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1.
Anadolu Kardiyol Derg ; 13(7): 675-81, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23996802

ABSTRACT

OBJECTIVE: We aimed to analyze the left ventricular (LV) remodeling in patients treated with coronary intervention (PCI) in the acute phase of anterior myocardial infarction (MI) and to analyze the relationship between LV functional remodeling and residual viability in the infarct zone detected by thallium-201 (Tl-201) imaging and echocardiography. METHODS: We designed an observational prospective cohort study including 30 patients (26 men, 4 women, mean age; 52±12 years old) with acute anterior MI. Echocardiography and Tl-201 imaging were performed in all patients three days and two months after PCI and left ventricular end-systolic volume (ESV), left ventricular end-diastolic volume (EDV), ejection fraction (EF) and summed redistribution score (SRS) were calculated. Paired samples t- test or Wilcoxon rank sign test for comparing continuous variables in dependent groups, Pearson correlation for testing relationship between continuous variables were used. RESULTS: Left ventricular function baseline values just after PCI and two months after PCI obtained by echocardiography and scintigraphy were statistically significant. Among patients 76.7% had an EF ≥0.50 after the event. EDV and ESV values are significantly low when compared to values two months before. There was not any marked change in SRS in five patients. Polar maps were correlated with heart rate (r=0.438; p=0.023), peak creatine kinase MB (r=0.440; p=0.015) and troponin (r=0.471; p=0.009) during acute MI. CONCLUSION: Significant recovery in EDV, ESV and SRS values, and increase in EF two months after the infarction shows us substantial part of the remodeling process is completed in two months and Tl-201 imaging is extremely effective in determining of salvaged myocardium.


Subject(s)
Myocardial Infarction/therapy , Ventricular Remodeling , Female , Humans , Male , Middle Aged , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/physiopathology , Percutaneous Coronary Intervention , Prospective Studies , Thallium Radioisotopes , Tomography, Emission-Computed, Single-Photon , Treatment Outcome , Ultrasonography
2.
Anadolu Kardiyol Derg ; 11(3): 218-24, 2011 May.
Article in Turkish | MEDLINE | ID: mdl-21501996

ABSTRACT

OBJECTIVE: Impaired left lung perfusion (LLP) has been described after transcatheter closure of the patent ductus arteriosus (PDA). In this study, we aimed to evaluate lung perfusion scans (LPSs) following occlusion of PDA with two frequently used coils: Cook detachable coil and Gianturco coil. METHODS: A prospective study of 89 patients who underwent PDA occlusion using the Cook coils in 49 and the Gianturco coils in 40, was conducted. LPSs were performed after a median period of 18 months. The relationships between the LPSs and continuous variables were assessed by Pearson correlation analysis and the cut-off value of the best correlated parameters to predict abnormal LPSs obtained by the Receiver Operating Characteristic (ROC) analysis. RESULTS: Decreased left lung perfusion (LLP) was found in 13 patients including 10 after using Cook coils and 3 after using Gianturco coils (p=0.077). LLP values were significantly correlated with the loops deployed at the pulmonary side, coil/ductal diameter ratio and number of coils deployed (p=0.002, p=0.006 and p=0.009, respectively). Number of loops deployed at the pulmonary side >1.4 (specificity 77%, sensitivity 85%, area under the ROC curve 0.804, 95%CI 0.661-0.947, p<0.001) and first coil/ductal diameter ratio >1.85 (specificity 70%, sensitivity 77%, area under the ROC curve 0.747, 95%CI 0.423-0.790, p<0.005) were the best discriminative cut-off values of decreased LLP. CONCLUSION: Impaired LLP may appear following transcatheter closure of PDA with either Cook detachable coils or Gianturco coils. This situation may be complicated with loops deployed at the pulmonary side, the use of relatively large size of coil with respect to the ductal diameter and the use of multiple coils.


Subject(s)
Blood Vessel Prosthesis Implantation/methods , Cardiac Catheterization/instrumentation , Ductus Arteriosus, Patent/therapy , Lung/blood supply , Lung/diagnostic imaging , Adolescent , Adult , Blood Vessel Prosthesis Implantation/instrumentation , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Prospective Studies , ROC Curve , Radionuclide Imaging , Young Adult
3.
Catheter Cardiovasc Interv ; 76(3): 418-24, 2010 Sep 01.
Article in English | MEDLINE | ID: mdl-20839357

