pyrophosphate and Heart-Diseases

Topics: Adolescent; Arrhythmias, Cardiac; Cardiac Catheterization; Coronary Angiography; Coronary Disease; Diphosphates; Electrocardiography; Exercise Test; Female; Heart; Heart Diseases; Heart Failure; Humans; Magnetic Resonance Spectroscopy; Male; Middle Aged; Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thallium; Tomography, X-Ray Computed; Ultrasonography

Topics: Adrenal Glands; Cardiology; Coronary Disease; Diphosphates; Exercise Test; Heart; Heart Diseases; Hemodynamics; Humans; Kidney; Radioisotopes; Serum Albumin, Radio-Iodinated; Technetium; Technetium Tc 99m Pyrophosphate; Thallium; Tomography, Emission-Computed; USSR

Noninvasive cardiology has made notable progress in the last several years. A variety of sophisticated tests are now available to the clinician, providing both anatomic and physiologic information. The result has been an improvement of the level of diagnostic accuracy, which in a final analysis translates into better patient care. Newer tests such as cardiac CAT scan and nuclear magnetic resonance, using incredibly advanced technologies, continue to be investigated and almost certainly will play an important role in cardiovascular diagnosis in year to come.

Topics: Angiography; Diphosphates; Echocardiography; Electrocardiography; Exercise Test; Heart Diseases; Humans; Medical History Taking; Physical Examination; Radioisotopes; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

Methods of radionuclide diagnosis modified with regard to the clinical problems and combined with new mathematic approaches to the processing of the data obtained make it possible to substantially enlarge the diagnostic information on myocardial contractility, central hemodynamics, the status and perfusion of the myocardium and to use it in combination with the latest research methods applied in cardiological patients.

Topics: Diphosphates; Electrocardiography; Heart; Heart Defects, Congenital; Heart Diseases; Humans; Myocardial Infarction; Technetium; Technetium Tc 99m Pyrophosphate; Thallium Radioisotopes; Tomography, Emission-Computed

The diagnosis of amyloid cardiomyopathy was only based, until the last few years, on the results of invasive techniques. It seems presently that the combined contribution of cardiac sonography and scintigraphy using technetium 99m pyrophosphate, makes, most of the time, this diagnosis possible without need for additional examinations. This notion is illustrated by a typical case-report and data from the literature. Demonstration on the cardiac sonogram of a thickening of the walls-while the context and especially the electrocardiogram are not in favor of a left ventricular hypertrophy--associated with a very particular "hyperechoing" aspect and an abnormal fixation on the scintigram, may be considered specific of this disease.

Topics: Amyloidosis; Diphosphates; Echocardiography; Female; Heart Diseases; Humans; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

It was found that simulation of stress of the white rats increases the myocardial uptake of Tc-99m-pyrophosphate (Tc-pyp). The before-adapted group of animals had a sufficiently lower content of Cc-PYP in myocardium, than the stress-control group. At that time, the before-adaptation led to a low rise in the plasma beta-endorphin and to a significant rise in its quantity. The authors discuss the role of endogenous beta-endorphin in the mechanisms of the protecting effect of adaptation.

Topics: Adaptation, Physiological; Animals; beta-Endorphin; Brain Chemistry; Diphosphates; Heart Diseases; Male; Myocardium; Plant Extracts; Rats; Restraint, Physical; Stress, Psychological; Technetium; Technetium Tc 99m Pyrophosphate; Time Factors

Topics: Diphosphates; Heart Diseases; Humans; Kinetocardiography; Radionuclide Imaging; Stroke Volume; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Diphosphates; Heart; Heart Diseases; Humans; Lupus Erythematosus, Systemic; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Diphosphates; Heart; Heart Diseases; Heart Function Tests; Humans; Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

Twelve patients with familial amyloidosis with polyneuropathy were examined both by cross sectional echocardiography and by technetium-99m pyrophosphate scintigraphy to assess involvement of the heart non-invasively. All 12 patients had echocardiographic abnormalities. The most prominent findings were highly refractile myocardial echoes, thickened heart valves, and increased thickness of the heart walls. Four patients had abnormal myocardial uptake of technetium-99m pyrophosphate. The remaining eight had equivocal or no myocardial uptake and were considered to have normal scintigrams. A certain amount of amyloid is probably required to produce an abnormal scintigram, although lesions with less amyloid can evidently be identified by echocardiography. Neither the duration of polyneuropathy nor its severity showed any relation to the echocardiographic or scintigraphic findings. It is concluded that cross sectional echocardiography is superior to technetium-99m pyrophosphate scintigraphy in detecting cardiac involvement in familial amyloidosis with polyneuropathy and that these results may also be applicable to other forms of amyloidosis.

