Résumé
Abstracts: Cardiovascular manifestations of Rheumatoid arthritis have never been studied before therefore this study was designed to evaluate cardiac disease in patients suffering from rheumatoid arthritis
Methodology: Fifty patients of Rheumatoid Arthritis presenting in Out Patient, Emergency and Rheumatology Clinic of Mayo Hospital Lahore from March 1998 till January 1999 were studied. All of them full filled the criteria for the diagnosis of Rheumatoid Arthritis as described by the American Rheumatism Association. After history and physical examination, a clinical assessment of the patient was made of whether he / she had Cardiac Manifestations of Rheumatoid Arthritis or not
Results: Out of 50 patients seen 35 were female, and 15 were male. Giving a female to male ratio of 2.3 to 1. Maximum number of patients seen were between 26 45 years i.e 31[62%] In which 19 [38%] were between 26 to 35 years and 12 [24%] were between 36-45 years. Next most frequent group was of 8 [16%] patients, between 15-25 years of age. Short systolic murmurs were heard in four patients. One patient showed pulsus paradoxus while in the rest no rhythm irregularity was felt. Myocarditis or Coronary Rheumatoid disease was not noticed in any patient. No heart block of any degree was seen. In 4 E.C.G's low voltage was demonstrated in the limb leads. Out of 50 Patients only 3 had pericardial effusion. In one patient it was only a thin rim more prominent posteriorly than anteriorly
Conclusion: Cardiac manifestations of Rheumatoid Arthritis also occur in Pakistani Population, although not with the same frequency as in the Western world. It is also concluded that in Pakistani population, like in the West, the most common Cardiac complication is Pericardial Effusion
Résumé
Background: To compare Cedars-Sinai QGS and Michigan University Corridor4DM algorithms for determination peak filling rate [PFR], time to peak filling rate [TPFR] and mean filling rate in first third of diastole [MFR3] using 16 frames gated myocardial perfusion single photon emission computed tomography [SPECT]. To determine inter-observer reproducibility of Cedars QGS and Michigan University Corridor4DM for determination PFR, TPFR and MFR3 using 16 frames gated myocardial perfusion SPECT
Methods: Forty patients [28 males and 12 females] with age range 35-70 years [mean 58.85+/-8.82] referred for assessment of left ventricular perfusion and function were included in the study. All patients were injected 1100 Mega Becquerel [MBq] of freshly prepared [99m]Tc Sestamibi. One hour later, patients underwent gated myocardial perfusion SPECT on Siemens ecam dual head variable angle gamma camera using 16 frames per cardiac cycle. Data were reconstructed using filter back projection and re-orientated to generate short axis slices. Short axis slices were processed with QGS and Corridor 4DM for assessment of PFR, TPFR and MFR3 by two observers. Data from both observers were compared to determine inter-observer reproducibility of both methods. Observeri PFR, TPFR and MFR3 values derived from QGS and Corridor4DM were compared and correlated
Results: Peak filling rate values determined with Cedars QGS program were not significantly different from those determined with Corridor4DM [p= 0.564]. Good correlation was found between QGS and 4DM measured PFR values [R[2]=0.6698]. TPFR values determined with QGS program were not significantly different from those determined with Corridor 4DM program [p= 0.615]. However, there was poor correlation between these two methods with R[2] value =0.0382. MFR3 values determined with QGS were not statistically different from those derived from 4DM [p=0.587]. However, there was poor correlation between these values R[2]= 0.0174. Cedars QGS algorithm was highly reproducible for determination of PFR, TPFR and MFR/3 with R2 values of 0.9922, 0.9874 and 0.9932 respectively. PFR, TPFR and MFR3 derived from Corridor4DM were also highly reproducible with R[2] values of 0.7775,0.8381 and 0.456 respectively
Conclusions: Both Cedars QGS and Michigan University Corridor 4DM programs are robust for determination of PFR, TPFR and MFR3 diastolic function parameters. There is good correlation between QGS and 4DM derived PFR measurements. However, there is poor correlation between QGS and 4DM derived TPFR and MFR3 values