (v 2 ) at midrapidity (|η|<1.0) in Au+Au collision at √(s NN )=7.7,11.5,19.6,27, and39 GeV in STAR Beam Energy Scan program is presented. We show that the observed increase of inclusive v 2 is mainly due to the average p T increase with energy. In Au+Au 200 GeV collisions, the triangular anisotropy (v 3 ) measurements highly depend on measurement methods; v 3 is strongly dependent on Δη. The difference between two- and four-particle cumulants v 2 {2} and v 2 {4} for Au+Au and Cu+Cu collision at √(s NN )=62.4 and 200 GeV is used to explore flow fluctuations. Furthermore, by exploiting the symmetry of average flow in pseudorapidity η about midrapidity, the Δη-dependent and independent components are separated using v 2 {2} and v 2 {4}

  4. Cardioprotective effect of amlodipine in oxidative stress induced by experimental myocardial infarction in rats

    Directory of Open Access Journals (Sweden)

    Sudhira Begum

    2007-12-01

    Full Text Available The present study investigated whether the administration of amlodipine ameliorates oxidative stress induced by experimental myocardial infarction in rats. Adrenaline was administered and myocardial damage was evaluated biochemically [significantly increased serum aspertate aminotransferase (AST, lactate dehydrogenase (LDH and malondialdehyde (MDA levels of myocardial tissue] and histologically (morphological changes of myocardium. Amlodipine was administered as pretreatment for 14 days in adrenaline treated rats. Statistically significant amelioration in all the biochemical parameters supported by significantly improved myocardial morphology was observed in amlodipine pretreatment. It was concluded that amlodipine afforded cardioprotection by reducing oxidative stress induced in experimental myocardial infarction of catecholamine assault.

  5. Clinical usefulness of technetium-99m pyrophosphate and Tl-201 myocardial imaging for the estimation of myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Akio; Sato, Akihiko; Miyakoda, Hiroyuki; Watanabe, Toshiya; Itatsu, Hidetaka; Ueda, Osamu; Sakurai, Kuniteru; Kawai, Naoki; Sotobata, Iwao

    1985-04-01

    A correlative study was performed between the infarct size estimated by either technetium-99 pyrophosphate (Tc-PYP) or Tl-201 myocardial imaging, and the cumulative total creatinine phosphokinase activity (..sigma..CPK) or left ventricular ejection fraction (LVEF) in 40 patients with acute myocardial infarction. Tc-PYP infarct area (TcIA) and mean Tl-201 uptake ratio (MUR) were calculated as indices of myocardial infarct size. LVEF was evaluated by first pass method using Tc-PYP in the acute phase of myocardial infraction. In 23 patients with anterior myocardial infarction, a significant correlation was shown between either TcIA or anterior-wall MUR and ..sigma..CPK (r=0.81 and r=-0.69, respectively) and also between either TcIA or anterior-wall MUR and LVEF (r=-0.84 and r=0.80, respectively). In 17 patients with inferior myocardial infarction without additional involvement of right ventricular wall, inferior-wall MUR correlated with ..sigma..CPK (r=-0.74). No statically significant correlation was shown between TcIA and ..sigma..CPK, and also between either TcIA or inferior-wall MUR and LVEF. In conclusion, the infarct size estimated with Tc-PYP or Tl-201 myocardial imaging could be a useful clinical indicator of the severity of acute myocardial infarction especially in anterior wall. (author).

  6. Myocardial myoglobin release after acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, P S; Saltissi, S; Coltart, D J; Croft, D N [Saint Thomas' Hospital, London (UK)

    1980-03-01

    The magnitude and time course of myoglobin release from the myocardium following infarction was assessed by radioimmunoassay. The assay showed acceptable precision over a working range from 50 to 750 ng cm/sup -3/, provided careful control of the assay temperature was maintained. The use of this radioimmunoassay as an early diagnostic test for infarction and as a potential measure of the extent of necrosis is considered and comparison made with the release of CK-MB, the myocardial specific isoenzyme of creatine kinase. Of the twenty patients studied with myocardial infarction, all had elevated levels of serum myoglobin including those admitted within 3 hours of the onset of pain. In contrast, CK-MB was not detected in the serum within 5 hours of the onset of pain. Peak serum levels of myoglobin (mean 852 +- 365 ng cm/sup -3/) and CK-MB (mean 71 +- 25 mIU cm/sup -3/) were detected at 8-16 hours and 20-24 hours respectively after the onset of pain. A comparison of peak serum levels of myoglobin and CK-MB showed a good correlation (r = 0.84).

  7. Reversible myocardial ischaemia or irreversible myocardial fibrosis

    International Nuclear Information System (INIS)

    Mathey, D.; Hanrath, P.; Kupper, W.; Bleifeld, W.; Montz, R.; Knop, J.; Stritzke, P.; Kroeger, E.; Bleese, N.