Topics: Adult; Aged; Amyloidosis; Diphosphates; Echocardiography; Female; Heart; Heart Diseases; Humans; Male; Middle Aged; Nervous System Diseases; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

A pyrophosphate heart scintigram was obtained in 16 boys with progressive muscular dystrophy Duchenne. All of them showed pathological ECG findings and high plasma levels of CK, AST, ALT and LD. In 4 patients the scintigram was distinctly positive and in further 3 it reached borderline values. The remaining 9 boys had normal scintigraphic findings. Those with a positive heart scintigram had very high plasma levels of the enzymes under study which was suggestive of current progression of the disease. There was, however, no relation between heart scintigraphy and the affliction of the skeletal muscles expressed by means of an index.

Topics: Adolescent; Alanine Transaminase; Aspartate Aminotransferases; Child; Child, Preschool; Creatine Kinase; Diphosphates; Electrocardiography; Heart; Heart Diseases; Humans; L-Lactate Dehydrogenase; Male; Muscular Dystrophies; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Angiography; Cardiomyopathy, Dilated; Diphosphates; Electrocardiography; Exercise Test; Heart Diseases; Heart Valve Diseases; Humans; Isoenzymes; Myocardial Infarction; Perfusion; Prognosis; Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

Topics: Angiocardiography; Coronary Angiography; Diphosphates; Echocardiography; Heart; Heart Diseases; Humans; Magnetic Resonance Spectroscopy; Radiography, Thoracic; Radionuclide Imaging; Subtraction Technique; Technetium; Technetium Tc 99m Pyrophosphate; Tomography, X-Ray Computed

Topics: Adult; Amyloidosis; Diphosphates; Heart; Heart Diseases; Humans; Middle Aged; Radionuclide Imaging; Serum Amyloid A Protein; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Diphosphates; Heart; Heart Diseases; Humans; Methods; Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

A prospective, comparative study was made of the efficacy of technetium-99m pyrophosphate (Tc PYP) and technetium-99m methylene diphosphonate (Tc MDP) in detecting soft-tissue amyloidosis. Tc PYP and Tc MDP scans were obtained within ten-day intervals in seven patients with histologically proven amyloidosis. Tc PYP was a better scanning agent for soft-tissue amyloidosis in all patients. Cardiac and hepatic involvement were proved by autopsy in one patient. Involvement of the heart was confirmed by echocardiography in five patients. The potential use of Tc PYP scanning as a screening test for soft-tissue amyloidosis is discussed.

Topics: Adult; Aged; Amyloidosis; Biopsy; Diphosphates; Diphosphonates; Echocardiography; Female; Heart Diseases; Humans; Liver Diseases; Male; Middle Aged; Prospective Studies; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Right ventricular function was studied in 60 patients with equilibrium gated radionuclide angiography. The mean (+/- standard deviation) right ventricular ejection fraction in 20 normal subjects was 53 +/- 6 percent, a value in agreement with previous data from both radionuclide and contrast angiographic studies. This value was similar (55 +/- 7 percent) in 11 patients with coronary artery disease but normal left ventricular function. Radionuclide measurements of right ventricular ejection fraction were correlated with right heart hemodynamics. There was a significant negative linear correlation between right ventricular ejection fraction and mean pulmonary arterial pressure (r = -0.82) and between right ventricular ejection fraction and right ventricular end-diastolic pressure (4 = -0.67). Furthermore, patients with elevated right ventricular end-diastolic pressure and mean pulmonary arterial pressure had a more severely depressed ejection fraction than did those with an elevated mean pulmonary arterial pressure alone. Thus, an abnormal value for right ventricular ejection fraction by gated radionuclide angiography in the absence of primary right ventricular volume overload suggests abnormal right heart pressures, whereas a normal value excludes severe pulmonary arterial hypertension or an elevated right ventricular end-diastolic pressure.

Topics: Adult; Aged; Blood Pressure; Cardiac Catheterization; Cardiac Output; Diastole; Diphosphates; Erythrocytes; Female; Heart; Heart Diseases; Humans; Male; Middle Aged; Pulmonary Artery; Radionuclide Imaging; Stroke Volume; Technetium; Technetium Tc 99m Pyrophosphate

A retrospective evaluation was done on 426 radionuclide cardiac studies performed on female patients at our institution from January through September, 1980. These procedures included pyrophosphate (PYP) myocardial scans, resting and exercise Tl-201 studies, and gated equilibrium studies. The purpose of this evaluation was to document the incidence and possible consequences of breast artifacts in various cardiac procedures. We found the incidence to range from 30 to 50% of the studies performed, and both the incidence and type of artifact encountered varied with the type of procedure performed. Furthermore, 13 to 35% of patients had artifacts directly overlying the myocardium. The possible consequences, including potential misdiagnosis, interference with computer derived quantitative parameters, and the technical maneuvers necessary to avoid or alleviate these problems are discussed.

