ABSTRACT
To determine the value of gated equilibrium angiography in secundum atrial septal defect (ASD) in children, the first pass pulmonic/systemic flow ratio (Qp/Qs) was compared with diastolic count ratio (DCR) and stroke count ratio (SCR) of the two ventricles. In 50 children we have found a correlation between Qp/Qs and DCR (r = 0.71) and between Qp/Qs and SCR (r = 0.66). For detection of significant atrial shunt (QP/Qs greater than 1.5) the sensitivity of DCR greater than 2 was 0.81 and the specificity 0.75. For SCR greater than 1.5 we sensitivity and specificity values of 0.87 and 0.71 respectively. Left and right ventricular ejection fractions were normal (0.67 +/- 0.08 and 0.50 +/- 0.07).
Subject(s)
Heart Septal Defects, Atrial/diagnostic imaging , Radionuclide Angiography , Adolescent , Adult , Child , Child, Preschool , Humans , Infant , Stroke VolumeABSTRACT
Radio-nuclide angiography after surgical correction of tetralogy of Fallot (TOF) allows measurement of the ejection fraction, especially of the right ventricle, under basal conditions and on effort, parameters which are difficult to measure by other non-invasive methods. Twenty-two children with a mean age of 12.6 +/- 6.9 years who had undergone complete correction of TOF at a mean age of 6.7 +/- 3.8 years underwent Technetium 99m blood pool studies at equilibrium. The results were compared with those of a control group of children with a mean age of 10.2 +/- 3.3 years. No first passage studies were performed because the frequency of postoperative pulmonary regurgitation does not allow quantification of the shunt due to a possible residual ventricular septal defect. No significant difference was found between the patients and control subjects at rest: LV ejection fraction (66.7 +/- 11 p. 100 vs 63 +/- 7.7 p. 100), RV ejection fraction (50.3 +/- 7.2 p. 100 vs 54 +/- 14.8 p. 100). The response to effort of the right and left ventricles depends on the type of exercise. The LV ejection fraction increased normally whilst the RV ejection fraction showed a lot of individual variation. Equilibrium radionuclide angiography was also used to calculate the ratio of right to left end diastolic ventricular volumes. This ratio indicates the degree of RV diastolic overload when LV diastolic volumes are normal, which was the case in our series. The study group showed a significant increase in this ratio compared to control subjects (1.94 +/- 0.65 vs 1.2 +/- 0.23). Exercise radionuclide imagery should provide more accurate assessments of the surgical results and prognosis of these children providing standardised protocols are used. These investigations are best performed in patients over 15 years old, so as to avoid the technical difficulties related to small size. Resting studies are possible at all ages.
Subject(s)
Heart Ventricles/physiopathology , Tetralogy of Fallot/diagnostic imaging , Adolescent , Adult , Child , Child, Preschool , Female , Heart/diagnostic imaging , Heart Function Tests/methods , Humans , Male , Physical Exertion , Postoperative Period , Radioisotopes , Radionuclide Imaging , Stroke Volume , Tetralogy of Fallot/surgery , ThalliumABSTRACT
Vascular reactivity to cold has been studied on 22 patients by means of digital dynamic thermography. Using an interface the thermographic images are digitized in real time and stocked in the computer. After the cooling (two minutes in water at 10 degrees C) the warming-up is followed by sequential thermographic images. Profiles of thermic evolution are represented for 12 regions of interest (at the level of each finger and two for the back of the hands). Four types of thermic profiles are observed: Type 0: all fingers and back of hands have the same basal temperature. After cooling the warming-up is immediate, synchronic for all fingers and goes on more or less rapidly. Type I: at the basal state all fingers have identical temperature. After cooling, the warming-up starts after a latency period of several minutes, which is identical for all fingers. After it the warming-up is fast and synchronic with a thermic "overshot" phenomenon at the end of the examination. Only the thumbs are warmed-up without a latency period. Type II: a latency period similar that of type I is observed but the following warming-up takes place with variable speeds for each considered finger. Type III: at the basal state the fingers are colder than the back of the hand. Spontaneously, some fingers are warmed only by the influence of the hand vertical position. After cooling, the warming-up takes place with variable speeds and after variable latency periods which are a characteristic of each finger.(ABSTRACT TRUNCATED AT 250 WORDS)
