sodium-pertechnetate-tc-99m and Cardiomyopathies

To comparatively assess the capabilities of currently available instrumental studies in the diagnosis of early cardiac performance changes in patients with lymph tumors at different stages of treatment and to study the myocardial histomorphological pattern in relation to the intensity of the therapy performed (as evidenced by sectional studies).. 44 patients, including 26 with various types of lymphogranulomatosis (LGM) and 18 with lymphosarcomas were examined at different stages of antitumor treatment. Radionuclide equilibrium ventriculography (REVG), echocardiography (EchoCG), and electrocardiography (ECG) were used. Postmortem studies of the myocardial histological pattern were conducted in 20 patients (archive data).. No significant pathological REVG, EchoCG, and ECG changes were found in 10 patients examined prior to treatment. In a group of 17 patients receiving a total dose of doxorubicine of 240 +/- 30 mg/m2, there was a significant decrease in diastolic duration, a reduction in diastolic volume, end systolic volume, stroke volume, stroke index, filling fraction over 1/3 diastole. In a group of 17 patients receiving a total dose of doxorubicine of 250 +/- 30 mg/m2 and radiotherapy applied to the mediastinum, the above changes were more marked. There were myocardial histomorphological changes whose magnitude progressed as therapy became more intensive. CONCLUSION. The findings have indicated that by using relatively small cumulative dose of anthracyclines, cardiovascular dysfunction can occur at the early stages of programmed treatment for LGM and lymphosarcomas. REVG has the greatest advantage in their detection.

Topics: Adult; Anthracyclines; Antibiotics, Antineoplastic; Cardiomyopathies; Diagnosis, Differential; Echocardiography; Electrocardiography; Female; Heart; Hodgkin Disease; Humans; Lymphoma, Non-Hodgkin; Male; Middle Aged; Myocardium; Radionuclide Ventriculography; Sodium Pertechnetate Tc 99m; Time Factors

Impaired exercise capacity and oxygen consumption are common in cirrhosis.. To explore the relationship between possible myocardial dysfunction and exercise tolerance in cirrhosis.. Cardiac responses to exercise, using radionuclide angiography and graded upright cycle ergometry with oxygen consumption, were assessed before and after exercise in 39 cirrhotics patients and compared with 12 age and sex matched healthy volunteers. Baseline cardiac chamber dimensions and wall thickness, ejection fraction, and diastolic function were measured using two dimensional echocardiography is all subjects.. Baseline diastolic dysfunction with prolonged isovolumic relaxation times (p=0.02), left atrial enlargement, and left ventricular wall thickening were present in all cirrhotics (p=0.02), despite increased mean ejection fraction. With graded exercise, cirrhotics achieved 71 (4)% (p=0.03) (pre-ascitics) and 46 (3)% (p<0.001) (ascitics) of predicted work loads, respectively, without significant increases in ejection fraction. The smaller absolute and percentage increases in cardiac output (p=0.003) in the cirrhotics were associated with significantly reduced oxygen consumption (p=0.003) and anaerobic threshold (p<0.001), and correlated significantly with work and metabolic parameters.. Impaired exercise capacity in cirrhosis is associated with myocardial thickening and ventricular stiffness leading to decreased diastolic function, inotropic and chronotropic incompetence under conditions of stress, with metabolic consequences. This picture is compatible with the condition now known as cirrhotic cardiomyopathy.

Topics: Analysis of Variance; Ascites; Cardiomyopathies; Case-Control Studies; Echocardiography; Exercise Test; Exercise Tolerance; Female; Humans; Liver Cirrhosis; Male; Middle Aged; Oxygen Consumption; Radionuclide Imaging; Radiopharmaceuticals; Regression Analysis; Sodium Pertechnetate Tc 99m; Stroke Volume

