sodium-pertechnetate-tc-99m and Scleroderma--Systemic

We assess the usefulness of

Topics: Adult; Aged; Female; Hand; Humans; Male; Middle Aged; Perfusion Imaging; Pilot Projects; Raynaud Disease; Scleroderma, Systemic; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m

To assess left ventricular (LV) diastolic function in scleroderma systematica (SS) with regard to SS course and skin lesion degree, a total of 24 SS patients were examined versus control subjects. Though cardiac symptoms manifested clinically only in 8 patients, parameters of LV diastolic function underwent changes in the majority of the examinees: the time to attaining maximal filling velocity increased, contribution of the first diastolic third to LV filling diminished, hemodynamic significance of the left atrial systole grew. More pronounced dysfunction of the myocardium occurred in patients with diffuse skin lesions, acute and subacute disease who also appeared to have reduced LV ejection fraction. The conclusion is made on frequent subclinical pattern of myocardial involvement in SS patients which runs primarily as LV diastolic dysfunction. Systolic disturbance emerge later or in more active forms.

Topics: Acute Disease; Adult; Chronic Disease; Diastole; Female; Gated Blood-Pool Imaging; Humans; Male; Middle Aged; Scleroderma, Systemic; Sodium Pertechnetate Tc 99m; Ventricular Function, Left

Esophageal involvement by scleroderma is frequent. Investigation by manometry or radiography is invasive and nonphysiological. Scintigraphy of the clearance of small radiolabelled liquid boluses in the supine position, while sensitive and noninvasive, may also be nonphysiological and does not allow the simultaneous determination of gastric emptying. We thus studied the esophageal clearance of a semisolid test meal ingested in the upright position. Forty-seven patients with scleroderma and 24 with Sjogren's syndrome were compared with ten normal controls and ten patients with gastric emptying abnormalities but no esophageal involvement. Results of scintigraphy were also correlated with manometry and contrast radiography. Quantitative evaluation of esophageal tracer retention at ten minutes postingestion was: (mean +/- SD), 2.8 +/- 1.0% in normals, 2.9 +/- 0.9% in gastric dysmotility, 4.8 +/- 2.9% in Sjogren's syndrome, and 22.3 +/- 25.0% in scleroderma; similar results were found at 20 and 60 minutes. The T 1/2 of gastric emptying was 47.1 +/- 5.7 minutes in normals, 95.9 +/- 25.3 minutes in gastric dysmotility, 62.9 +/- 19.5 minutes in Sjogren's syndrome, and 52.9 +/- 13.5 minutes in scleroderma. We conclude that esophageal clearance of a semisolid test meal is a sensitive index of esophageal dysmotility and correlates well with results from manometry and contrast radiography but is noninvasive and quantifiable. The simultaneous measurement of gastric emptying is also possible in many cases.

Topics: Adult; Chelating Agents; Esophageal Motility Disorders; Esophagus; Female; Food; Humans; Male; Manometry; Middle Aged; Radionuclide Imaging; Resins, Synthetic; Scleroderma, Systemic; Sjogren's Syndrome; Sodium Pertechnetate Tc 99m

Topics: Adult; Deglutition Disorders; Esophagus; Female; Humans; Male; Radionuclide Imaging; Scleroderma, Systemic; Sodium Pertechnetate Tc 99m; Technetium