sodium-pertechnetate-tc-99m and cesium-iodide

Impairment of left ventricular function during controlled myocardial ischemia induced by coronary angioplasty has been reported from angiographic and echocardiographic studies. Ejection fraction, peak ejection, peak filling rates, and end-systolic and end-diastolic volumes were investigated before, during and after coronary occlusion on-line with a nonimaging scintillation probe. The study consisted of 18 patients (mean age 59 +/- 10 years) with coronary artery stenosis of greater than 70%. During balloon inflation of 60 seconds' duration, coronary occlusion pressure was 31.6 +/- 12 mm Hg. There was no significant change in heart rate. Delay between first and second dilatation was 109 +/- 63 seconds. Ejection fraction decreased from 53 +/- 16 to 40 +/- 12% (first dilatation, p less than 0.01) and to 39 +/- 14% (second dilatation, p less than 0.01) and recovered to 51 +/- 16% 5 minutes after the second dilatation. Peak ejection rate was significantly reduced during the first and second balloon inflations. Peak filling rate decreased from 2.5 +/- 0.8 to 2.0 +/- 0.7 end-diastolic volume.s-1 (first dilatation, p less than 0.01) and to 1.8 +/- 0.7 end-diastolic volume.s-1 (second dilatation, p less than 0.01) and remained reduced at 2.2 +/- 0.7 end-diastolic volume.s-1 (p = not significant) at 5 minutes after the second dilatation. End-systolic and end-diastolic volumes increased significantly during the first and second dilatations and returned to normal after dilatation. It is concluded that short, controlled myocardial ischemia during coronary angioplasty leads to a decrease in systolic and diastolic left ventricular function. Sequential dilatations do not further decrease function if a sufficient interval is kept.

Topics: Angioplasty, Balloon, Coronary; Cardiac Output; Cardiac Volume; Cesium; Coronary Disease; Coronary Vessels; Diastole; Electrocardiography; Gated Blood-Pool Imaging; Humans; Iodides; Male; Middle Aged; Sodium Pertechnetate Tc 99m; Stroke Volume; Systole; Time Factors; Ventricular Function, Left

A commercially available system of caesium iodide crystal mini-detectors (Oakfield Instruments, Oxon, UK) was modified so that it was suitable for dual isotopic measurement of the plasma protein accumulation index (PPA)- a measure of pulmonary endothelial permeability. Using this modified system the mean PPA x 10(-3) min-1 +/- (S.E.M.) recorded in 11 normal subjects (22 lungs) was 0.18 (0.08) and in 6 patients (9 lungs) with the adult respiratory distress syndrome was 2.88 (0.63) (P less than 0.02). These values for PPA concur with those found by other groups using larger sodium iodide detectors. We conclude that with simple modification caesium iodide mini-detectors may be used successfully for the measurement of PPA in the intensive care setting.

Topics: Capillary Permeability; Cesium; Humans; Indium; Iodides; Lung; Radionuclide Imaging; Respiratory Distress Syndrome; Scintillation Counting; Sodium Pertechnetate Tc 99m