The aim of this study was to compare three automatic programs (P1, P2, P3) for evaluating radionuclide left ventricular ejection fraction (LVEF) and to emphasize the clinical consequences. Gated radionuclide ventriculography was performed in 73 subjects, 15 of whom were healthy and 58 of whom had experienced heart failure. All scintigraphic data were processed with the three programs. Good inter-observer, intra-observer and automatic-manual reproducibility were observed using each of the three programs. On the other hand, in the normal subjects, the three mean normal LVEF values were significantly different from each other (P1 = 77 +/- 5%, P2 = 63 +/- 7%, P3 = 68 +/- 8%; P < 0.0001) In the pathological patients, the values obtained with P2 were significantly different from those obtained using P1 and P3 (P1= 32 +/- 15%, P2 = 26 +/- 13%; P < 0.0001), Moreover, the linear regression studies between the three automatic programs were always significantly different from the identity line equation (y = x). This study shows that LVEF criteria for normality depend on the program used, and inter-program measurement of LVEF is poorly reproducible. Caution is recommended when comparing data obtained from different centres (or different computers), either in the follow-up of a given patient or in gathering results from patient groups.

Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Automation; Cardiomyopathies; Case-Control Studies; Heart Failure; Humans; Middle Aged; Myocardial Ischemia; Observer Variation; Regression Analysis; Reproducibility of Results; Sodium Pertechnetate Tc 99m; Stroke Volume; Tomography, Emission-Computed; Ventricular Function, Left

Left ventricular function of 20 diabetic patients was investigated at rest and during hand-grip test using radionuclide ventriculography. The aim of the study was to discuss the correlation of cardiac function with autonomic cardiac neuropathy (ACN) in diabetic subjects. ACN was tested using heart rate response to valsalva maneuver, standing up, deep breathing; blood pressure response to standing up, sustained hand-grip, and additionally corrected QT (QTc) measurements. Plasma glucose regulation was screened with fructosamine levels. Ejection fraction (EF), peak ejection (PER) and filling rates (PFR), times to peak ejection (TPE) and filling (TPF), time to endsystole (TES), TES/T, TPE/T, TPF/T, 1/3 PER, 1/3 PFR, 1/3 EF, 1/3 FF (filling fraction) we calculated. Thirteen patients had ACN. Six patients (30%) had a low EF at rest. As a response to hand-grip, 14 patients (70%) showed a decrease in EF (9 ACN). PFR was low in 10 patients (50%) at rest and in 12 (60%) during hand-grip. The mean rest PER value of ACN+ patients (4.4 +/- 1.3) was significantly higher than that of controls (2.9 +/- 0.5) and patients without ACN (3.4 +/- 0.4; p < 0.05) as well as the mean 1/3 PER value (1.7 +/- 0.5 vs. 1.3 +/- 0.5; p < 0.05). Fourteen patients (70%) had a fall in PER 10 ACN) as a response to hand-grip. The mean TES/T value of patients with ACN (0.44 +/- 0.05) was significantly higher than of those without ACN (0.38 +/- 0.05; p < 0.05). In conclusion, diastolic dysfunction was detected frequently at rest. Systolic parameters were markedly impaired as a response to hand-grip in patients with ACN. Sympathetic overactivity was noted in ACN+ group at rest. Our results indicated that the patients with diabetes and ACN have subclinical left ventricular diastolic dysfunction and symphatic overactivity.

Topics: Adult; Autonomic Nervous System Diseases; Cardiomyopathies; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Female; Gated Blood-Pool Imaging; Heart; Humans; Male; Sodium Pertechnetate Tc 99m; Ventricular Function, Left

The effects of postextrasystolic potentiation during spontaneous ventricular ectopy on both left and right ventricular function were studied in 12 patients with the aid of list-mode radionuclide ventriculography. The left ventricular ejection fraction showed a significant increase (+ 11.0 +/- 5.0%; p less than .001) with associated mild increases in end-diastolic volumes (+ 4.9 +/- 4.6; p less than .01) and significant decreases in end-systolic volumes (-13.4% +/- 7.3%; p less than .001). A more heterogeneous response was seen for the right ventricle. Right ventricular ejection increased significantly in 8/12 patients (+ 3.3 +/- 3.0%; p less than .02). Despite a large increase in end-diastolic volumes (+ 10 +/- 7.9%; p less than .001), there were only mild changes in end-systolic volumes (+ 2.2 +/- 9.0; p = NS). It is concluded that, for spontaneous ventricular ectopy in man, the increase in right ventricular ejection fraction reflects improved ventricular filling whereas the increase in left ventricular ejection fraction is linked to improved emptying.

