Asymmetric dimethylarginine is not a good predictor of ischemia using myocardial perfusion scintigraphy.

BACKGROUND/AIM: Asymmetric dimethylarginine (ADMA) plays role in the pathogenesis of coronary artery disease and related mortality and morbidity through a number of mechanisms. We hypothesized that plasma ADMA levels would be increased in the presence of reversible ischemia as measured by GATED single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy (MPS). MATERIALS AND METHODS: Fasting i.v. blood samples were drawn before testing. All patients underwent 99mTc-sestamibi GATED SPECT MPS with a one-day stress-rest protocol; the images were visually analyzed. Post-stress GATED parameters, including ejection fraction, end systolic and end diastolic volumes, and automatic stress defect scores, were recorded. RESULTS: The plasma ADMA levels were higher in the ischemic group than in the non-ischemic group (0.46 ± 0.19 vs. 0.40 ± 0.15; P = 0.016). Plasma ADMA levels (odds ratio [OR] = 13.5; 95% confidence interval [CI] = 1.7-109.01; P = 0.015) and sex (OR = 2.49, 95% CI = 1.18-5.26; P = 0.017) were independent predictors of ischemia. There was no linear correlation between plasma ADMA levels and both the GATED SPECT and stress test parameters. CONCLUSION: Our data support the hypothesis that increased baseline ADMA levels are independently related with the presence of reversible ischemia.

The Scintigraphic Findings of Gastroesophageal Reflux in Children is Related to Body Weight?

BACKGROUND: Gastroesophageal reflux disease (GERD) is the most common cause of children admissions to pediatric gastroenterology unit and affects about 30% of pediatric population. Body weight and height percentiles of children with GERD and their relationship between presence and the severity of reflux on scintigraphic images were studied. METHODS: Patients who underwent reflux scintigraphy between 2005 - 2012 were retrospectively reviewed. Among 200 patients, 49 patients were involved that their ages were ranging from 0 to 18 years old and body weight and height percentiles were recorded. Accurately 37 MBq (1 mCi) 99mTc-MAA in 100 - 150 mL of milk was ingested by the patient. Presence, number, duration and level of reflux were evaluated on the dynamic images. Presences of reflux within last ten minute were also recorded. Region-of-interests were drawn on esophagus and stomach and reflux ratio (RR) was calculated. RESULTS: The ratio of the presence of reflux which occurred within the last ten minutes was significantly higher in children with low body weight percentile. High-level reflux frequency was higher in these children than in normal's. Presence of reflux which occurred within the last ten minutes was related with low body weight percentile. CONCLUSIONS: If reflux is shown within the last ten minutes and there is high level of reflux, the clinician should be warned about possible low body weight percentile in the future and scintigraphic study should be a guide or a reference for the assessment of more effective treatment methods.

Resistin predicts ischemia in myocardial perfusion scintigraphy.

UNLABELLED: Aim: Resistin plays a role in the pathogenesis of coronary artery disease and is related to mortality and morbidity through a number of mechanisms. We hypothesize that plasma resistin levels are increased in the presence of ischemia, as measured by GATED single- photon emission computed tomography myocardial perfusion scintigraphy (SPECT MPS), in comparison with nonischemic subjects. MATERIALS AND METHODS: Fasting intravenous blood samples of patients were drawn before a stress test. An ELISA kit was used for the assays. All patients underwent a technetium 99m-sestamibi GATED SPECT MPS study with a 1-day stress-rest protocol. Images were analyzed visually and patients were assessed as ischemic or nonischemic. Resistin levels were presented as medians (25th-75th percentiles) and were compared using the Mann-Whitney U test. RESULTS: Plasma resistin levels were higher in the ischemic group (n = 47) than in the nonischemic group (n = 67) [9.04 pmol/L (6.27-11.8 µmol/L) vs. 3.56 µmol/L (0.39-7.93 pnol/L), respectively; P < 0.001). We showed that plasma resistin levels (OR = 1.26, 95% CI: 1.13-1.41; P < 0.001) and METs (OR = 0.82, 95% CI: 0.70-0.92; P = 0.021) were independent predictors ofischemia. No linear correlation was found between plasma resistin levels and GATED SPECT or stress test parameters. CONCLUSION: Increased baseline resistin levels are independently related to presence of ischemia but are not related to the extent or severity of ischemia, or other functional parameters such as poststress ejection fraction, end systolic, and end diastolic volumes.