    1978-01-01

    The results of biphasis 201 thallium ( 201 Tl) scanning were compared with those of coronary arteriography, left ventricular angiography and stress ECG in 56 patients with coronary artery disease and six with no evidence of heart disease. There were 104 201 Tl defects, 50 of them reversible. The defects were always located in the area supplied by a critically stenotic coronary artery. Correlation of regional wall motion with 201 Tl activity demonstrated that in all forms of abnormal wall motion there was either ischaemia or fibrosis. The resting LV angiogram thus does not make it possible to distinguish between myocardial ischaemia and fibrosis. Taking the LV angiogram as a standard, the rate of false-positive 201 Tl scintigrams was 5%, that of false-negative ones 23%. The biphasic 201 Tl scintigram was more sensitive than the stress ECG in detecting myocardial ischaemia. It furthermore made it possible to localize the ischaemic (or fibrotic) region within the LV and to estimate its size. (orig.) [de

  8. Detecting Myocardial Ischemia With 99mTechnetium-Tetrofosmin Myocardial Perfusion Imaging in Ischemic Stroke.

    Science.gov (United States)

    Giannopoulos, Sotirios; Markoula, Sofia; Sioka, Chrissa; Zouroudi, Sofia; Spiliotopoulou, Maria; Naka, Katerina K; Michalis, Lampros K; Fotopoulos, Andreas; Kyritsis, Athanassios P

    2017-10-01

    To assess the myocardial status in patients with stroke, employing myocardial perfusion imaging (MPI) with 99m Technetium-tetrofosmin ( 99m Tc-TF)-single-photon emission computed tomography (SPECT). Fifty-two patients with ischemic stroke were subjected to 99m Tc-TF-SPECT MPI within 1 month after stroke occurrence. None of the patients had any history or symptoms of coronary artery disease or other heart disease. Myocardial perfusion imaging was evaluated visually using a 17-segment polar map. Myocardial ischemia (MIS) was defined as present when the summed stress score (SSS) was >4; MIS was defined as mild when SSS was 4 to 8, and moderate/severe with SSS ≥9. Patients with SSS >4 were compared to patients with SSS SSS >9 were compared to patients with SSS SSS, with the oldest age exhibiting the highest SSS ( P = .01). The association of age with SSS remained statistically significant in the multivariate analysis ( P = .04). The study suggested that more than half of patients with stroke without a history of cardiac disease have MIS. Although most of them have mild MIS, we suggest a thorough cardiological evaluation in this group of patients for future prevention of severe myocardial outcome.

  9. Higher-order anisotropies in the blast-wave model: Disentangling flow and density field anisotropies

    Energy Technology Data Exchange (ETDEWEB)

    Cimerman, Jakub [Czech Technical University in Prague, FNSPE, Prague (Czech Republic); Comenius University, FMPI, Bratislava (Slovakia); Tomasik, Boris [Czech Technical University in Prague, FNSPE, Prague (Czech Republic); Univerzita Mateja Bela, FPV, Banska Bystrica (Slovakia); Csanad, Mate; Loekoes, Sandor [Eoetvoes Lorand University, Budapest (Hungary)

    2017-08-15

    We formulate a generalisation of the blast-wave model which is suitable for the description of higher-order azimuthal anisotropies of the hadron production. The model includes anisotropy in the density profile as well as an anisotropy in the transverse expansion velocity field. We then study how these two kinds of anisotropies influence the single-particle distributions and the correlation radii of two-particle correlation functions. Particularly we focus on the third-order anisotropy and consideration is given averaging over different orientations of the event plane. (orig.)

  10. Monitoring of myocardial edema following acute myocardial infarction

    International Nuclear Information System (INIS)

    Tahir, E.; Sinn, M.; Avanesov, M.; Wien, J.; Saering, D.; Stehning, C.; Radunski, U. K.; Muellerleile, K.; Adam, G.; Lund, G. K.