Topics: Adult; Aged; Cardiac Complexes, Premature; Cardiac Output; Cardiomyopathies; Coronary Disease; Female; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Contraction; Myocardial Infarction; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

It has been established that natrium oxybutirate, prolactin, inderal and ionol affecting different links of pathogenetic chain of stress injury, efficiently prevent structural damage to cardiomyocytes and the accumulation of 99mTc-pyrophosphate in the myocardium.

Topics: Animals; Antioxidants; Butylated Hydroxytoluene; Cardiomyopathies; Heart; Male; Prolactin; Propranolol; Psychophysiologic Disorders; Rats; Sodium Oxybate; Sodium Pertechnetate Tc 99m; Stress, Psychological

Right-to-left extra cardiac shunts are usually congenital and are rarely due to trauma or complicating thoracic or vascular surgery. A case of a right-to-left cardiac shunt due to an arteriovenous fistula between the left pulmonary artery and the left pulmonary vein is reported. This may be the first report of this abnormality. The etiology is not clear. The case was investigated only by radionuclide procedures because the general condition of the patient was so poor that invasive procedures could not be undertaken.

Topics: Arteriovenous Fistula; Cardiomyopathies; Heart Septum; Humans; Male; Middle Aged; Pulmonary Artery; Pulmonary Veins; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

12 patients with cardiomyopathy were examined by MRT and first pass angiocardiography. MRT provides detailed images of cardiac anatomy and abnormalities without using any contrast medium. The first pass method is an excellent complement to MRT. The functional imaging describes regional wall motion of myocardium exactly. Both non-invasive methods are useful for the diagnosis of cardiomyopathy.

Topics: Cardiac Output; Cardiomyopathies; Cardiomyopathy, Dilated; Cardiomyopathy, Hypertrophic; Electrocardiography; Gold Radioisotopes; Heart Ventricles; Humans; Magnetic Resonance Spectroscopy; Myocardial Contraction; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Clinical use of radiotracer techniques in pediatric cardiology is increasing. Three basic methods being employed are first pass radionuclide angiocardiography, gated blood pool scanning and myocardial perfusion scintigraphy. These methods are rapid, safe and accurate. They are minimally invasive and result in a low radiation dose to the patient. The development of ultrashort-lived radionuclides (such as iridium-191m with a half-life of only 5 seconds), improvements in nuclear imaging instrumentation and numerical analysis should contribute to a further utilization of these methods.

Topics: Angiocardiography; Blood Volume; Cardiac Output; Cardiomyopathies; Child; Heart; Humans; Mathematics; Pulmonary Circulation; Sodium Pertechnetate Tc 99m; Stroke Volume

We investigated the diagnostic accuracy of radionuclide global and regional left ventricular (LV) function after coronary revascularization. A consecutive series of 43 patients was studied. First-pass radionuclide angiograms were performed preoperatively (4 days +/- s.d. 3 days, range 1-18 days) and postoperatively (7 days +/- s.d. 3 days, range 3-19 days). Regional radionuclide LV function was assessed using the two-dimensional display of systole and the three-dimensional ejection fraction image. Electrocardiograms were obtained the day prior to surgery and every 8 h for the first three postoperative days. Creatine kinase (CK) and lactate dehydrogenase (LDH) isoenzymes were obtained the day prior to surgery and every 8 h for the first three postoperative days. In 39 patients who did not develop perioperative myocardial infarction by isoenzyme or ECG criteria, we found that 38 patients showed unchanged or improved global and regional LV function, while one patient without isoenzyme or ECG evidence of perioperative myocardial infarction developed a new septal wall motion abnormality. Thus, the specificity of the radionuclide radioventriculogram for new septal wall motion abnormalities was very high. In four patients who developed isoenzyme and ECG evidence of myocardial infarction, septal wall motion worsened in all four patients while global left ventricular ejection function fell significantly in three patients. Thus, the radionuclide radioventriculogram also had high diagnostic sensitivity. In summary, contrary to past and recent reports, this investigation demonstrated that the radionuclide radioventriculogram can be used to assess global and regional LV function after coronary artery bypass surgery and furthermore, that it reliably indicates the presence of a new postoperative myocardial infarction.

