technetium-tc-99m-pyrophosphate and Heart-Diseases

More than half of all subjects with chronic heart failure are older adults with preserved ejection fraction (HFpEF). Effective therapy for this condition is yet to be delineated by clinical trials, suggesting that a greater understanding of underlying biologic mechanisms is needed, especially for the purpose of clinical intervention and future clinical trials. Amyloid infiltration of the myocardium is an underappreciated contributing factor to HFpEF that is often caused by misfolded monomers or oligomers of the protein transthyretin. While previously called senile cardiac amyloidosis and traditionally requiring endomyocardial biopsy for diagnosis, advances in our pathophysiologic understanding of this condition, coupled with nuclear imaging techniques using bone isotopes that can diagnose this condition noninvasively and the development of potential therapies, have resulted in a renewed interest in this previously considered "rare" condition. This reviewer focuses on the re-emergence of nuclear cardiology using pyrophosphate agents that hold promise for early, noninvasive identification of affected individuals.

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

Amyloidosis is a heterogeneous group of diseases characterized by localized or systemic deposition of insoluble extracellular fibrillary proteins in organs and tissues. Several types of amyloid can infiltrate the heart resulting in a restrictive cardiomyopathy, heart failure, and atrial and ventricular arrhythmias. Scintigraphy is a noninvasive method that may facilitate early diagnosis, distinguish various forms of cardiac amyloid, and may be useful in following disease burden. The amyloid-specific tracers presented in this article have been used with planar imaging and/or single-photon emission computed tomography. To date, there are no approved cardiac amyloid tracers although investigational tracers are currently under examination. This article serves to review the current nuclear imaging modalities available in the detection of cardiac amyloid.

Topics: 3-Iodobenzylguanidine; Amyloidosis; Cardiomyopathies; Diphosphonates; Disease Progression; Heart Diseases; Humans; Iodine Radioisotopes; Organotechnetium Compounds; Positron-Emission Tomography; Radionuclide Imaging; Radiopharmaceuticals; Technetium; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed, Single-Photon

Amyloidosis is a heterogeneous group of diseases with a common feature of extracellular deposition and infiltration of different types of amyloid fibrils in various organs. For example, Alzheimer's disease is characterized by deposition of amyloid β in the brain. Radiolabeled positron emission tomography (PET) tracers, mainly derivatives of thioflavin-T, were recently introduced for identification of amyloid β plaques in Alzheimer's patients. Such advances of amyloid β plaque imaging of the brain may shed light into imaging of other organs in amyloidosis patients, such as the heart. Cardiac infiltration of amyloid confers poor clinical outcomes, which renders early diagnosis for appropriate clinical management. At present, nuclear imaging of cardiac amyloidosis is predominantly accomplished with bone-seeking radiotracers, such as 99m-technetium-labeled pyrophosphate ((99m)Tc-PYP), 99m-technetium-methylene diphosphonate ((99m)Tc-MDP), and 99m-technetium-3,3,-diphosphono-1,2-propanodicarboxylic acid ((99m)Tc-DPD), with conflicting results in terms of diagnostic performance, with the exception for (99m)Tc-DPD, which may differentiate light-chain amyloidosis from transthyretin-related cardiac amyloidosis. Although other non-bone-seeking radiotracers such as iodine-123-labeled amyloid P component ((123)I-SAP), 123-iodine-Meta-iodobenzylguanidine ((123)I-mIBG), 99m-technetium-labeled protease inhibitor, and indium-111-labeled amyloid antibodies have also shown some success in identifying cardiac amyloidosis, the future, however, may lie in labeling derivatives of thioflavin-T. With the recent success of visualizing deposition of amyloid β in the brain, the US Food and Drug Administration-approved PET imaging agent (18)F-florbetapir may be used to target cardiac amyloidosis next.

Topics: 3-Iodobenzylguanidine; Amyloidosis; Benzothiazoles; Early Diagnosis; Female; Fluorescent Dyes; Heart Diseases; Humans; Male; Molecular Imaging; Positron-Emission Tomography; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate; Thiazoles

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

Topics: Aged; Amyloid Neuropathies, Familial; Echocardiography; Electrocardiography; Female; Heart Diseases; Humans; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed

