Endothelial Dysfunction; Myocardial Perfusion Abnormalities; Cardiac MRI Perfusion With Vasomotor Stress; Diabetes

Diagnostic and prognostic power of myocardial perfusion imaging in patients with coronary artery disease has been demonstrated with planar imaging which was further improvised with addition of gated SPECT and newer Technetium labeled myocardial perfusion tracers like SestaMIBI, Tetrofosmin. Myocardial perfusion ...

Myocardial involvement is an important prognostic factor in patients with systemic sclerosis, and early diagnosis and staging of the disease have been sought after. Since myocardial damage is characterized by connective tissue disease, including fibrosis and diffuse vascular lesions or microcirculation, nuclear myocardial perfusion ...

AimsDipyridamole stress myocardial contrast echocardiography (MCE) can be used to detect coronary artery disease (CAD). Because it measures myocardial blood flow velocity in addition to measuring myocardial blood volume, we hypothesized that it should have greater prognostic utility compared to single photon ...

Anomalous origin of the left coronary artery from the pulmonary artery (Bland-Garland-White syndrome) may produce myocardial ischemia, infarction, and frequently death in infancy. Some patients, however, develop satisfactory coronary artery collaterals and are relatively asymptomatic into adulthood. Very little is known about their myocardial perfusion ...

Exercise-induced abnormalities during thallium-201 scintigraphy that normalize at rest frequently occur in patients with hypertrophic cardiomyopathy. However, it is not known whether these abnormalities are indicative of myocardial ischemia. Fifty patients with hypertrophic cardiomyopathy underwent exercise {sup 201}Tl scintigraphy ...

The accuracy with which the extent of coronary artery disease can be predicted from stress thallium-201 myocardial images has been assessed in 81 patients with chest pain. Whereas the appearance of the myocaridal images was both a sensitive means of detecting coronary artery disease (images abnormal in 43 of 47 patients with ...

We have recently discovered that if ultrasound transmission is briefly suspended (triggered to just one frame per cardiac cycle) after very small doses of intravenous perfluorocarbon-exposed sonicated dextrose albumin, the myocardial contrast produced is significantly enhanced. The objective of this study was to test whether this technique (termed transient response imaging) ...

Stress and resting myocardial perfusion were assessed in 38 patients who received 96 grafts. Stress perfusion was evaluated with thallium-201 and resting myocardial blood flow distribution with radiolabeled particles. When both stress and rest perfusion were normal, graft patency was 82% (51 of ...

The diagnostic principle of stress echocardiography and cardiac magnetic resonance imaging (CMR) for the diagnosis of coronary artery disease is based on the visualisation of ischaemia-induced wall motion abnormalities. From a logistic point of view, stress echocardiography is the easiest test given that it can be performed at bedside. ...

Basic knowledge of active and passive transport mechanisms for concentrating monovalent cations in myocardial cells led to the investigation of the application of radioisotopes of potassium, thallium, rubidium, and ammonia to the in vivo noninvasive assessment of regional myocardial perfusion and viability utilizing gamma camera or positron emission ...

Thallium-201 exercise myocardial perfusion scintigraphy, a new, non-invasive screening method, serves to visualize stress-induced ischemic regions and scarred tissue. As compared to the exercise electrocardiogram, the method shows higher sensitivity and specificity in detecting coronary artery disease. Moreover, it makes it possible to localize the ...

The biodistribution, dosimetry, and safety of a new myocardial imaging agent, /sup 99m/Tc-hexakis-2-methoxyisobutyl isonitrile (HEXAMIBI), was evaluated in 17 normal volunteers at rest and exercise (Phase I studies). Technetium-99m HEXAMIBI clears rapidly from the blood with good myocardial uptake and favorable myocardial-to-background ...

and myocardial metabolism in patients with syndrome X: response to pacing stress. J Am Coll Cardiol 1991 of Medicine ABNORMAL SUBENDOCARDIAL PERFUSION IN CARDIAC SYNDROME X DETECTED BY CARDIOVASCULAR MAGNETIC Background In cardiac syndrome X (a syndrome characterized by typical angina, abnormal exercise- test ...

BACKGROUND: The aim of this study was to investigate the incidence, reversibility, and severity of LV perfusion abnormalities in patients with isolated myocardial bridges using a gated myocardial perfusion SPECT study (GSPECT). METHODS: A retrospective study involved 42 patients without history of myocardial ...

The efficacy of single injection thallium-201 exercise stress and rest redistribution imaging in the evaluation of myocardial ischemia was compared with stress electrocardiography and coronary arteriography. Thallium-201 imaging was interpreted at two levels of sensitivity in order to define the circumstances under which it best serves ...

Dense cavitary ''photopenia'' was observed on 21 of 200 consecutive stress perfusion scintigrams. A prominent finding in many cases, it sometimes occupied only a portion of the region overlying the ventricular cavity, was often seen in some projections and not others, and was frequently adjacent to myocardial perfusion ...

We performed a multicenter trial of 99mTc-tetrofosmin myocardial SPECT for the assessment of acute thrombolysis, pre and post elective PTCA and myocardial viability in comparison with 201Tl myocardial SPECT. The participants consisted of 212 patients at 44 institutions and the study lasted for 10 months. In assessing acute ...

