Comparison of gated blood pool ventriculography with echocardiography and contrast ventriculography for left ventricular ejection fraction determination in post myocardial infarction patients

Obective: We compared the efficacy of gated blood pool [GBP] ventriculography with echocardiography and contrast ventriculography for measurement of left ventricular ejection fraction [LVEF] in patients with myocardial infarction. Gated blood pool ventriculography [invivo technique] and echocardiography were performed in 30 patients at least after 24 hours but within 48 hours of contrast ventriculography. Echocardiographic methods included: [1] Subjective [visual] estimation of LVEF from 2 dimensional [2D] echocardiography. [2] 2D directed M-mode [Cubed method] echocardiography. Single plane cine ventriculographic ejection fractions were calculated using Dot calibration method. The comparison of GBP ventriculographic LVEF with contrast ventriculographic LVEF and 2D echo estimated LVEF revealed no significant difference in their mean ejection fraction [44.04 +/- 11.93 vs 48.46 +/- 12.78% p = NS] and [44.04 +/- 11.93 vs 47.38 +/- 13.06%, p= NS] respectively, while comparison of GBP LVEF with 2D directed M-mode [cubed method] echocardiography revealed highly significant difference in their mean EF [44.04 +/- 11.93 vs 61.7 +/- 15.65%, p < 0.01]. GBP LVEF has statistically significant correlation with contrast ventriculographic [r = 0.86] and 2D echo estimated [r = 0.77] LVEF, while has poor correlation [r = 0.57] with cubed formula from 2D echo. GBP ventriculography can be utilized accurately for determination of ejection fraction in post myocardial infarction patients for diagnostic and prognostic evaluation

Comparison of myocardial perfusion imaging studies with technetium 99' tetrofosmin and coronary angiography findings in non-diabetic and diabetic patients of ischemic heart disease

The main objective of this study was to compare the results of myocardial perfusion imaging studies with Tc99' tetrofosmin and coronary angiography finding in non-diabetic and diabetic patients of ischemic heart disease. This study compared the results of Single Photon Emission Computed Tomographic [SPECT] imaging with technetium-99m tetrofosmin with those of coronary angiography findings in non-diabetic and diabetic patients of ischemic heart disease. Total 35 patients were included in this study and divided in to two groups, the diabetic group and non-diabetic group. Out of 35 patients 18 were were non-diabetics and 17 were diabetics. All the patients underwent stress/rest imaging with technetium tetrofosmin and coronary angiopgraphy. SPECT images were divided in to five segments per patients and >= 70% occlusion of coronary artery were considered to be significant. In comparison with nondiabetic from diabetics, the diabetics have significant number of reversible ischemia in anterior wall [p=0.023] although the angiography findings showed no significant difference in the severity of disease in left anterior descending coronary artery that is the main coronary artery to supply the anterior wall. This shows that due to diffuse disease in diabetics the severity of disease could not be assessed correctly by coronary angiography because due to diffuse nature of disease there is a lack of normal lumen for comparison. Therefore in diabetics myocardial perfusion imaging is more informative as compared to non-diabetics

Left ventricular ejection fraction [LVEF] determination in post myocardial infarction patients. A comparison of gated blood pool [GBP] ventriculography and contrast ventriculography

To compare the efficacy of gated blood pool versus contrast ventriculography [Gold standard] for determination of ejection fraction in post myocardial infarction patients. Patients and Gated blood pool imaging [BPI] was performed by gated blood pool radionuclide ventriculography or MUGA in 30 patients within 48 hours after single plane [RAO-30] contrast ventriculography. Statistical analysis was done by student "t-test" [unpaired] and by Pearson's correlation co-efficient. Result: There was no significance difference in their mean ejection fraction [44.04 +/- 11.93 Vs 48.46 ' 12.78%, P = NS] and has statistically significant correlation [r=0.86, P=0.171] GBP ventriculography can therefore be utilized accurately for determination of ejection fraction for prognostic and diagnostic evaluation of post myocardial infarction patients

Correlation of technetium 99 M tetrofosmin perfusion imaging with coronary angiography in patients with known or suspected coronary artery disease

This study correlated the results of Single Photon Emission Computed Tomographic [SPECT] imaging with technetium-99m tetrofosmin with those of coronary angiography in patients with known or suspected coronary artery disease. Total 65 patients were included in this study and divided in to two groups, the study group and the control group. 35 patients included in study group and 30 patients in control group. All the patients underwent stress/ rest imaging with technetium tetrofosmin and coronary angiography. SPECT images were divided in to five segments per patient and > 70% occlusion of coronary arteries were considered to be significant. 95 perfusion defects were noted and 70 coronary arteries were involved in diseased process. Left anterior descending artery [LAD] was involved in 70% of cases and right coronary artery [RCA] in 66%. In Tc. Tetrofosmin study the fixed defect was more common in left ventricular apex and reversible ischemia and mixed defect in inferior wall. Regarding sensitivity RCA 87%, LAD 85% and circumflex 70% and specificity 93% in circumflex, 83% in RCA and 75% in LAD and the p-value is <0.01