ABSTRACT
We sought to determine the usefulness of the [99m]Tc-MIBI [MIBI] washout rate for the evaluation of steroid therapy in cardiac sarcoidosis [CS]. Eleven CS patients underwent MIBI myocardial SPECT both before and 6 months after initiating steroid therapy. The washout rate [WOR] of MIBI was calculated using early and delayed polar map images. The washout score [WOS] of MIBI was derived from the difference between the early and delayed total defect scores [TDS]. Serum ACE and BNP exhibited significant improvement after the therapy [p = 0.004, p = 0.045]. In the LV function, EDV and E/A ratio exhibited significant improvement after the therapy [p = 0.041, p = 0.007], while there were no significant differences between before and after therapy in EF or ESV. Early and delayed TDS showed no significant differences between before and after the therapy. In contrast, WOR differed significantly [p < .0001], while WOS did not differ significantly between before and after the therapy. The washout rate of MIBI is suitable for assessment of cardiac function in CS with steroid therapy, being especially better than the washout score of MIBI for assessment of disease activity of mild myocardial damage in CS with steroid therapy
Subject(s)
Humans , Female , Male , Sarcoidosis/diagnostic imaging , Cardiomyopathies , Steroids , Technetium Tc 99m SestamibiABSTRACT
The purpose of the present study was to investigate a useful exercise protocol and method of evaluation for determining the gas exchange threshold (VO<SUB>2</SUB>GET) and correlation coefficient between VO<SUB>2</SUB>GET and maximal oxygen uptake (VO<SUB>2</SUB>max), which is an index of aerobic capacity. Five healthy male volunteers (age: 25.6 ± 2.0 yrs; height: 172.9±4.0 cm; weight: 69.5±6.6 kg) performed exercise tests 82 times. Each volunteer randomly conducted a RAMP exercise (1 W⋅3 sec<SUP>-1</SUP>), STEP-1 exercise (20W⋅min<SUP>-1</SUP>) and STEP-2 exercise (40W⋅2 min<SUP>-1</SUP>), respectively, at least 4 to 8 rotations. The gas exchange parameters (VE, VO<SUB>2</SUB>and VCO<SUB>2</SUB>) for incremental exhaustive cycle ergometer exercise were measured using a“breath-by-breath”method. Three different methods of evaluation- (VE/VO<SUB>2</SUB>and VE/VCO<SUB>2</SUB>) exchange (M-1), V-slope method (M-2), and M-1 & M-2 (M-3) -were attempted to determine VO<SUB>2</SUB>GET. The VO<SUB>2</SUB>GET values, determined by three different methods (M-1, -2 and -3) of evaluation, were classified as‘easy’ (J-A) and‘difficult’ (J-B) in all tests. Reproducibility of VO<SUB>2</SUB>max and VO<SUB>2</SUB>GET were assessed using the coefficient of variation (CV) and correlation coefficients (r) between VO<SUB>2</SUB>max and VO<SUB>2</SUB>GET.<BR>The results are summarized as follows:<BR>1) The means of the reproducibility of VO<SUB>2</SUB>max were determined among the 5 subjects by us ing RAMP, 4.8% (n=25), STEP-1, 3.1% (n=28) and STEP-2, 2.9% (n=29) exercise tests; STEP-2 exercise test values (CV) were lower than the others. There was no significant difference in the means of VO<SUB>2</SUB>max among the 5 subjects according to the RAMP and two STEP exercise tests (Two-way ANOVA) .<BR>2) The best reproducibility value of VO<SUB>2</SUB>GET among the 5 subjects was determined using RAMP exercise tests with the V-slope method (M-2) and evaluations were classified as easy (J-A) . The value (CV) was 2.8%. There was no significant difference in the VO<SUB>2</SUB>GET values (M-1 (J-A, -B), M-2 (J-A, -B) and M-3) (Two-way ANOVA) and their means among the 5 subjects concerning RAMP and two STEP exercise tests (Two-way ANOVA) .<BR>3) The best correlation coefficient (r) value between VO<SUB>2</SUB>max and VO<SUB>2</SUB>GET was obtained using RAMP exercise tests with M-2 (J-A) (r=0.976, n=20) .<BR>The present results indicate that the most useful exercise protocol and method of evaluation for determining VO<SUB>2</SUB>GET is the RAMP exercise test with the V-slope method.
ABSTRACT
A motor performance test was administered to elderly adults in Koganei City and Nangai Village of Japan as the baseline study of Tokyo Metropolitan Institute of Gerontology, Longitudinal Interdisciplinary Study on Aging (TMIG-LISA) . The participants in this study totaled 405 (183 males and 222 females) aged 65 to 84 from Koganei City, and 734 (295 males and 439 females) aged 65 and over from Nangai Village. The test consisted of measurement of grip strength, one-leg stand-ing, walking at preferred and maximum speeds, and finger-tapping. All motor performances examined were higher among males than females, and they all deteriorated with aging. A regional difference was found in terms of motion speed abilities: finger-tapping rate and walking speed were higher among urban residents than rural residents. Individual differences (coefficient of variation) in the motor ability increased with aging, and reached 106% (maximum tapping rate in female) to 290% (maximum walking speed in female) of those in the twenties. Significant correlations between motor abilities were detected indicating that the specificity of the motor ability found in the young may not account for older adults.