ABSTRACT

BACKGROUND: Reduced left lung perfusion has been described after transcatheter closure of the patent ductus arteriosus (PDA) with several prostheses. Although the Amplatzer ductal occluder (ADO) device is currently the most widely used occluder for closure of large-sized PDAs, the potential consequences of flow distribution to the lungs of this device have not been completely clarified. We evaluated lung perfusion following occlusion of PDA with the ADO device. METHODS: Forty-seven patients underwent successful transcatheter PDA occlusion using the ADO device were included in this study. Lung perfusion scans were performed 6 months after the procedure. RESULTS: Decreased perfusion to the left lung (defined as < 40% of total lung flow) was observed in 17 patients (36%), 5 of whom were low-weight symptomatic infants. Ductal ampulla length was significantly shorter and minimal ductal diameter to ampulla diameter ratio was significantly higher in patients with decreased left lung perfusion and correlated well with left lung perfusion values (r = 0.516 and r = -0.501, respectively). A cut-off value of ≤ 5.8 mm for the ductal ampulla length and ≥ 1.9 for ampulla diameter to ampulla length ratio showed high sensitivity and specificity for reduced lung perfusion. CONCLUSIONS: The incidence of abnormal left lung perfusion is high 6 months after transcatheter closure of PDA with the ADO, more likely in the low weight symptomatic infants and in patients with a short duct or a relatively shallow duct having abrupt narrowing of a large ampulla.


Subject(s)
Cardiac Catheterization/instrumentation , Ductus Arteriosus, Patent/therapy , Lung/blood supply , Pulmonary Artery/physiopathology , Pulmonary Circulation , Septal Occluder Device , Adolescent , Albumins , Cardiac Catheterization/adverse effects , Chi-Square Distribution , Child , Child, Preschool , Ductus Arteriosus, Patent/physiopathology , Female , Humans , Infant , Infant, Newborn , Male , Organotechnetium Compounds , Perfusion Imaging , Prospective Studies , Pulmonary Artery/diagnostic imaging , Radiography , Radiopharmaceuticals , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome , Turkey , Ultrasonography, Doppler, Color , Ultrasonography, Doppler, Pulsed
4.
Ann Nucl Med ; 19(6): 523-7, 2005 Sep.
Article in English | MEDLINE | ID: mdl-16248392

ABSTRACT

OBJECTIVE: The mechanisms of dyspnea and exercise intolerance have not been fully elucidated. We aimed to investigate the clearance rate of technetium-99m diethyltriaminepentaaceticacid (Tc-99m DTPA) from lungs in hyperthyroid patients without clinical evidence of lung disease and to explore the interactions between their Tc-99m DTPA radioaerosol lung scintigraphy, spirometric measurements, and the levels of thyroid hormones. METHODS: We studied 19 hyperthyroid patients and 16 sex- and age-matched controls. Thyroid hormone levels were assessed. Spirometric lung function tests, diffusing capacity of the lung for carbon monoxide (DLCO) and the clearance rate of Tc-99m DTPA were performed in all participants. Ratio of DLCO value to the alveolar ventilation (DLCO/VA) and the means of half-time (T1/2) of Tc-99m DTPA clearance rate, which were used to evaluate alveolar-capillary membrane permeability, were calculated. RESULTS: There were no statistical differences between spirometric parameters (VC, FVC, FEV1/FVC, FEF 25-75) of the two groups (p > 0.05). Although the mean FEV1 level was significantly lower in the hyperthyroid patients than the control subjects (p < 0.01), in five patients FEV1 was only less than 80 percent of the predicted value. No significant difference in the means of DLCO, DLCO/VA or T1/2 values of Tc-99m DTPA clearance was observed between the two groups (p > 0.05). In hyperthyroid patients, there was a positive relation between DLCO/VA, DLCO/VA % and T1/2 values of Tc-99m DTPA clearance (p < 0.01, r = 0.732, p < 0.01, r = 0.742, respectively). The lung volumes and the levels of thyroid hormones did not show a significant relationship to T1/2 values of Tc-99m DTPA clearance in hyperthyroid group (p > 0.05). CONCLUSIONS: We conclude that increased thyroid hormones have no effect on permeability of alveolar-capillary membrane in hyperthyroid patients.


Subject(s)
Hyperthyroidism/diagnostic imaging , Hyperthyroidism/metabolism , Lung Diseases/diagnosis , Lung Diseases/metabolism , Respiratory Function Tests , Technetium Tc 99m Pentetate/pharmacokinetics , Administration, Inhalation , Aerosols/pharmacokinetics , Female , Humans , Hyperthyroidism/complications , Lung Diseases/etiology , Male , Metabolic Clearance Rate , Middle Aged , Radionuclide Imaging , Radiopharmaceuticals/administration & dosage , Spirometry , Technetium Tc 99m Pentetate/administration & dosage
5.
Nucl Med Commun ; 25(2): 195-9, 2004 Feb.
Article in English | MEDLINE | ID: mdl-15154711