In order to evaluate the detectability of coronary artery disease (CAD) with positron-emission computed tomography (PET), we performed /sup 13/N-ammonia myocardial PET scanning at rest and with exercise loading in 20 normal subjects and 40 patients with CAD, by means of a high-resolution, multi-slice, whole-body PET scanner. Myocardial PET scanning was ...

Diabetes mellitus is associated with a poor cardiovascular prognosis. Stress myocardial single-photon emission computed tomography (SPECT) reliably detects coronary ischaemia in asymptomatic patients. Our study aimed to evaluate the association between systolic and diastolic left ventricular function, left ventricular hypertrophy, endothelial function and ...

Extensive myocardial bridging in the left anterior descending coronary artery was found in a 46 year old survivor of sudden cardiac near-death. Positron emission tomography and dobutamine stress echocardiography revealed ischaemia in the myocardium distal to the bridging. Spasm was excluded as cause of the ischaemia by intracoronary infusion of ...

Patients who cannot be separated from mechanical ventilation (MV) after an episode of acute respiratory failure often have coexisting coronary artery disease. The authors hypothesized that increased left ventricular (LV) wall stress during periods of spontaneous ventilation (SV) could alter myocardial perfusion in these patients. Using thallium-201 (201TI) ...

We sought to investigate the role of two-dimensional stress echocardiography in the early assessment of myocardial contusion. For this purpose, 12 dogs, weighing 11.36���1.50�kg, were selected and the myocardial contusion was experimentally induced. Two-dimensional dobutamine stress echocardiography (DSE) ...

Background: The diagnostic value of myocardial perfusion scintigraphy in patients with left bundle branch block (LBBB) and previous acute myocardial infarction has not been evaluated.Objective: To determine the utility of single photon emission computed tomography (SPECT) in patients with LBBB and previous acute myocardial ...

Myocardial contrast echocardiography has the potential to accurately detect functionally significant coronary artery disease during pharmacologic stress testing. Different low-mechanical index modalities, including triggering replenishment imaging (TRI) and real-time imaging (RTI), are currently used to identify myocardial perfusion ...

Regional variations in left ventricular contractility and myocardial perfusion are frequent in idiopathic dilated cardiomyopathy and might result from an increase in left ventricular wall stress responsible for regional wall motion abnormalities. The aim of the study was to perform radionuclide studies in patients with idiopathic ...

A method for the evaluation of myocardial perfusion with {sup 201}Tl scintigraphic images is presented. The method is based on making a pixel-by-pixel comparison of the stress and the redistribution images aligned by using bidimensional correlation techniques between the nonpathologic regions of the myocardium. The comparison is made by means of parametric ...

Eight patients with coronary heart disease and exertional angina pectoris successfully completed an 11-15 wk program of endurance exercise conditioning. Angina threshold was determined by upright bicycle ergometer exercise and by atrial pacing. The product of heart rate and arterial systolic blood pressure at the exercise angina threshold was higher after conditioning. suggesting that conditioning ...

Identification of dipyridamole-induced regional wall motion abnormalities by echocardiography has recently been proposed as an alternative diagnostic stress test for coronary artery disease. This study evaluates this new technique by comparing the results obtained (overall, regionally and by abnormality type) with those of thallium-201 ...

Sixty consecutive patients who were symptom free 2-12 months after an uncomplicated acute myocardial infarction underwent maximal treadmill exercise testing, radionuclide angiography before and during submaximal bicycle stress test, and coronary angiography. The results of the non-invasive procedures were compared with those of coronary angiography. The ...

BackgroundMultidetector computed tomography coronary angiography (CTA) is a robust method for the noninvasive diagnosis of coronary artery disease. However, in its current form, CTA is limited in its prediction of myocardial ischemia. The purpose of this study was to test whether adenosine stress computed tomography myocardial ...

There is an enormous amount of literature on psychological stress and cardiovascular disease. This report reviews conceptual issues in defining stress and then explores the ramifications of stress in terms of the effects of acute versus long-term stressors on cardiac functioning. Examples of acute stressor studies are discussed in ...

BACKGROUND:Although positron emission tomography (PET) is routinely performed using vasodilator stress, exercise and dobutamine stress are available alternatives. Evidence suggests that vasodilator PET myocardial perfusion imaging (MPI) has prognostic value, but the prognostic value of treadmill exercise and dobutamine PET MPI is ...

A rare case of benign cardiac fibroma causing a focal defect on Tl-201 imaging in an adult patient is presented. The abnormalities on the Tl-201 scan are correlated with other studies performed on the same patient. The usefulness of the Tl-201 myocardial perfusion scan as an early, noninvasive test in cardiac workup is stressed.

BackgroundAdenosine stress perfusion is very sensitive for detection of coronary artery disease (CAD), and yields good specificity. Standard adenosine cine imaging lacks high sensitivity, but is very specific. Myocardial tagging improves detection of wall motion abnormalities (WMAs). Perfusion and tagging cardiovascular magnetic ...

Myocardial perfusion single-photon emission computed tomography (SPECT) has been extensively applied in the clinical assessment of patients with diabetes mellitus. The aim of the present study was to evaluate stress technetium-99m sestamibi SPECT MPI perfusion in silent myocardial ischemia and its association with some clinical and ...

BACKGROUND: Stress myocardial perfusion imaging (MPI) is an established means of predicting cardiovascular events and is suitable in chronic kidney disease (CKD) patients. We aimed to evaluate the prognostic value of CKD parameters and an abnormal stress MPI for cardiovascular events. METHODS: A total of 495 ...