Topics: Adult; Cardiomyopathies; Coronary Artery Bypass; Heart Septum; Humans; Male; Middle Aged; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Electrocardiographic gating provides an alternative method of acquiring first pass radionuclide ventriculograms from both ventricles. This report details the methods of acquisition and analysis, provides validation and reproducibility data, and describes applications of gated first pass radionuclide ventriculography using a count-based method. Left ventricular ejection fractions measured by gated first pass were correlated quite closely with gated blood pool ventriculography (n = 43; r = 0.95) but less well with contrast angiography (n = 23; r = 0.72). The right ventricular ejection fractions measured by gated first pass compared favorably with gated blood pool ventriculography (n = 32; r = 0.93). When one observer processed the images two times, the reproducibilities of RVEF (n = 10; r = 0.99) and LVEF (n = 10; r = 0.88) were excellent. Similarly, when two observers processed the images independently, the reproducibilities of RVEF (n = 11; r = 0.99) and LVEF (n = 11; r = 0.98) were excellent. The first pass studies were obtained in a right anterior obliquity, which provided the best atrioventricular chamber separation and provided a different view of global ventricular function and segmental wall motion from that provided by the standard blood pool views.

Topics: Adolescent; Adult; Aged; Cardiomyopathies; Female; Heart Diseases; Heart Valve Diseases; Humans; Male; Methods; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stroke Volume

Topics: Cardiology; Cardiomyopathies; Heart; Heart Function Tests; Heart Valve Diseases; Humans; Lung Diseases, Obstructive; Myocardial Infarction; Nuclear Medicine; Prognosis; Quality Control; Radiation Dosage; Radioisotopes; Reference Values; Sodium Pertechnetate Tc 99m; Terminology as Topic; Tomography, Emission-Computed

Topics: Cardiac Output; Cardiomyopathies; Coronary Circulation; Coronary Disease; Coronary Vessels; Heart; Heart Diseases; Heart Valve Diseases; Heart Ventricles; Humans; International Cooperation; Lung Diseases, Obstructive; Myocardial Infarction; Perfusion; Quality Control; Radionuclide Imaging; Reference Values; Societies, Medical; Sodium Pertechnetate Tc 99m; Terminology as Topic; Tomography, Emission-Computed; World Health Organization

First pass radionuclide angiocardiography was utilized to calculate right and left ventricular ejection fraction in 74 infants and children. For the synchronization of radionuclide imaging with the cardiac cycle, the peaks and valleys of corrected ventricular time activity curve were adopted as the time reference points instead of R wave of electrocardiogram. Left ventricular ejection fractions obtained by the radionuclide technique correlated well with those derived from the contrast angiographic technique (r = 0.90), but right ventricular ejection fractions correlated less well (r = 0.74). This noninvasive technique appeared useful for evaluation of right and left ventricular ejection fraction.

Topics: Aortic Valve Insufficiency; Aortic Valve Stenosis; Cardiac Output; Cardiomyopathies; Child; Child, Preschool; Female; Heart Defects, Congenital; Heart Diseases; Humans; Infant; Male; Mitral Valve Insufficiency; Mucocutaneous Lymph Node Syndrome; Pulmonary Valve Insufficiency; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stroke Volume; Syndrome; Technetium

Topics: Adult; Aged; Blood Volume; Cardiac Volume; Cardiomyopathies; Computers; Coronary Disease; Female; Heart Septal Defects, Atrial; Heart Valve Diseases; Heart Ventricles; Humans; Male; Middle Aged; Radiography; Radioisotope Dilution Technique; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stroke Volume; Technetium