    2015-01-01

    Full text: Currently, myocardial edema monitoring after acute myocardial infarction (AMI) is based on visualization of the region with increased signal-intensity on T2-weighted images. Native T1 and T2 mapping are promising novel MRI techniques to quantitatively assess myocardial edema. The purpose of the study was to quantitatively evaluate resorption of myocardial edema following AMI by native T1 and T2 -mapping cardiac magnetic resonance imaging (CMR). CMR (1.5 Tesla Philips Achieva) was performed in 30 patients four times after reperfused AMI at baseline (BL) at 9±6 days after infarction and at 7±1 weeks (follow-up 1, FU1), 3.6±0.5 months (FU2) and 6.5±0.7 months (FU3), respectively. Edema sensitive black-blood T2-weighted (T2w) STIR CMR was performed on end-diastolic LV short-axes. A free-breathing, navigatorgated multi-echo sequence was used for short-axis T2 mapping. T1 mapping was performed using the modified look-locker inversion recovery (MOLLI) sequence. T2 maps were calculated from nine and T1 maps from eight echoes using a dedicated plug-in written for OsiriX software. Two experienced observers independently evaluated T2w-CMR as well as T1 and T2 mapping using the HeAT-Software applying a threshold method. Size of edema and prolongation of the native T1- or T2-time was measured using a cutoff >2SD of remote normal myocardium. Edema size continuously decreased from BL with 32.8 %LV to 24.6 %LV at FU1, to 19.1 %LV at FU2 and to 16.4 %LV at FU3 using T2w-CMR. An almost identical decrease of edema size was observed using native T1 and T2 - mapping. T2 times only decreased between BL from 79±5 ms to 73±2 ms at FU1 (P<0.05), but no further change was observed at later time points with 70±5 ms at FU2 and 70±6 ms at FU3. At all time points the T2 times of remote normal myocardium were about 50±2 ms and significantly lower compared to the edema zone. Also native T1 time within the edema was with 1253 ±103 ms significantly increased compared to remote

  11. Myocardial infarction false alarm: initial electrocardiogram and cardiac enzymes.

    Science.gov (United States)

    Gupta, Esha Das; Sakthiswary, Rajalingham

    2014-05-01

    The objectives of this study were to determine the incidence of a myocardial infarction "false alarm" and evaluate the efficacy of the initial electrocardiogram and cardiac enzymes in diagnosing myocardial infarction in Malaysia. We recruited patients who were admitted with suspected myocardial infarction from June to August 2008. The medical records of these patients were reviewed for the initial electrocardiogram, initial cardiac enzyme levels (creatinine kinase-MB and troponin T), and the final diagnosis upon discharge. The subjects were stratified into 2 groups: true myocardial infarction, and false alarm. 125 patients were enrolled in this study. Following admission and further evaluation, the diagnosis was revised from myocardial infarction to other medical conditions in 48 (38.4%) patients. The sensitivity and specificity of the initial ischemic electrocardiographic changes were 54.5% and 70.8%, respectively. Raised cardiac enzymes had a sensitivity of 44.3% and specificity of 95.8%. A significant proportion of patients in Malaysia are admitted with a false-alarm myocardial infarction. The efficacy of the electrocardiogram in diagnosing myocardial infarction in Malaysia was comparable to the findings of Western studies, but the cardiac enzymes had a much lower sensitivity.

  12. Myocardial perfusion SPECT imaging in patients with myocardial bridging

    International Nuclear Information System (INIS)

    Fang Wei; Qiu Hong; Yang Weixian; Wang Feng; He Zuoxiang

    2008-01-01

    Objective: Stress myocardial perfusion SPECT imaging was used to assess myocardial ischemia in patients with myocardial bridging. Methods: Ninety-six patients with myocardial bridging of the left anterior descending artery documented by coronary angiography were included in this study. All under- went exercise or pharmacological stress myocardial perfusion SPECT assessing myocardial ischemia. None had prior myocardial infarction. One year follow-up by telephone interview was performed in all patients. Results The mean stenotic severity of systolic phase on angiography was (65 ± 19)%. In the SPECT study, 20 of 96 (20.8%) patients showed abnormal perfusion. This percentage was significantly higher than that of stress electrocardiogram (ECG). The higher positive rate of SPECT perfusion images was showed in the group of patients with severe systolic narrowing (≥75%) than that with mild-to-moderate systolic narrowing (50% vs 6.3%, P<0.001). The prevalence of abnormal image was significantly higher in ELDERLY PEOPLE; patients with STT change on rest ECG than in those with normal rest ECG (54.2% vs 9.7%, P<0.001). During follow-up, one patient with abnormal SPECT perfusion image sustained angina and accepted percutaneous coronary intervention, and no cardiac event occurred in patients with normal images. Conclusions: Stress myocardial perfusion SPECT imaging can be used effectively for assessing myocardial ischemia and has potential prognostic value for patients with myocardial bridging. (authors)

  13. Differential impact of multi-focus fan beam collimation with L-mode and conventional systems on the accuracy of myocardial perfusion imaging: Quantitative evaluation using phantoms

    International Nuclear Information System (INIS)

    Onishi, Hideo; Matsutomo, Norikazu; Kangai, Yoshiharu; Saho, Tatsunori; Amijima, Hizuru