IntroductionWe have recently described a technique for assessing myocardial perfusion using adenosine-mediated stress imaging (CTP) with dual source computed tomography. SPECT myocardial perfusion imaging (SPECT-MPI) is a widely utilized and extensively validated method for assessing myocardial perfusion. The aim ...

ObjectiveTo describe two cases of Takotsubo like myocardial contractile pattern during exercise stress test secondary to hypertensive response.BackgroundTreadmill exercise testing is known to cause sympathetic stimulation, leading to increased levels of catecholamine, resulting in alteration in vascular tone. Hypertensive response during exercise testing ...

Background Cocaine addiction is associated with either ischaemic or non-ischaemic cardiac complications. The prevalence of myocardial damage in asymptomatic addicts has never been evaluated by cardiovascular magnetic resonance (CMR), which allows non-invasive detection of myocardial oedema and fibrosis. Objective To prospectively evaluate the prevalence of ...

Fifty patients who presented with angina pectoris were studied to examine the disturbances of regional myocardial perfusion during stress. Each patient underwent 16-point precordial mapping of the ECG during an exercise test, and coronary and left ventricular angiography. Regional myocardial perfusion was assessed using an atrial ...

We compared simultaneous dual-radionuclide stress and rest myocardial perfusion imaging (MPI) with a novel solid-state cardiac camera and a conventional SPECT camera with separate stress and rest acquisitions.Methods24 consecutive patients (64.5 � 11.8 years, 16 men) were injected with 74 MBq of ²⁰¹Tl (rest) ...

The efficacy of single injection thallium-201 exercise stress and rest redistribution imaging in the evaluation of myocardiacl ischemia was compared with stress electrocardiography and coronary arteriography. Thallium-201 imaging was interpreted at two levels of sensitivity in order to define the circumstances under which it best serves as a screening ...

Although perfluorocarbon-exposed sonicated dextrose albumin (PESDA) microbubbles produce myocardial contrast after intravenous injection, it is unknown whether their use can accurately identify myocardial blood-flow abnormalities during stress echocardiography. Accordingly, we compared the background-subtracted ...

Patients with type 2 diabetes mellitus (T2DM) might have subclinical myocardial dysfunction identified at rest or unmasked during exercise. We examined the correlates of the myocardial exercise response in patients with T2DM. Myocardial dysfunction was sought during at rest and exercise echocardiography in 167 healthy patients with ...

ABSTRACT: Stress-related cardiomyopathies can be observed in the four following situations: Takotsubo cardiomyopathy or apical ballooning syndrome; acute left ventricular dysfunction associated with subarachnoid hemorrhage; acute left ventricular dysfunction associated with pheochromocytoma and exogenous catecholamine administration; acute left ventricular dysfunction in the ...

Thallium-201 behaves physiologically as a potassium analog, and when injected intravenously accumulates rapidly within the cells of many organs. Uptake of the isotope reflects both regional perfusion and sodium-potassium pump activity. The main clinical application of /sup 201/Tl scintigraphy has been in myocardial imaging. Abnormalities due to ischemia ...

Myocardial contrast echocardiography (MCE) utilizes compressible microbubbles behaving similarly to red blood cells. Destruction of microbubbles and observation of the gradual refill into the myocardium are key to evaluating perfusion using real-time MCE. We aimed to assess the feasibility and diagnostic accuracy of qualitative MCE utilizing a 17-segment model for localization ...

We report on three patients with acute myocardial ischemia syndrome, without significant coronary artery disease, who were admitted within one year in our hospital and presenting an atypical balloon-like, reversible left ventricular apical wall motion abnormality. The reported cases showed the following similarities: 1) elderly women (age >65 years), 2) ...

Cardiac computed tomography and magnetic resonance are relatively new imaging modalities that can exceed the ability of established imaging modalities to detect present pathology or predict patient outcomes. Coronary calcium scoring may be useful in asymptomatic patients at intermediate risk. Computed tomographic coronary angiography is a first-line indication to evaluate congenitally ...

Takotsubo cardiomyopathy is usually described following acute emotional stress. We report here the case of a 48-year-old woman admitted for acute coronary syndrome after an intensive squash match. Diagnosis of Takotsubo cardiomyopathy due to acute physical stress was suspected in presence of normal coronary arteries and transitory left ventricular ...

Dobutamine induced ST-segment elevation in the absence of obstructive coronary artery disease is a rare condition. We report a case of a 37-year-old man, a smoker, who developed severe chest pain associated with transient ST-segment elevation in anterolateral leads and significant segmental wall motion abnormalities during dobutamine stress ...

In man a close interrelationship exists between hyperadrenergic states, myocardial ischemia, necrosis, infarction and sudden cardiac death. Persistent high catecholamine levels may also be associated with increased vascular endothelial turnover and permeability to calcium and lipoproteins, increased blood velocity, abnormal blood flow patterns and atheroma ...

Purrpose: To evaluate myocardial microvascular disease in patients with type 2 diabetes mellitus (DM) using myocardial contrast echocardiography (MCE) and to report on its diagnostic accuracy using single photon emission tomography (SPECT) as reference test. Methods: We prospectively enrolled 79 patients (25 DM; 66�11 years) who underwent simultaneous ...