Transthyretin cardiac amyloidosis (ATTR) is a rare, but underdiagnosed, cardiomyopathy. Traditionally diagnosed invasively, ATTR can be diagnosed with non-invasive. Forty-three subjects (24 ATTR, 19 non-ATTR) were imaged with Philips Dual-Head Anger (planar) and General Electric CZT cameras. Myocardial uptake was quantified by heart-to-contralateral (H/CL) ratios. CZT scans were quantified by two readers blinded to planar H/CL, with one repeating blinded quantification. Using the previously validated diagnostic threshold (H/CL ≥ 1.5), sensitivity and specificity of CZT scintigraphy was measured. McNemar's test and Pearson's correlation coefficient were calculated.. Among subjects (76.7% male, age 77 ± 9), there was no significant difference in proportion of ATTR-positive identification between modalities. There was high correlation between CZT and planar H/CL ratios (r = 0.92, P < 0.0001), with low intra- [ICC = 0.89 (0.80-0.94)] and inter-observer [ICC = 0.80 (0.65-0.89)] variability. CZT scintigraphy had 100% sensitivity and specificity for diagnosing ATTR.. ANTECEDENTES: la amiloidosis cardíaca asociada a transtiretina (ATTR) es una cardiomiopatía poco frecuente y poco diagnosticada. Tradicionalmente el diagnóstico se realiza de forma invasiva, aunque se puede diagnosticar con gammagrafía planar con tecnecio 99m pirofosfato (99mTc-PYP). En el presente trabajo se desarrolla y se valida un protocolo diagnóstico de ATTR. MéTODO: Se estudiaron 43 sujetos (24 con diagnóstico de ATTR y 19 sin ATTR) las imágenes fueron adquiridas con las cámaras Philips Dual-Head Anger (planar) y General Electric CZT. La captación miocárdica se cuantificó con proporción corazón-contralateral (H/CL). La adquisición con las cámaras CZT se cuantificaron mediante 2 lectores cegados a la proporción H/CL planar, con una cuantificación ciega repetida. Utilizando el umbral de diagnóstico previamente validado (H/CL ≥ 1.5), se midió la sensibilidad y la especificidad de la gammagrafía con CZT. Para el análisis estadístico se utilizó la prueba De McNemar y el coeficiente de correlación de Pearson. RESULTADOS: entre la población de estudio (76.7% varones, edad 77 ± 9), no hubo diferencias estadísticamente significativas en la proporción de identificación de ATTR positiva. Se identificó una alta correlación entre la cámara CZT y la proporción planar H/CL (r = 0.92, p < 0.0001), así como una baja variabilidad intraobservador (ICC = 0.89 (0.80-0.94)) e interobservador (ICC = 0.80 (0.65-0.89)). La gammagrafía con CZT tuvo una sensibilidad y especificidad del 100% para el diagnóstico de ATTR. CONCLUSIóN: La imagen con 99mTc-PYP en cámaras CZT es altamente sensible y específica para el diagnóstico de ATTR. Estos hallazgos son de relevancia debido a la aparición de terapias modificadoras de la enfermedad.. 背景: 甲状腺素转运蛋白相关型心脏淀粉样变 (ATTR) 是一种罕并且难以诊断的心肌病。 传统的诊断方法是有创的, ATTR 可以通过无创99m锝标记的焦磷酸钙 (99mTc-PYP) 平面闪烁扫描进行诊断。而其它非平面成像方法尚未得到验证。本研究中我们探讨了一种镉锌碲化物(CZT)成像方案用于ATTR的可行性。 方法: 43 名受试者 (24名ATTR, 19名非ATTR) 分别使用飞利浦公司双探头显像仪平面扫描,以及通用公司CZT探头显像仪进行扫描。 心肌摄取采用心/对侧肺 (H/CL) 放射性计数比值作为定量方法。CZT 图像由2位研究者在不知道(双探头)平面扫描 H/CL 值的情况下进行定量测量。 以既往验证的 H/CL ≥ 1.5 作为 ATTR 诊断阈值,评价 CZT 扫描的诊断敏感性和特异性。 (统计学上) 计算了配对卡方检验和皮尔逊相关系数。 结果: 在受试者中 (男性占76.7%,年龄77 ± 9岁), ATTR 阳性诊断率无显著差异。 CZT 与平面扫描 H/CL 值相关性高 (r = 0.92, p  < 0.0001), 观察者内部 (ICC = 0.89(0.80-0.94)) 和观察者之间 (ICC = 0.80(0.65-0.89)) 的变异系数低。 CZT 扫描诊断 ATTR 的敏感性和特异性均为 100%。 结论: 99mTc-PYP CZT 扫描对 ATTR 的诊断具有与双探头扫描类似的高灵敏度和特异性。 鉴于 ATTR 疾病调节疗法的出现,这种新的扫描方法由于提高了诊断能力将具有重要的临床价值。.. L’amyloïdose cardiaque à transthyrétine (ATTR) est une cardiomypathie rare, mais sous-diagnostiquée. Traditionnellement diagnostiquée de façon invasive, l’ ATTR peut être évaluée par scintigraphie planaire au 99mTechnetium (99mTc-PYP). Dans cette étude, nous avons développé et validé un protocole avec detectors Cadmium Zinc Telluride (CZT) pour le diagnostic de l’ATTR. MéTHODES: 43 sujets (24 ATTR, 19 non-ATTR), ont été évaluées avec la camera Anger double tête de Philips et avec la camera CZT de General Electric. L’uptake myocardique du tracer a été quantifié en utilisant le rapport cœur- hemithorax contro-latéral (H/CL). Les scintigraphies obtenues sur camera CZT ont été analysées à deux reprises par deux experts qui n’avaient pas connaissance des résultats des images planaires obtenus au moyen de la caméra Philips. Utilisant le seuil diagnostique précédemment validé (H/CL) de 1.5, la sensibilité et la spécificité de la scintigraphie CZT ont été mesurées. Le test de McNemar et le coefficient de corrélation de Pearson ont été calculés. RéSULTATS: Nous n’avons pas observé de difference significative dans l’identification de l’amyloïdose cardiaque à transthyrétine (ATTR) chez les sujets étudies (76,7% d’ hommes, 77 à 9 ans) entre les deux modalitées scintigraphiques. De plus, nous avons noté une étroite correlation entre les résultats H/CL obtenus par imagerie CZT et Anger planaire (r-0,92, p-0,0001), avec une faible variabilité intra- (ICC-0,89(0,80-0,94)) et inter-observateurs (ICC 0,80 (0,65-0,89)). Le diagnostique de l’ATTR par scintigraphie à CZT a montré une sensibilité et une spécificité de 100%.. l’imagerie scintigraphique au 99mTc-PYP obtenue sur camera CZT est aussi sensible et spécifique que celle obtenue sur camera Anger planaire pour le diagnostiqe de l’amyloidose cardiaque ATTR. L’utilisation des caméras CZT devraient faciliter le diagnostic et par conséquent l’implémentation des nouvelles thérapies de l’amyloidose cardiaque ATTR.