    2013-01-01

    A novel IQ-SPECT™ method has become widely used in clinical studies. The present study compares the quality of myocardial perfusion images (MPI) acquired using the IQ-SPECT™ (IQ-mode), conventional (180° apart: C-mode) and L-mode (90° apart: L-mode) systems. We assessed spatial resolution, image reproducibility and quantifiability using various physical phantoms. SPECT images were acquired using a dual-headed gamma camera with C-mode, L-mode, and IQ-mode acquisition systems from line source, pai and cardiac phantoms containing solutions of 99m Tc. The line source phantom was placed in the center of the orbit and at ± 4.0, ± 8.0, ± 12.0, ± 16.0 and ± 20.0 cm off center. We examined quantifiability using the pai phantom comprising six chambers containing 0.0, 0.016, 0.03, 0.045, 0.062, and 0.074 MBq/mL of 99m-Tc and cross-calibrating the SPECT counts. Image resolution and reproducibility were quantified as myocardial wall thickness (MWT) and %uptake using polar maps. The full width at half maximum (FWHM) of the IQ-mode in the center was increased by 11% as compared with C-mode, and FWHM in the periphery was increased 41% compared with FWHM at the center. Calibrated SPECT counts were essentially the same when quantified using IQ-and C-modes. IQ-SPECT images of MWT were significantly improved (P<0.001) over L-mode, and C-mode SPECT imaging with IQ-mode became increasingly inhomogeneous, both visually and quantitatively (C-mode vs. L-mode, ns; C-mode vs. IQ-mode, P<0.05). Myocardial perfusion images acquired by IQ-SPECT were comparable to those acquired by conventional and L-mode SPECT, but with significantly improved resolution and quality. Our results suggest that IQ-SPECT is the optimal technology for myocardial perfusion SPECT imaging

  14. Differential impact of multi-focus fan beam collimation with L-mode and conventional systems on the accuracy of myocardial perfusion imaging: Quantitative evaluation using phantoms

    Directory of Open Access Journals (Sweden)

    Tatsunori Saho

    2013-10-01

    Full Text Available Introduction: A novel IQ-SPECTTM method has become widely used in clinical studies. The present study compares the quality of myocardial perfusion images (MPI acquired using the IQ-SPECTTM (IQ-mode,conventional (180° apart: C-mode and L-mode (90° apart: L-mode systems. We assessed spatial resolution, image reproducibility and quantifiability using various physical phantoms. Materials and Methods: SPECT images were acquired using a dual-headed gamma camera with C-mode, L-mode, and IQ-mode acquisition systems from line source, pai and cardiac phantoms containing solutions of 99mTc. The line source phantom was placed in the center of the orbit and at ± 4.0, ± 8.0, ± 12.0, ± 16.0 and ± 20.0 cm off center. We examined quantifiability using the pai phantom comprising six chambers containing 0.0, 0.016, 0.03, 0.045, 0.062, and 0.074 MBq/mLof 99m-Tc and cross-calibrating the SPECT counts. Image resolution and reproducibility were quantified as myocardial wall thickness (MWT and %uptake using polar maps. Results: The full width at half maximum (FWHM of the IQ-mode in the center was increased by 11% as compared with C-mode, and FWHM in the periphery was increased 41% compared with FWHM at the center. Calibrated SPECT counts were essentially the same when quantified using IQ-and C-modes. IQ-SPECT images of MWT were significantly improved (P<0.001 over L-mode, and C-mode SPECT imaging with IQ-mode became increasingly inhomogeneous, both visually and quantitatively (C-mode vs. L-mode, ns; C-mode vs. IQ-mode, P<0.05. Conclusion: Myocardial perfusion images acquired by IQ-SPECT were comparable to those acquired by conventional and L-mode SPECT, but with significantly improved resolution and quality. Our results suggest that IQ-SPECT is the optimal technology for myocardial perfusion SPECT imaging.

  15. Effect of nicorandil on the myocardial tissue perfusion and myocardial cell injury in patients with diabetes after PCI

    Directory of Open Access Journals (Sweden)

    Xue-Li Ren1

    2017-04-01

    Full Text Available Objective: To study the effect of nicorandil on the myocardial tissue perfusion and myocardial cell damage in patients with diabetes after percutaneous coronary intervention (PCI. Methods: 68 patients with coronary heart disease and type 2 diabetes mellitus who received PCI in our hospital between May 2011 and September 2015 were collected and then divided into observation group and control group (n=34 according to the single-blind randomized control method. Control group of patients received PCI alone, and the observation group of patients received nicorandil therapy after PCI. After treatment, real-time myocardial ultrasound contrast was used to evaluate the myocardial perfusion of two groups of patients; blood biochemical analyzer was used to detect the contents of peripheral blood myocardial enzyme spectrum indexes; the ELISA method was used to detect the contents of serum oxidative stress indicators; RIA method was used to detect the contents of serum apoptosis molecules. Results: After treatment, the myocardial tissue perfusion parameters plateau peak intensity (A, slope rate of curve (β and myocardial blood flow (A×β levels of observation group were significantly higher than those of control group (P<0.05; peripheral blood myocardial enzyme spectrum indexes creatine kinase (CK, lactate dehydrogenase (LDH, troponin I (cTnI and glutamic oxalacetic transaminase (GOT contents of observation group were significantly lower than those of control group (P<0.05; serum vitamin E (VitE and vitamin C (VitC contents of observation group were significantly higher than those of control group while malondialdehyde (MDA, advanced oxidation protein products (AOPPs, soluble apoptosis-associated factor (sFas and soluble apoptosis-associated factor ligand (sFasL contents were lower than those of control group (P<0.05. Conclusion: Adjuvant nicorandil therapy can improve the myocardial perfusion and reduce the myocardial cell injury in patients with coronary