OBJECTIVE--To compare the ability of dobutamine and exercise stress to induce myocardial ischaemia and perfusion heterogeneity under routine clinical circumstances. DESIGN--86 active patients without previous myocardial infarction were studied by dobutamine and exercise stress protocols and coronary angiography. ...

Fifty French-Canadian patients presenting with typical or atypical anginal pain were studied by selective cinearteriography and coronary sinus catheterization, with measurement of myocardial function, oxygen and lactate extraction at rest and during isoproterenol infusion. In 28 of 42 patients all three coronary arteries were involved, but angina pectoris also occurred in ...

A total of 110 patients suspected with CAD who had symptoms or ECG abnormalities were enrolled in the stress-rest ECG gated SPECT one day protocol using 99mTc-MIBI. All the patients underwent symptom-limited exercise testing and 250 MBq of MIBI was injected at peak exercise. Exercise perfusion SPECT images were reviewed by two trained doctors to classify ...

Within the scope of this review, non-invasive imaging modalities applicable for further work-up of suspected coronary artery disease (CAD) are discussed with regard to methodology, diagnostic accuracy and prognostic value. All of these imaging modalities can be employed in patients with an intermediate pretest probability of disease, if ECG stress testing is either not ...

We developed a novel clinical tool (PERFIT) for automated 3-D voxel-based quantification of myocardial perfusion, validated it with a wide spectrum of angiographically correlated cases, compared it to previous approaches, and tested its agreement with visual expert reading. A multistage, 3-D iterative inter- subject registration of patient images to normal ...

Thallium imaging in conjunction with electrocardiographic stress testing has become a widely utilized method for evaluating the presence and location of coronary artery disease. The literature has emphasized the appearance of the left ventricle with little mention of the right ventricle. This report presents the initial demonstration of abnormal right ...

A 3-week-old male neonate with heart failure associated with Coxsackie virus infection was imaged with Tc-99m PYP and TI-201. The abnormal imaging pattern suggested myocardial infarction. Autopsy findings indicated that the cause was myocardial necrosis secondary to an acute inflammatory process. Causes of abnormal ...

PURPOSE: Vascular stiffness may potentially be used as a screening tool to identify asymptomatic patients with diabetes with abnormal myocardial perfusion. The purpose of this study was therefore to determine the association between vascular stiffness, measured in term of pulse wave velocity (PWV) and augmentation index (AIx), and ...

The role of structural and functional abnormalities of small vessels in diabetes cardiomyopathy remains unclear. Myocardial contrast echocardiography allows the quantification of myocardial blood flow at rest and during dipyridamole infusion. The aim of the study was to determine the myocardial blood flow reserve ...

The clinical usefulness of quantitative analysis of exercise thallium-201 myocardial emission computed tomography (ECT) was evaluated in twenty coronary artery disease patients and 10 normal controls. Longaxial and shortaxial myocardial images of left ventricle were interpreted quantitatively using circumferential profile analysis and two types of ...

Cardiovascular disease, the leading cause of death in patients with type 2 diabetes mellitus (T2DM), is usually preceded by endothelial dysfunction and altered myocardial blood flow (MBF) regulation. Hyperglycemia, oxidative-nitrosative stress, systemic inflammation, and insulin resistance are implicated in the pathogenesis of abnormal ...

The patients with diabetes mellitus and another risk factors have significantly higher risk to suffer from ischemic heart disease. Myocardial stress SPECT represents the examination which correlates very well with the results of selective coronary angiography even in asymptomatic diabetic patients. The aim of our study was to evaluate the relation of SPECT ...

IntroductionRheumatoid arthritis (RA) is a multi-organ inflammatory disorder associated with high cardiovascular morbidity and mortality. We sought to assess cardiac involvement using a comprehensive cardiac magnetic resonance imaging (cMRI) approach and to determine its association with disease characteristics in RA patients without symptomatic cardiac disease.MethodsRA patients with no history ...

In patients with coronary artery disease, radionuclide investigations have documented a high incidence of mental stress-induced myocardial ischemia in the absence of significant electrocardiographic changes and/or angina. To investigate the causes of the low electrocardiographic sensitivity, we recorded body surface maps during mental arithmetic in 22 ...

INTRODUCTION: The discovery of silent myocardial ischemia in a diabetic placed in a logic of secondary prevention. The objectives of this study were to investigate the echocardiographic parameters of type�2 Senegalese diabetics at high cardiovascular risk and identify those that are predictors of silent myocardial ischemia. PATIENTS AND METHODS: We ...

BackgroundMyocardial perfusion imaging (MPI), using single photon emission computed tomography (SPECT) is a validated method for detecting coronary artery disease. Transthoracic Doppler echocardiography (TTDE) of flow at rest and during adenosine provocation has previously been evaluated in selected patient groups. We therefore wanted to compare the diagnostic ability of TTDE ...

Sport related myocardial infarctions are rare. They concern a population mainly male, of more than 35 years, with a high prevalence of smoker. The initial clinical presentation is serious, with frequent ventricular fibrillations, the mode of revelation that can be a sudden death. The angiographic data mainly shows a single vessel disease or no significant lesion. These ...

Probabilistic criteria for abnormality would enhance application of stress-redistribution Tl-201 rotational tomography (tomo) for evaluation of coronary artery disease (CAD). Thus, 91 pts were studied, of whom 45 had angiographic CAD (greater than or equal to 50% coronary narrowing) and 46 were normal (nl). The validity of this model was prospectively ...