ABSTRACT

BACKGROUND AND AIM: The angiotensin II type 1 (AT1) receptor antagonist irbesartan is used for the treatment of hypertension, but its anti-ischaemic effect is not yet known. Our aim was to assess the effect of irbesartan administration on the diagnostic yield of 99mTc sestamibi single photon emission computed tomography (SPECT) in patients with coronary artery disease (CAD) after dipyridamole stress. METHODS: Our study group consisted of 13 patients (11 men and two women; mean age, 53.3 +/- 10.6 years; body mass index, 26.9 +/- 3.3 kg x m(-2)) with angiographically documented CAD. All patients underwent SmTc sestamibi SPECT studies at rest, before (STRESS-1) and 2 weeks after irbesartan (150 mg daily) administration (STRESS-2) at dipyridamole stress. The extent and severity of defects were analysed by using visual and quantitative 99mTc sestamibi SPECT. RESULTS: The mean summed stress score was significantly higher during the STRESS-1 study than the STRESS-2 study (13.2 +/- 7.4 vs. 11 +/- 7.4, P=0.003). The mean size of perfusion defects at stress was significantly larger for the STRESS-1 group than the STRESS-2 group (17.8% +/- 2.85% vs. 15.3% +/- 2.95%, P=0.01). CONCLUSION: Our study showed that the AT1 receptor blocker irbesartan reduces the extent and severity of 99mTc sestamibi perfusion defects after dipyridamole stress in patients with CAD. Irbesartan may alter coronary blood flow reserve. The continued use of irbesartan before stress myocardial perfusion SPECT has a masking effect on stress induced myocardial perfusion defects. For this reason AT1 receptor blockers must be stopped before stress myocardial perfusion scintigraphic examinations.


Subject(s)
Antihypertensive Agents/adverse effects , Biphenyl Compounds/adverse effects , Coronary Circulation/drug effects , Dipyridamole , Heart/diagnostic imaging , Stress, Physiological/chemically induced , Stress, Physiological/diagnostic imaging , Tetrazoles/adverse effects , Vasodilator Agents , Adult , Angiotensin II Type 1 Receptor Blockers , Blood Pressure/drug effects , Female , Gated Blood-Pool Imaging , Heart Rate/drug effects , Humans , Irbesartan , Male , Middle Aged , Radiopharmaceuticals , Technetium Tc 99m Sestamibi , Tomography, Emission-Computed, Single-Photon , Ventricular Function, Left
6.
Ann Nucl Med ; 16(1): 19-23, 2002 Feb.
Article in English | MEDLINE | ID: mdl-11922204

ABSTRACT

Renal osteodystrophy (ROD) is a common and serious complication for uremic patients and patients are treated with 1,25-dihydroxyvitamin D3. The bone scanning agent 99mTc-phosphate has also been used to evaluate in ROD but it is not clear that bone scintigraphy has a role in the follow-up of treatment. In this study 99mTc(V)-DMSA scintigraphy was performed in eleven patients [age 40.7 +/- 17.3 (mean +/- SD) yr] with ROD before and after vitamin D3 therapy. Images were obtained after hemodialysis performed following tracer injection to maintain normal blood levels of the radiopharmaceutical and to reduce soft tissue activity. Lumbar vertebra-to-soft tissue uptake ratios (LUR) were quantified with the planar 99mTc(V)-DMSA images. Alkaline phosphatase and parathyroid hormone levels after treatment had significantly decreased compared with pre-therapy. In all patients there was visually decreased uptake in bone structures after treatment. After treatment the mean LUR ratio was significantly lower than those of before treatment (3.59 +/- 2.63 vs. 1.65 +/- 0.62; p = 0.01). LUR values were correlated with pre-therapy alkaline phosphatase and parathyroid hormone. These findings indicate that 99mTc(V)-DMSA scintigraphy is sensitive in evaluating the response of ROD to vitamin D3 therapy.


Subject(s)
Calcitriol/administration & dosage , Chronic Kidney Disease-Mineral and Bone Disorder/diagnostic imaging , Chronic Kidney Disease-Mineral and Bone Disorder/drug therapy , Technetium Tc 99m Dimercaptosuccinic Acid , Adult , Aged , Alkaline Phosphatase/blood , Bone Density , Calcium/blood , Chronic Kidney Disease-Mineral and Bone Disorder/physiopathology , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Male , Middle Aged , Osteomalacia/blood , Osteomalacia/diagnostic imaging , Osteomalacia/drug therapy , Osteoporosis/blood , Osteoporosis/diagnostic imaging , Osteoporosis/drug therapy , Parathyroid Hormone/blood , Phosphates/blood , Radionuclide Imaging , Radiopharmaceuticals , Reproducibility of Results , Sensitivity and Specificity , Treatment Outcome
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