[Radionuclide diagnosis of right ventricular myocardial infarction]. / Radionuklidnaia diagnostika infarkta miokarda pravovo zheludochka.

The diagnostic capacities of 99mTc-pyrophosphate plane myocardial scintigraphy versus 99mTc-pyrophosphate single photon emission computed tomography (SPECT) were compared. Recording right precordial ECG leads showed that 26 patients had right ventricular myocardial infarction (MI)-typical changes as ST-segment evaluation, followed by abnormal Q wave. Plane scintigraphy indicated a characteristic inclusion of 99mTc-pyrophosphate into the right ventricular myocardium in 18.8% of the patients with acute lower MI and in one of 38 patients with acute MI of the anterior left ventricular wall. SPECT revealed a characteristic inclusion of 99mTc-pyrophosphate into the right ventricular myocardium much more frequently than did plane myocardial scintigraphy--in 34% of cases. Right ventricular myocardial inclusion of 99mTc-pyrophosphate was found in 50% of the patients with acute lower MI, including all 9 patients with positive 99mTc-pyrophosphate myocardial scintigraphy. Thus, the sensitivity of SPECT in the diagnosis of right ventricular MI is somewhat higher than that of precordial ECG and more than thrice higher than that of plane scintigraphy.

[Evaluation of the overall contractile function of the right ventricle using two-dimensional echocardiography in patients with myocardial infarction]. / Otsenka obshchei sokratitel'noi funktsii pravogo zheludochka s pomoshch'iu dvukhmernoi ékhokardiografii u bol'nykh infarktom miokarda.

The paper presents two methods for calculating the contractile function of the right ventricle (RV): (1) three-plane one with the use of short- and long-axis-cut RV; (2) single-plane one which was modified to the use of long-axis RV images in the projection of 4 chambers. A total of 56 patients with first acute gross myocardial infarction were studied. A control group included 14 healthy subjects aged 25-60 years. The proposed three-plane method for estimating the volume parameters and ejection fraction of the right ventricle was shown to correlate with contrast ventriculography significantly. A high correlation was found between the stroke output of RV (as calculated for the left ventricle by the Chapman method) and that (by the three-plane method). The RV volume values in patients with anterior or inferior myocardial infarction suggest that there is a trend to suppress RV function in the patients, but it is more specific for those with inferior myocardial infarction.

[Modern methods for the instrumental diagnosis of intracavitary thrombosis of the left ventricle in myocardial infarct]. / Sovremennye metody instrumental'noi diagnostiki vnutripolostnogo tromboza levogo zheludochka pri infarkte miokarda.

To study the sensitivity and specificity of two-dimensional echocardiography in the diagnosis of left ventricle thrombosis which often attends myocardial infarction and to define diagnostic potentialities of the new research methods (digital subtraction ventriculography and MR tomography), 449 patients with acute transmural myocardial infarction were examined. Based on the comparison of the echocardiographic readings and morbid anatomy data it has been shown that the sensitivity of two-dimensional echocardiography in revealing left ventricle thrombosis amounts to 89%, specificity to 88%. Digital subtraction ventriculography has a lower (77%) sensitivity, with the specificity being satisfactory enough (88%). Meanwhile MR tomography enables a highly precise diagnosis of left ventricle thrombosis and can be used as a supplementary diagnostic method in questionable cases and in thrombi small in size or in unsatisfactory ultrasonic visualization of the heart structures.