BACKGROUND: Myocardial perfusion radionuclide imaging (MPRI) is a noninvasive method extremely useful for evaluating ischemia in patients with coronary disease. However, the idea that this method would not be effective for patients with multivessel coronary disease is still entertained. OBJECTIVE: Assess the value of MPRI with gated-SPECT for tracing pharmacological ...

A total of 42 symptomatic patients with coronary artery disease involving two or three vessels were studied using exercise thallium-201 myocardial scintigraphy. Qualitative analysis of the images predicted multivessel disease in 75% of the patients with two-vessel disease and in 82% of the patients with three-vessel disease. Quantitative analysis of the size of the perfusion ...

Experimental studies in animals have suggested that coronary flow reserve may be limited in patients with left ventricular hypertrophy (LVH). Accordingly, to noninvasively determine the effect of LVH on myocardial perfusion reserve, 25 patients, 9 with LVH and 16 controls, underwent positron imaging with rubidium-82 (82Rb) (30-55 mCi) or nitrogen-13 (13N) ammonia (12-19 mCi) ...

Takotsubo cardiomyopathy (TTC) is characterized by clinical and electrocardiographic features that mimic acute myocardial infarction, normal or mildly elevated cardiac enzymes, distinctive left ventricular wall motion abnormalities, and absence of significant obstructive coronary artery disease. Often there is a history of emotional ...

Climatic warming in Russia presents a real hazard to population health. The authors consider effects of warming on prevalence of a range of infectious and parasitic diseases and stress that nowadays the most sufficient evedence has been obtained for West Nil fever and Crimea fever. Long-term dynamic stationary observations are necessary to obtain sufficient data on other ...

Exercise testing in the magnetic resonance (MR) scanner is difficult because of space restriction and movement artefact, which limit its use in the investigation of patients with suspected coronary artery disease. Pharmacological stress, however, can be used as a substitute for exercise. Therefore, a patient with angina underwent MR ventricular wall motion studies before and ...

Pharmacologic stress imaging has increasingly been employed as an alternative to exercise imaging for detection of coronary artery disease and risk stratification particularly in patients who are unable to perform adequate exercise. Sensitivity and specificity of thallium 201 scintigraphy using intravenous dipyridamole infusion as a stress for coronary ...

Two families are described in which individuals showed widespread myocardial disarray at histological examination, in the absence of macroscopic cardiac hypertrophy. In one family the clinical presentation was that of sudden unexpected cardiac death in four family members; members of the other family presented with electrocardiographic repolarisation changes and ...

Experiments were undertaken using /sup 82/Rb and position tomography to examine the relation between myocardial perfusion and cation uptake during acute ischemia. /sup 82/Rb was repeatedly eluted from a /sup 82/Sr-/sup 82/Rb generator. In six dogs emission tomograms were used to measure the delivered arterial and myocardial concentrations at rest and after ...

The diagnostic value of exercise /sup 201/Tl single photon emission computed tomography (SPECT) for assessing coronary artery disease (CAD) was comparatively evaluated with exercise (13N) ammonia positron emission tomography (PET). Fifty-one patients underwent both stress-delayed SPECT imaging using a rotational gamma camera and stress-rest PET imaging ...

Twenty-four patients with mitral valve prolapse underwent cardiac catheterization, exercise testing, and exercise /sup 201/T1 scintigraphy. Of 10 patients with coronary artery disease, six had abnormal scintigrams. Two of these six had exercise-induced reversible defects, two had defects that persisted during redistribution, and two had both reversible and persistent defects. ...

Researchers present two patients who exhibited striking abnormalities on stress thallium-201 scintigrams, suggesting ventricular aneurysm before documentation of this diagnosis by contrast ventriculography. The features of the scintigrams included: a large perfusion defect overlying the cavity of the left ventricle, the defect extending to the periphery of ...

This study describes an application based on the optical flow algorithm to construct a 2D velocity field plot. The estimated velocity field is used to track the movement of blood in real time. This methodology has been applied to medical images to quantify blood flow turbulence in the right atrium of the heart. Blood intensity fields that are obtained from clinical MRI scan sequences can be ...

... stress. This project evaluates the role of mitochondrial abnormalities in oxidative stress in breast cancer development. An ...

We report three patients in whom dobutamine stress magnetic imaging (DS-MRI) was essential in assessing myocardial ischaemia. Two patients were referred to the cardiologist because of chest pain. Patient A had typical exertional angina and a normal resting electrocardiogram (ECG). Patient B had typical exercise-induced angina and had recently experienced ...

Introduction:Chest pain (CP) patients in the Emergency Department (ED) present a diagnostic dilemma, with a low prevalence of coronary disease but grave consequences with misdiagnosis. A common diagnostic strategy involves ED cardiac monitoring while excluding myocardial necrosis, followed by stress testing. We sought to describe the use of ...

Fifty five patients suffering from blunt chest trauma were studied to assess the diagnosis of myocardial contusion using thallium 201 myocardial scintigraphy. Thirty-eight patients had consistent scintigraphic defects and were considered to have a myocardial contusion. All patients with scintigraphic defects had paroxysmal arrhythmias ...

The value of ultrafast MRI for detection of myocardial perfusion abnormalities in patients with coronary artery disease (CAD) was assessed in 10 patients with stable angina pectoris and angiographically proven one-vessel CAD using double-level short-axis ultrafast MRI with bolus injection of gadolinium-DTPA and tomographic technetium-99m SestaMIBI imaging ...