  16. Myocardial Blood Volume Is Associated with Myocardial Oxygen Consumption: An Experimental Study with CMR in a Canine Model

    Science.gov (United States)

    McCommis, Kyle S.; Zhang, Haosen; Goldstein, Thomas A.; Misselwitz, Bernd; Abendschein, Dana R.; Gropler, Robert J.; Zheng, Jie

    2009-01-01

    OBJECTIVES To evaluate the feasibility of cardiovascular MR (CMR) to determine regional myocardial perfusion and O2 metabolism, and assess the role of myocardial blood volume (MBV) on oxygen supply. BACKGROUND Coronary artery disease presents as an imbalance of myocardial oxygen supply and demand. We have developed relevant CMR methods to determine the relationship of myocardial blood flow (MBF) and MBV to oxygen consumption (MVO2) during pharmacologic hyperemia. METHODS Twenty-one mongrel dogs were studied with varying stenosis severities imposed on the proximal left anterior descending (LAD) coronary artery. MBF and MBV were determined by CMR first-pass perfusion, while the oxygen extraction fraction (OEF) and MVO2 were determined by the myocardial Blood-Oxygen-Level-Dependent (BOLD) effect and Fick’s law, respectively. MR imaging was performed at rest, and during either dipyridamole-induced vasodilation or dobutamine-induced hyperemia. Regional differences in myocardial perfusion and oxygenation were then evaluated. RESULTS Dipyridamole and dobutamine both led to 145–200% increases in MBF and 50–80% increases in MBV in normal perfused myocardium. As expected, MVO2 increased more significantly with dobutamine (~175%) than dipyridamole (~40%). Coronary stenosis resulted in an attenuation of MBF, MBV, and MVO2 in both the LAD-subtended stenosis region and the left circumflex subtended remote region. Liner regression analysis showed that MBV reserve appears to be more correlated with MVO2 reserve during dobutamine stress than MBF reserve, particularly in the stenotic regions. Conversely, MBF reserve appears to be more correlated with MVO2 reserve during dipyridamole, although neither of these differences was significant. CONCLUSIONS Noninvasive evaluation of both myocardial perfusion and oxygenation by CMR facilitates direct monitoring of regional myocardial ischemia and provides a valuable tool for better understanding microvascular pathophysiology. These

  17. Myocardial bridges of the coronary arteries in the human fetal heart.

    Science.gov (United States)

    Cakmak, Yusuf Ozgür; Cavdar, Safiye; Yalin, Aymelek; Yener, Nuran; Ozdogmus, Omer

    2010-09-01

    During the last century, many investigators reported on myocardial bridges in the adult human heart. In the present study, 39 human fetal hearts (the mean gestastional age was 30 weeks) were studied for myocardial bridging, and the results were correlated with adult data. Among the 39 (27 male and 12 female) fetal hearts studied, 26 bridges were observed on 18 fetal hearts (46.2%). Ten of the bridges had one myocardial bridge, whereas double myocardial bridges were observed in eight fetal hearts. The most frequent myocardial bridges were observed on the left anterior descending artery (LAD), which had 13 bridges (50%). Eight (30.7%) myocardial bridges were on the diagonal artery, and on the posterior descending artery there were five (19.3%). Myocardial bridges were not observed on the circumflex artery. The data presented in this study may provide potentially useful information for the preoperative evaluation of the newborn and may have a clinical implication for sudden fetal death.

  18. Evaluation of general-purpose collimators against high-resolution collimators with resolution recovery with a view to reducing radiation dose in myocardial perfusion SPECT: A preliminary phantom study.

    Science.gov (United States)

    Armstrong, Ian S; Saint, Kimberley J; Tonge, Christine M; Arumugam, Parthiban

    2017-04-01

    There is a growing focus on reducing radiation dose to patients undergoing myocardial perfusion imaging. This preliminary phantom study aims to evaluate the use of general-purpose collimators with resolution recovery (RR) to allow a reduction in patient radiation dose. Images of a cardiac torso phantom with inferior and anterior wall defects were acquired on a GE Infinia and Siemens Symbia T6 using both high-resolution and general-purpose collimators. Imaging time, a surrogate for administered activity, was reduced between 35% and 40% with general-purpose collimators to match the counts acquired with high-resolution collimators. Images were reconstructed with RR with and without attenuation correction. Two pixel sizes were also investigated. Defect contrast was measured. Defect contrast on general-purpose images was superior or comparable to the high-resolution collimators on both systems despite the reduced imaging time. Infinia general-purpose images required a smaller pixel size to be used to maintain defect contrast, while Symbia T6 general-purpose images did not require a change in pixel size to that used for standard myocardial perfusion SPECT. This study suggests that general-purpose collimators with RR offer a potential for substantial dose reductions while providing similar or better image quality to images acquired using high-resolution collimators.