Topics: Aged; Aged, 80 and over; Amyloidosis; Cadmium; Cardiology; Electrocardiography; Female; Follow-Up Studies; Heart Diseases; Heart Failure; Humans; Male; Natriuretic Peptide, Brain; Peptide Fragments; Prealbumin; Radionuclide Imaging; Reproducibility of Results; Sensitivity and Specificity; Technetium Tc 99m Pyrophosphate; Tellurium; Zinc

Taking an overdose of AMT, a commonly prescribed tricyclic antidepressant drug, has an increased risk of sudden cardiac death. The cardiotoxicity of amitriptyline (AMT) is a commonly observed toxicity with high morbidity and mortality rates in emergency departments (ED). Nevertheless, there are still no effective treatment options for AMT-induced cardiotoxicity. The aim of the present study was to evaluate the effects of paricalcitol (PRC), a Vitamin D receptor agonist, using electrocardiographic (ECG), biochemical, and scintigraphic methods. Twenty-eight male Wistar rats were randomly divided into four groups: untreated control (CON), amitriptyline-induced cardiotoxicity (AMT), paricalcitol (PRC), and amitriptyline + paricalcitol (AMT + PRC). Cardiotoxicity was induced by intraperitoneal (i.p) injection of a single-dose AMT (100 mg/kg). PRC was administered as 10 μg/kg (i.p.) after the injection of AMT. We examined ECG, biochemical, and scintigraphic results of PRC administration on AMT-induced changes. Cardiotoxicity of AMT was characterized by conduction abnormalities (increased QRS complex, T wave, and QT interval duration and elevation of ST segment amplitude), elevated

Topics: Action Potentials; Amitriptyline; Animals; Antidepressive Agents, Tricyclic; Biomarkers; Cardiotoxicity; Disease Models, Animal; Electrocardiography; Ergocalciferols; Heart; Heart Diseases; Heart Rate; Male; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Radiopharmaceuticals; Rats, Wistar; Technetium Tc 99m Pyrophosphate; Troponin T