Myocardial imaging with intravenous thallium-201 (/sup 201/Tl) was performed at rest and following maximal treadmill exercise in 101 patients with suspected coronary artery disease. Results were interpreted from Polaroid scintiphotos by three independent observers with complete interobserver agreement in 79%. Of 25 patients with no or insignificant coronary artery disease ...

OBJECTIVES�To systematically compare the results of dobutamine stress echocardiography in matched groups of hypertensive and normotensive patients with anginal chest pain and normal coronary arteriograms (CPNA).?SETTING�University hospital.?SUBJECTS�33 patients with exertional anginal chest pain, a positive exercise stress ECG, and a completely ...

Patients with mitral valve prolapse (MVP) frequently experience chest pain which may, especially in older subjects and males, be difficult to differentiate from angina pectoris. Electrocardiographic (ECG) changes, ventricular arrhythmias, metabolic abnormalities and rare reports of myocardial infarction and sudden death further suggest the presence of an ...

It is known that insects can cause various clinical effects such as myocardial ischaemia and hypotension from vasospasm and the myocardial toxic effects of the venom and anaphylaxis. Although myocardial ischaemia resulting from centipede sting has been reported once before, myocardial injury has not. In this ...

Dipyridamole cardiac imaging is a useful alternative technique to exercise stress testing in the evaluation of patients with ischemic heart disease. Intravenous dipyridamole is still in the investigational phase, while oral dipyridamole is widely available. The hemodynamic effects of dipyridamole include an increase in coronary blood flow (due to coronary vasodilation) which ...

BACKGROUND: Stress-only myocardial perfusion imaging (MPI) saves time by eliminating rest imaging, which is important for emergency department (ED) throughput but has not been studied in an ED population. Study Objective: To determine the prognosis of a normal stress-only MPI study compared to a normal rest-stress ...

We offer a comprehensive classification of coronary artery anomalies, together with angiographic examples of each entity. Minimal requirements for normality include the following criteria: (1) the dual aortic origin is from right and left coronary ostia; (2) the course of the right coronary artery follows the right atrioventricular groove; (3) the course of the left coronary artery follows the ...

BACKGROUNDWe investigated time dependence and spatial progression of cardiac function and angiogenesis signaling in a porcine model of chronic myocardial ischemia.STUDY DESIGNYorkshire mini-swine (n = 7/group) were subjected to chronic myocardial ischemia by placing an ameroid constrictor on the left circumflex coronary artery under general anesthesia. ...

Objective: To investigate whether persistent ischaemic dysfunction of the myocardium after dynamic stress can be diagnosed from changes in ultrasonic strain rate and strain.Design: Prospective observational study, with age matched controls.Setting: University hospital.Patients and methods: 26 patients (23 men, mean (SD) age 58.9 (8.1) years) with coronary artery disease but no ...

Diabetes mellitus (DM) is a major risk factor for heart failure, independent of coronary artery disease or hypertension (HT). Therefore, our study was designed to examine the mechanisms of DM-induced left ventricular (LV) diastolic dysfunction. In this study, we made five different 10-week treatment groups of Dahl salt-sensitive rats as follows: Control; a low-salt (0.5% NaCl) diet, HT; a ...

Single photon emission computed tomography (SPECT) imaging with 201Tl or 99mTc agent is used to assess the location or the extent of myocardial infarction or ischemia. A method is proposed to decrease the effect of operator variability in the visual or quantitative interpretation of scintigraphic myocardial perfusion studies. To effect this, the patient's ...

Endothelial dysfunction is the earliest abnormality in the development of coronary atherosclerosis. Several coronary risk factors adversely affect endothelial function. Therefore, a finding of endothelial dysfunction may guide interventions for preventing the development of future cardiovascular events. The non-invasive aspects and coronary specificity of measurements of ...

Despite high sensitivity and specificity for overall detection of coronary artery disease (CAD), planar stress-redistribution thallium-201 (Tl-201) scintigraphy remains suboptimal in localizing disease, because of overlap of myocardial segments. Single photon emission computerized tomography (SPECT), by providing three-dimensional representation of ...

Ten patients with previous myocarditis were evaluated to determine cardiac conditions by T1-201 myocardial perfusion imaging and stress radionuclide ventriculography during the follow-up of 18-102 (average 56) months; the results were compared with those from ten sex- and age-matched controls. Exercise capacity by supine bicycle ergometer was reduced in ...

Exercise thallium scanning and stress radionuclide angiography were compared in 16 normal subjects and 42 patients with more than 75% coronary arterial obstruction in studies using upright exercise on a bicycle ergometer. Studies at rest were subsequently obtained. Exercise thallium scans in the control group were normal in 15 and showed a defect in 1. Ejection fraction ...

OBJECTIVES: The presence of angina pectoris and myocardial scarring in patients with hypertrophic cardiomyopathy (HCM) suggests that myocardial ischemia is a factor in the pathophysiology of the disease. The clinical evaluation of ischaemia is problematic in HCM as baseline electrocardiographic abnormalities are frequent and ...

Thirty-eight women with Takayasu arteritis were studied using thallium-201 stress myocardial scintigraphy to assess the prevalence and pathophysiology of the perfusion abnormality. Twenty (53%) had abnormal scintigraphic findings (group A). Abnormal scans were divided into 3 groups: permanent ...