  19. Pacing and the non-invasive evaluation of myocardial fatty acid metabolism by means of 17-123I-heptadecanoic acid scintigraphy

    International Nuclear Information System (INIS)

    Duwel, C.M.B.; Visser, F.C.; Eenige, M.J. van; Roos, J.P.; Roos, J.C.

    1988-01-01

    The extent of myocardial non-esterified fatty acid (NEFA) oxidation depends among other things on exogeneous NEFA supply and energy demand. In 6 patients with a multi-programmable pacemaker scintigraphy with 17- 123 Iodo-heptadecanoic acid (17- 123 I-HDA) was performed to investigate NEFA metabolism at two levels: at a control level (basal heart rate 69±6) and at increased pace frequency (104±5). In both situations the derived time-activity curves, measured during a period of 75 min, were fitted with a monoexponential plus a constant curve: A(t) = A(0).exp (-t In2/T1/2)+C. The half-time value, the uptake measured as the peak activity and the relative size of the oxidation pool were determined. The median of the half-time value did not change: 24 min (range 19-31) in the control heart rate study and 22 min (19-27) during the increased pace frequency study. The median of the uptake increased significantly from 33 cpm/pixel/2 mCi/100 kg (23-34) to 40 cpm/pixel/2 mCi/100 kg (35-42; p 123 I-HDA. This result suggests that radioiodinated NEFA may be a valuable tool to quantify non-invasively the level of the myocardial NEFA metabolism in the human heart. (orig.) [de

  20. Evaluation of specific neural marker GAP-43 and TH combined with Masson-trichrome staining for forensic autopsy cases with old myocardial infarction.

    Science.gov (United States)

    Yu, Tian-Shui; Wang, Xu; Zhang, Hai-Dong; Bai, Ru-Feng; Zhao, Rui; Guan, Da-Wei

    2018-01-01

    It has been a puzzling forensic task to determine the cause of death as a result of old myocardial infarction (OMI) in the absence of recognizable acute myocardial infarction. Recent studies indicated that the heterogeneous cardiac nerve sprouting and sympathetic hyperinnervation at border zones of the infarcted site played important roles in sudden cardiac death (SCD). So, the present study explored the value of growth associated protein-43 (GAP-43) and tyrosine hydroxylase (TH) as objective and specific neural biomarkers combined with Masson-trichrome staining for forensic autopsy cases. Myocardium of left ventricle of 58 medicolegal autopsy cases, 12 OMI cases, 12 acute/OMI cases, and 34 control cases, were immunostained with anti-GAP-43 and anti-TH antibodies. Immunoreactivity of GAP-43 and TH identified nerve fibers and vascular wall in OMI cases and acute/OMI cases. Specifically, TH-positive nerve fibers were abundant at border zones of the infarcted site. There were a few GAP-43 and TH expressions in the control cases. With Masson-trichrome staining, collagen fibers were blue and cardiac muscle fibers were pink in marked contrast with the surrounding tissue, which improved the location of nerve fibers. Thus, these findings suggest that immunohistochemical detection of GAP-43 and TH combined with Masson-trichrome staining can provide the evidence for the medicolegal expertise of SCD due to OMI, and further demonstrate a close relationship between sympathetic hyperinnervation and SCD.

  1. Use of resting myocardial scintigraphy during chest pain to exclude diagnosis of acute myocardial infarction

    International Nuclear Information System (INIS)

    Barbirato, Gustavo Borges; Azevedo, Jader Cunha de; Felix, Renata Christian Martins; Correa, Patricia Lavatori; Volschan, Andre; Viegas, Monica; Pimenta, Lucia; Dohmann, Hans Fernando Rocha; Mesquita, Evandro Tinoco; Mesquita, Claudio Tinoco

    2009-01-01

    Background: Images of myocardial perfusion taken during an episode of chest pain have been used for patients in the emergency department. Objective: To evaluate the operating characteristics of 99m Tc-Tetrofosmin scintigraphy during an episode of chest pain to exclude the diagnosis of cute myocardial infarction. Methods: One hundred and eight patients admitted with chest pain, or up to four hours after the end of symptoms and non diagnostic electrocardiogram, underwent resting scintigraphy and measurement of troponin I concentrations. Patients with a history of myocardial infarction (MI) were not excluded (24 patients). Troponin I concentrations were determined at admission and 6 hours later. Nuclear physicians performed a blind analysis of the images, and myocardial infarction was confirmed whenever troponin I level increase was three times that of the control. Results: Resting perfusion image was abnormal in all 6 patients with MI. Only 1 patient had a normal image and increased troponin levels. Fifty-five patients had positive images without MI, and 46 patients had normal images and troponin levels. The prevalence of the disease was 6.5%. The sensitivity and specificity of the resting images during an episode of chest pain to diagnose MI was 85.7% and 45.5%, respectively. The negative predictive value was 97.7%. Conclusion: Patients undergoing chest pain protocol with SPECT showed an excellent negative predictive value to exclude diagnosis of myocardial infarction. These results suggest that resting perfusion image is an important tool at the chest pain unit. (author)

  2. Thallium-201 myocardial imaging

    International Nuclear Information System (INIS)

    Wackers, F.J.Th.