Topics: Breast; Computers; Diagnostic Errors; Diphosphates; Electrocardiography; Erythrocytes; Female; Heart Diseases; Humans; Middle Aged; Radioisotopes; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

Topics: Diphosphates; Heart; Heart Diseases; Humans; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Intense, diffuse localization of Tc-99m-pyrophosphate was demonstrated in the right and left ventricles of a patient with biopsy-proved amyloidosis and severe congestive heart failure. This finding is strong presumptive evidence of myocardial infiltration by amyloid in the presence of biopsy-proven amyloidosis elsewhere in the body.

Topics: Adult; Amyloidosis; Bone and Bones; Diphosphates; Echocardiography; Heart Diseases; Heart Failure; Heart Ventricles; Humans; Hypertrophy; Male; Radioisotopes; Radionuclide Imaging; Technetium; Thallium

Topics: Computers; Diphosphates; Heart Aneurysm; Heart Diseases; Heart Ventricles; Humans; Methods; Myocardial Contraction; Radiography; Radionuclide Imaging; Stroke Volume; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Adolescent; Adult; Aged; Diagnostic Errors; Diphosphates; Diphosphonates; Female; Heart Diseases; Humans; Male; Middle Aged; Radionuclide Imaging; Technetium; Tissue Distribution; Visual Acuity

Thirty-four New Zealand white rabbits were treated with doxorubicin and imaged weekly with Tc-99m pyrophosphate to define the value of abnormal myocardial images in predicting doxorubicin-induced cardiac toxicity. Increased myocardial uptake was detected in most animals on sustained treatment with doxorubicin. A greater proportion of the heart was involved with doxorubicin-related histologic changes in animals with strongly positive myocardial images than in treated animals with moderately positive or normal scans. The myocardial images returned to normal levels 2--6 wk after doxorubicin was discontinued. Five of seven rabbits that received doxorubicin after they had three moderately positive myocardial scans, died from congestive heart failure. Three rabbits whose doxorubicin was discontinued because of scan findings, survived for 6 wk or more before dying from renal failure. The three rabbits who received the highest total dose of doxorubicin died of renal failure without developing abnormal myocardial scans.

Topics: Animals; Antibiotics, Antineoplastic; Diphosphates; Doxorubicin; Heart; Heart Diseases; Prognosis; Rabbits; Radionuclide Imaging; Technetium

Topics: Diphosphates; Heart Diseases; Heart Ventricles; Humans; Myocardial Infarction; Radionuclide Imaging; Technetium

Topics: Cost-Benefit Analysis; Diphosphates; Heart; Heart Diseases; Humans; Myocardial Contraction; Myocardial Infarction; Radioisotopes; Radionuclide Imaging; Technetium; Thallium

A total of 10 patients were examined. In five children who suffered from secondary cardiomyopathy accompanying progressive muscular dystrophy scintigraphic examination of the myocardium was made using 99mTc-labelled pyrophosphate. In two cases the scan was distinctly positive, in three cases negative. Five men with poorly defined primary nonobstructive cardiomyopathy were examined too. The scan was positive in three cases and negative in two cases. The positivity of the pyrophosphate scan of the heart is therefore not pathonomonic of ischaemic damage. An increased accumulation of pyrophosphate in the myocardium in cardiomyopathy indicates an acute phase of the disease.

Topics: Adolescent; Adult; Child; Diphosphates; Electrocardiography; Evaluation Studies as Topic; Heart Diseases; Humans; Male; Methods; Middle Aged; Muscular Dystrophies; Radionuclide Imaging; Technetium

Topics: Coronary Disease; Diphosphates; Heart; Heart Diseases; Humans; Myocardial Infarction; Radionuclide Imaging; Technetium

Topics: Coronary Circulation; Coronary Disease; Diphosphates; Erythrocytes; Heart Diseases; Humans; Myocardial Infarction; Myocardium; Radioisotopes; Radionuclide Imaging; Serum Albumin; Technetium; Thallium

The interpretations of 156 99mtechnetium pyrophosphate myocardial scintigrams by four observers were analyzed in order to determine the reliability and reproducibility of the subjective process of reading scintigrams. The scintigrams were scored on an integral scale from 0 to 4, depending upon the degree of myocardial radionuclide accumulation, and the site and nature of uptake were specified. Exact agreement upon score was generally poor but approximate concurrence of interpretation was good (90.4 and 92.5% inter- and intra-observer agreement, respectively). There was somewhat less agreement on scintigrams with the higher scores of 3 and 4 (83.3 and 78.0%, respectively). A high level of concurrence upon the differentiation between diffuse and localized uptake, and upon the site of uptake, was found. We conclude that only approximate rather than exact agreement of individual readers' interpretations can be expected in this subjective technique, that scintigrams with higher degrees of radionuclide accumulation produce slightly greater observer disagreement, and that variability of interpretation could account for some of the diagnostic inaccuracy of 99mtechnetium pyrophosphate myocardial scintigraphy.