The sensitivity of the commonly used stress tests for the diagnosis of coronary artery disease was analyzed in 46 patients with significant occlusion (greater than or equal to 70% luminal diameter obstruction) of only one major coronary artery and no prior myocardial infarction. In all patients, thallium-201 perfusion imaging (both planar and seven-pinhole ...

An abnormal increase in pulmonary thallium activity may be visualized on post-stress thallium images in patients with coronary artery disease. Because this increased pulmonary thallium activity usually disappears by the time of redistribution imaging, this study was designed to assess whether measurement of the degree of pulmonary thallium washout between ...

Limitation of space and motion artefact make magnetic resonance imaging during dynamic exercise difficult. Pharmacological stress with dipyridamole can be used as an alternative to exercise for thallium scanning. Forty patients with a history of angina and an abnormal exercise electrocardiogram were studied by dipyridamole thallium ...

A 65 year old woman with history of ischaemic heart disease underwent standard adenosine stress test for myocardial perfusion imaging. She sustained inferior myocardial infarction during the final stages of the stress test. She was admitted to the coronary care unit and received thrombolytic treatment. The patient ...

Currently available diagnostic techniques for myocardial contusion following blunt chest trauma were evaluated. We investigated 30 patients prospectively over a period of 1 year for the presence of myocardial contusion. Among the 30 patients, eight were found to have myocardial contusion on the basis of abnormal ...

As a result of raising COHb of patients with coronary artery disease to 8.0%, cardiac output, minute ventilation, and oxygen consumption increased; arterial-coronary sinus oxygen difference decreased, myocardial oxygen consumption decreased, and myocardial lactate and pyruvate consumption decreased. Similar results were found with patients with noncoronary ...

An approach using positron emission tomography (PET) was developed, validated and used to measure myocardial fatty acid metabolism in patients with inherited forms of heart failure. Abnormalities were correlated with the severity of the clinical illness. The approach developed was also shown to identify abnormalities in ...

Background- Patients with human immunodeficiency virus (HIV) infection are at increased risk of accelerated coronary artery disease (CAD) and cardiovascular events. Stress echocardiography (SE) is routinely used for risk stratification and prognosis of patients with known or suspected CAD. The prognostic value of SE in this high-risk group is unknown. The purpose of this study ...

ObjectivesTo assess the accuracy of real?time myocardial contrast perfusion imaging (MCPI) for the diagnosis of restenosis and extent of coronary artery disease (CAD) in patients with previous percutaneous coronary intervention (PCI).Methods56 patients were studied 1.9 (SD 1.4) years after PCI. They underwent MCPI with commercially available ultrasound contrast agents (Optison ...

A case of constritive pericarditis was demonstrated by a positive thallium SPECT stress test for myocardial ischemia. After pericardiectomy, the repeat thallium stress test was normal. The disappearance of the criteria for a positive test suggests that constrictive pericarditis can cause myocardial ischemia, which ...

Stress dipyridamole technetium-99(m) sestamibi single photon emission computed tomographic imaging was used to study myocardial perfusion in 1116 hypertensive patients without known coronary artery disease (CAD). The test confirmed the presence of CAD in 28.9% of patients. As expected, patients with diabetes mellitus (DM) had a significantly higher ...

Takotsubo cardiomyopathy, also known as broken heart syndrome or stress cardiomyopathy, is a very interesting syndrome of acute transient left ventricular dysfunction, usually following significant emotional stress. It was first described in Japan nearly two decades ago and many aspects of its pathogenesis still remain poorly understood. The incidence of ...

Polar map display (PM) is a comprehensive interpretation of the left ventricle. This is a non-rigid registration of the left ventricle originally for the visual and quantitative analysis of tomographic myocardial perfusion scintigrams. In this scheme the maximal-count circumferential profiles of well-defined short- and long-axis planes are plotted to a map showing the ...

... 250 micrograms vial, King Pharmaceuticals Research and Development, Inc., for ... myocardial perfusion imaging tests to detect perfusion abnormalities in patients ...

Sequential first pass radionuclide angiocardiography can be performed in rapid succession using gold-195m because of its low radiation dose and short half-life (30.5 seconds). In 25 patients with known or suspected coronary artery disease, first pass studies with gold-195m were obtained using a computerized multicrystal gamma camera at rest (n . 29), at the end of each 3 minute stage of exercise ...

There is an established link between Left Ventricular (LV) geometry and its performance. As a consequence of ischemic heart disease and the attempt to relieve myocardial tissue stress, ventricle shape begins to distort from a conical to spherical geometry with a reduction in pumping efficiency of the chamber. If untreated, premature heart failure will ...

Impaired left ventricular systolic function secondary to sepsis can occur in up to 20% of patients with septic shock. The electrocardiogram (ECG) and echocardiographic changes it produces can be very similar to those occurring during acute coronary syndromes (ACS). Myocardial contrast echocardiography (MCE) allows assessment of myocardial perfusion. This ...

The objective of this article was to determine whether the presence of left ventricular apical thrombus is a marker of nonviable myocardium. Reduced coronary blood flow secondary to atherosclerosis may result in chronic reversible left ventricular wall-motion abnormalities. Severe regional abnormalities also predispose to formation of left ventricular ...