    1980-01-01

    Three views are routinely obtained for 201 Tl scintigraphy: 0 0 anterior, 45 0 left-anterior-oblique, both views with the patient supine and a left-lateral view, with the patient lying on his right side. Following intravenous injection of 201 Tl, the scintiscans of a normal subject only demonstrate the left ventricle. In patients with normal myocardial perfusion, the left ventricle appears horseshoe or ovoid in shape. The central area of decreased activity represents the left ventricular cavity and is normal. The accumulation of 201 Tl in the normal left ventricle is usually homogeneous. However, some areas with apparent diminished uptake may occur in the normal subject. These variations of the normal image are discussed. The right ventricle, because of its smaller myocardial mass and relatively less 201 Tl accumulation per gram of tissue, is usually on a resting study not, or only faintly, visualized. However, following exercise, the right ventricle is clearly visualized. (Auth.)

  3. Primordial anisotropies in gauged hybrid inflation

    Science.gov (United States)

    Akbar Abolhasani, Ali; Emami, Razieh; Firouzjahi, Hassan

    2014-05-01

    We study primordial anisotropies generated in the model of gauged hybrid inflation in which the complex waterfall field is charged under a U(1)gauge field. Primordial anisotropies are generated either actively during inflation or from inhomogeneities modulating the surface of end of inflation during waterfall transition. We present a consistent δN mechanism to calculate the anisotropic power spectrum and bispectrum. We show that the primordial anisotropies generated at the surface of end of inflation do not depend on the number of e-folds and therefore do not produce dangerously large anisotropies associated with the IR modes. Furthermore, one can find the parameter space that the anisotropies generated from the surface of end of inflation cancel the anisotropies generated during inflation, therefore relaxing the constrains on model parameters imposed from IR anisotropies. We also show that the gauge field fluctuations induce a red-tilted power spectrum so the averaged power spectrum from the gauge field can change the total power spectrum from blue to red. Therefore, hybrid inflation, once gauged under a U(1) field, can be consistent with the cosmological observations.

  4. Primordial anisotropies in gauged hybrid inflation

    International Nuclear Information System (INIS)

    Abolhasani, Ali Akbar; Emami, Razieh; Firouzjahi, Hassan

    2014-01-01

    We study primordial anisotropies generated in the model of gauged hybrid inflation in which the complex waterfall field is charged under a U(1)gauge field. Primordial anisotropies are generated either actively during inflation or from inhomogeneities modulating the surface of end of inflation during waterfall transition. We present a consistent δN mechanism to calculate the anisotropic power spectrum and bispectrum. We show that the primordial anisotropies generated at the surface of end of inflation do not depend on the number of e-folds and therefore do not produce dangerously large anisotropies associated with the IR modes. Furthermore, one can find the parameter space that the anisotropies generated from the surface of end of inflation cancel the anisotropies generated during inflation, therefore relaxing the constrains on model parameters imposed from IR anisotropies. We also show that the gauge field fluctuations induce a red-tilted power spectrum so the averaged power spectrum from the gauge field can change the total power spectrum from blue to red. Therefore, hybrid inflation, once gauged under a U(1) field, can be consistent with the cosmological observations

  5. Myocardial ischemia in hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Lima Filho, Moyses de Oliveira; Figueiredo, Geraldo L.; Simoes, Marcus V.; Pyntia, Antonio O.; Marin Neto, Jose Antonio

    2000-01-01

    Myocardial ischemia in hypertrophic cardiomyopathy is multifactorial and explains the occurrence of angina, in about 50% of patients. The pathophysiology of myocardial ischemia may be explained by the increase of the ventricular mass and relative paucity of the coronary microcirculation; the elevated ventricular filling pressures and myocardial stiffness causing a compression of the coronary microvessels; the impaired coronary vasodilator flow reserve caused by anatomic and functional abnormalities; and the systolic compression of epicardial vessel (myocardial bridges). Myocardial ischemia must be investigated by perfusion scintigraphic methods since its presence influences the prognosis and has relevant clinical implications for management of patients. Patients with hypertrophic cardiomyopathy and documented myocardial ischemia usually need to undergo invasive coronary angiography to exclude the presence of concomitant atherosclerotic coronary disease. (author)

  6. Psychological rehabilitation after myocardial infarction: multicentre randomised controlled trial.

    OpenAIRE

    Jones, D. A.; West, R. R.