Topics: Aged, 80 and over; Amyloidosis; Creatinine; Echocardiography; Heart Diseases; Humans; Immunoglobulin lambda-Chains; Male; Natriuretic Peptide, Brain; Prealbumin; Radiopharmaceuticals; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed, Single-Photon; Troponin I

Topics: 3-Iodobenzylguanidine; Citrates; Gallium; Gated Blood-Pool Imaging; Heart; Heart Diseases; Iodine Radioisotopes; Positron-Emission Tomography; Radiopharmaceuticals; Technetium Tc 99m Pyrophosphate; Tissue Survival

Topics: Antibodies, Monoclonal; Cardiomyopathies; Cardiomyopathy, Dilated; Cardiomyopathy, Hypertrophic; Contrast Media; Diagnosis, Differential; Heart Diseases; Heart Transplantation; Humans; Indium Radioisotopes; Myocardial Infarction; Myocarditis; Myosins; Radionuclide Imaging; Technetium Tc 99m Pyrophosphate; Technetium Tc 99m Sestamibi; Thallium Radioisotopes

Left ventricular contraction is routinely assessed by radionuclide ventriculography. Although a planar image is conventionally used, tomography has been to improve the detection of wall motion abnormalities. A blood pool image is often used in positron emission tomography on which to superimpose metabolic tracers. Can this image also be used to assess left ventricular contraction? Nine healthy controls, mean (S.D.) age 55 (5) years, and 12 patients, mean (S.D.) age 61 (8) years, with normal, proven or suspected left ventricular damage underwent blood pool tomography with 11CO positron emission tomography (PET) and 99Tcm single photon emission computed tomography (SPECT). A normal value of ejection fraction and range of phase were defined. The normal left ventricular ejection fraction was > or = 37% for PET and > or = 40% for SPECT. The ejection fractions obtained by the two methods in the patient group were positively correlated (r = 0.89, P < 0.001). Abnormalities of left ventricular contraction were detected in nine patients by PET and 10 patients by SPECT imaging. The discrepancy was in a patient with a previous inferior myocardial infarction. Blood pool imaging with 11CO PET can be used to assess left ventricular ejection fraction and regional wall motion.

Topics: Carbon Monoxide; Carbon Radioisotopes; Female; Fourier Analysis; Gated Blood-Pool Imaging; Heart Diseases; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Myocardial Infarction; Stroke Volume; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon; Ventricular Function, Left

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: Deoxyglucose; Fluorodeoxyglucose F18; Heart; Heart Diseases; Humans; Image Processing, Computer-Assisted; Myocardial Infarction; Radioisotopes; Technetium; Technetium Tc 99m Pyrophosphate; Thallium; Tin Polyphosphates; Tomography, Emission-Computed; Tomography, X-Ray Computed

Raynaud's phenomenon and cardiac abnormalities are frequent in patients with systemic sclerosis. Radionuclide ventriculograms were obtained in 16 patients with Raynaud's phenomenon and systemic sclerosis or the related CREST syndrome and in 11 normal volunteers in order to evaluate changes in left ventricular function that might be induced by exposure to cold. Left ventricular regional wall motion abnormalities developed in nine of 16 patients during cooling compared with only one of 11 control subjects, despite a comparable rise in mean arterial pressure (p less than 0.02). The abnormalities occurred in seven of 11 patients with systemic sclerosis, one of four with CREST syndrome, and one with Raynaud's disease. To test the potential protective effect of nifedipine, radionuclide ventriculograms were then obtained during cooling after sublingual nifedipine (20 mg). Only five of 13 patients had wall motion abnormalities, and the severity of the abnormalities was significantly less than during the first cooling period (p = 0.03). Five of eight patients who had cold-induced wall motion abnormalities during the first cooling period had none after nifedipine, whereas two other patients demonstrated small abnormalities only during the second cooling period after treatment with nifedipine. It is concluded that cold induces segmental myocardial dysfunction in patients with systemic sclerosis and that nifedipine may blunt the severity of this abnormal response.

Topics: Adult; Cold Temperature; Female; Heart Diseases; Heart Ventricles; Hemodynamics; Humans; Hypothermia, Induced; Male; Middle Aged; Nifedipine; Radionuclide Imaging; Raynaud Disease; Scleroderma, Systemic; Technetium; Technetium Tc 99m Pyrophosphate; Tin Polyphosphates

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

Topics: Cardiomyopathies; Diagnosis, Differential; Echocardiography; Electrocardiography; Heart Aneurysm; Heart Diseases; Humans; Myocardial Infarction; Prognosis; Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thallium; Thrombosis; Tin Polyphosphates

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

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