Topics: Angina Pectoris; Diphosphates; Heart; Heart Diseases; Humans; Radionuclide Imaging; Technetium

Topics: Diphosphates; Doxorubicin; Heart; Heart Diseases; Humans; Neoplasms; Radionuclide Imaging; Technetium

In order to evaluate methods for detecting peri-operative myocardial damage we studied 41 patients before and serially following coronary artery bypass graft surgery utilizing the 12-lead ECG, serum MB-CPK measurements, and 99mTc pyrophosphate myocardial scans. Six of the 41 patients (15%) developed persistent new Q waves after surgery. Six other patients demonstrated ischemic ST-T wave changes that persisted for 48 hours or more. Mean total MB-CPK released was highest for the group with new Q waves [1598+/-545 (SE) I.U./L-hr] as compared to the group with ischemic ST-T wave changes 708+/-65 I.U./L-hr) or the group with no ECG changes (262+/-47 I.U./L-hr). Ten patients (24%) has positive postoperative pyrophosphate scans consistent with myocardial infarction. The three techniques were compared in these 41 patients utilizing 465 I.U./L.-hr as the upper limit of normal MB-CPK released after uncomplicated coronary bypass surgery (no ECG changes, negative scan). Five patients with ischemic ECG changes had a positive scan and high MB-CPK; six patients with no ECG changes had high MB-CPK but a negative scan; and one patient with high MB-CPK and new Q wave had a negative scan. We conclude 1) new Q waves on ECG underestimate the incidence of myocardial damage after coronary artery surgery; 2) MB-CPK alone overestimates the incidence of infarction; and 3) a combination of the three techniques is the best means for detecting myocardial damage after coronary artery bypass graft surgery.

Topics: Adult; Aged; Coronary Artery Bypass; Creatine Kinase; Diphosphates; Electrocardiography; Female; Heart Diseases; Humans; Isoenzymes; Male; Middle Aged; Myocardial Infarction; Myocardium

Technetium-99m pyrophosphate was utilized for myocardial imaging in 15 patients on adriamycin treatment for neoplasia. We have noted abnormal accumulation of the pyrophosphate in several patients, particularly in those in whom the so-called poor-risk factors were operative, namely prior radiation, cyclophosphamide therapy, and ischemic heart disease.

Topics: Adult; Aged; Antineoplastic Agents; Diphosphates; Doxorubicin; Female; Heart Diseases; Humans; Male; Middle Aged; Neoplasms; Radionuclide Imaging; Technetium

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.

Topics: Abscess; Aged; Diphosphates; Endocarditis, Bacterial; Gallium Radioisotopes; Heart Diseases; Humans; Male; Radioisotopes; Radionuclide Imaging; Staphylococcal Infections; Technetium; Thallium

150 patients, admitted to the coronary care unit with suspicion of acute myocardial infarction, received pyrophosphate labelled with 99mTc, 6-120 h after onset of symptoms, mean 24 h, and were examined in the anterior posterior position and in the left anterior oblique position with a mobile gamma camera. Scintigrams were obtained initially at the injection, and then every 15th min during 1h. The scintigrams were evaluated with regard to presence and localization of radionuclide uptake in myocardial area. In 98 patients with a clinical diagnosis of acute myocardial infarction, uptake was found in 95, with good correlation between ECG and scintigraphic localization. 2. patients with myocardial infarction, verified at autopsy, did not show any uptake and 1 patient, surviving the myocardial infarction, also showed negative result. 19 of 26 patients with unstable angina pectoris also exhibited an uptake in the myocardium. 25 of 26 patients with other diagnoses showed no uptake, while in 1 patient an uptake was recorded. It is concluded that with 99mTc-pyrophosphate scintigraphy it is possible to separate ischemic heart disease from other diseases in patients with chest pain.

Topics: Adult; Aged; Angina Pectoris; Coronary Care Units; Diagnosis, Differential; Diphosphates; Electrocardiography; Female; Heart Diseases; Humans; Male; Middle Aged; Myocardial Infarction; Radionuclide Imaging; Technetium