    1996-01-01

    OBJECTIVE: To evaluate rehabilitation after myocardial infarction. DESIGN: Randomised controlled trial of rehabilitation in unselected myocardial infarction patients in six centres, baseline data being collected on admission and by structured interview (of patients and spouses) shortly after discharge and outcome being assessed by structured interview at six months and clinical examination at 12 months. SETTING: Six district general hospitals. SUBJECTS: All 2328 eligible patients admitted ove...

  7. Acute myocardial infarcts

    International Nuclear Information System (INIS)

    Just, H.

    1988-01-01

    Acute myocardial infarction is a major complication of stenosing coronary artery disease and constitutes the most frequent single cause of death. It is caused by thrombotic occlusion of one of the major epicardial coronary arterial branches in most cases. Sudden death due to ventricular fibrillation is responsible for the majority of early fatalities. In 60% of all fatal infarcts, death occurs within 1 h of the onset of pain. The final extension of myocardial necrosis is reached within 2-4 h. An integrated programme has therefore been developed for the supervision and treatment of patients suffering acute coronary attack; it has been shown that it can markedly lower infarct mortality. It includes mobile prehospital care, intensive care treatment in the hospital, and rehabilitative procedures for application during reconvalescence. Early antiarrhythmic treatment and myocardial reperfusion via fibrinolysis are the main therapeutic procedures in the earliest stage. In hospital an operating room and an operating team must be available round the clock for the performance of coronary angiography followed by percutaneous transluminal coronary angioplasty or bypass surgery, which can be safely carried out in the acute stage provided the indications are strictly observed. Mortality and morbidity can be significantly lowered and both life expectancy and quality of life can be remarkably improved. (orig.) [de

  8. A perturbative DFT approach for magnetic anisotropy

    Energy Technology Data Exchange (ETDEWEB)

    Khoo, Khoong Hong; Laskowski, Robert, E-mail: rolask@ihpc.a-star.edu.sg

    2017-04-15

    We develop a perturbative formalism for computing magnetocrystalline anisotropy within density functional theory and the magnetic force theorem. Instead of computing eigenvalues of the spin–orbit Hamiltonian for selected spin polarizations, as in the conventional “force theorem” approach, we show that the effect can be cast into a redefined form of the spin–orbit operator. This allows to separate the large eigenvalue shift due to spin-orbit interaction common for both polarizations from the much smaller magnetic anisotropy splitting. As a consequence the anisotropy splitting may by considered as a perturbation.

  9. A preliminary feasibility study of simultaneous dual-isotope imaging with a solid-state dedicated cardiac camera for evaluating myocardial perfusion and fatty acid metabolism.

    Science.gov (United States)

    Ko, Toshiyuki; Utanohara, Yuko; Suzuki, Yasuhiro; Kurihara, Makiko; Iguchi, Nobuo; Umemura, Jun; Sumiyoshi, Tetsuya; Tomoike, Hitonobu

    2016-01-01

    Simultaneous dual-isotope SPECT imaging with 201Tl and (123)I-β-methyl-p-iodophenylpentadecanoic acid (BMIPP) is used to study the perfusion-metabolism mismatch. It predicts post-ischemic functional recovery by detecting stunned myocardium. On the other hand, (99m)Tc-MIBI is another radioisotope widely used in myocardial perfusion imaging because of its better image quality and lower radiation exposure than 201Tl. However, since the photopeak energies of (99m)Tc and (123)I are very similar, crosstalk hampers the simultaneous use of these two radioisotopes. To overcome this problem, we conducted simultaneous dual-isotope imaging study using the D-SPECT scanner (Spectrum-Dynamics, Israel) which has a novel detector design and excellent energy resolution. We first conducted a basic experiment using cardiac phantom to simulate the condition of normal perfusion and impaired fatty acid metabolism. Subsequently, we prospectively recruited 30 consecutive patients who underwent successful percutaneous coronary intervention for acute myocardial infarction, and performed (99m)Tc-MIBI/(123)I-BMIPP dual-isotope imaging within 5 days after reperfusion. Images were interpreted by two experienced cardiovascular radiologists to identify the infarcted and stunned areas based on the coronary artery territories. As a result, cardiac phantom experiment revealed no significant crosstalk between (99m)Tc and (123)I. In the subsequent clinical study, (99m)Tc-MIBI/(123)I-BMIPP dual-isotope imaging in all participant yielded excellent image quality and detected infarcted and stunned areas correctly when compared with coronary angiographic findings. Furthermore, we were able to reduce radiation exposure to significantly approximately one-eighth. In conclusion, we successfully demonstrated the practical application of simultaneous asses