Cirrhotic cardiomyopathy is a recently recognized condition in cirrhosis consisting of systolic incompetence under condition of stress, diastolic dysfunction related to altered diastolic relaxation, and electrophysiological abnormalities in the absence of any known cardiac disease. It can be diagnosed by using a combination of electrocardiograph, ...

The effects of peripheral cold exposure on myocardial perfusion and function were studied in 13 patients with scleroderma without clinically evident myocardial disease. Ten patients had at least one transient, cold-induced, myocardial perfusion defect visualized by thallium-201 scintigraphy, and 12 had reversible, cold-induced, ...

Phase analysis of radionuclide ventriculograms is used for identifying ischemic wall motion abnormalities. Myocardial segments with an abnormal phase and the synchronicity of LV wall motion can be assessed from a histogram of LV phase distribution. We exa...

OBJECTIVES: This study was designed to determine the prognostic importance of left ventricular (LV) myocardial stiffness, a hemodynamic index which is closely related to B-type natriuretic peptide (BNP) concentration in patients with congestive heart failure (CHF). BACKGROUND: While elevated BNP, an abnormality of cardiac neurohormones, is known to be an ...

The identification of ischemic and hibernating myocardium facilitates the selection of patients most likely to benefit from revascularization. This study examined the feasibility of metabolic imaging, using post-exercise F-18 deoxyglucose positron emission tomography (FDG-PET) for the diagnosis of both ischemia and hibernation in 27 patients with known coronary anatomy. Normal post-exercise FDG ...

We explored whether dietary-induced obesity hastens the transition from concentric left ventricular (LV) hypertrophy to pump dysfunction in spontaneously hypertensive rats (SHRs) and the mechanisms thereof. After feeding rats a diet for 4 to 5 months, obesity was induced in SHRs and Wistar-Kyoto (WKY) control rats. Obesity was not associated with abnormal blood glucose control ...

As a direct result of the rapid technical progress which has been realized regarding hardware and software, cardiovascular magnetic resonance imaging (CMR) is increasingly established as an important method in the diagnosis of cardiovascular disease. Numerous clinical and experimental studies have demonstrated the equality or even superiority of CMR compared to other imaging modalities such as ...

Thallium-201 exercise myocardial perfusion scintigraphy was accomplished in 130 aircrew members prior to their undergoing coronary angiography. Most were undergoing cardiac catheterization for an abnormal exercise response to treadmill testing. Of these, 22 men had arteriographic evidence of obstructive coronary disease of at least 50% narrowing in a ...

A protocol for dipyridamole exercise stress testing with myocardial thallium scintigraphy has been used successfully for the evaluation of exercise or walking-impaired patients.

Myocardial performance was studied in awake dogs to evaluate the effect of beta adrenergic blockade on increases in cardiac output and contractility previously reported during thermal stress. Four dogs with implanted aortic root flow probes and left ventr...

We developed a parametric washout image which color codes regional washout, and blindly compared enhanced perfusion images in multiple projections with regional washout graphs and images in 25 patients. Washout images permitted true spatial and anatomic assessment of regions viewed en face as well as those seen in tangent, making possible the exclusion of non-coronary irregularities and permitting ...

BackgroundBlood viscosity is fundamentally important in clinical practice yet the apparent viscosity at very low shear rates is not well understood. Various conditions such as blunt trauma may lead to the appearance of zones inside the vessel where shear stress equals zero. The aim of this research was to determine the blood viscosity and quantitative aspects of rouleau ...

When coronary artery disease is extensive and of relatively uniform severity, regional myocardial hypoperfusion may be balanced during stress, precluding development of spatially relative perfusion defects. Assessment of the washout of thallium-201 from myocardial regions may provide diagnostic assistance in these cases because washout ...

To clarify the relationship between angiographic and hemodynamic stenosis severity and the appearance during stress-redistribution myocardial T1-201 scintigraphy (Ex-T1) of a visual (V) or quantitative (Q) perfusion defect (PD) or washout (WO) abnormality, 24 pts with CAD underwent intracoronary pressure gradient study at bypass ...

Aim of this study was to assess the behaviour of left ventricular volumes during dobutamine echocardiography in patients with coronary artery disease (CAD) compared to subjects with normal coronary angiograms. We have measured the end-diastolic and end-systolic volumes and a non invasive index of myocardial contractility (the ratio between systolic blood pressure and ...

Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in ...

A young woman with hypertrophic cardiomyopathy confirmed by echocardiography and cardiac catheterization presented with chest pain and features of a large left ventricular aneurysm. The initial diagnosis was myocardial ischemia with either an evolving or an ancient myocardial infarction. Subsequently, verapamil therapy was associated with complete ...

Myocardial bridging is a common congenital abnormality of a coronary artery, and is usually thought to be a benign anatomical variant. Although rare, previous studies have reported that patients with myocardial bridging may suffer from myocardial ischemia, myocardial infarction (MI), ...

We evaluated 39 patients >45 years old with paroxysmal supraventricular tachycardia (SVT), 21 of whom had ST-segment depression during SVT. Treadmill exercise testing, including thallium stress scintigraphy, was performed in all patients and coronary angiography in 21 patients with ST-segment depression. Based on the presence of abnormal findings on ...

Total body Tc-99m pyrophosphate scintigraphy was performed on 11 ''ultramarathon'' runners to assess the ability of nuclear medicine techniques to evaluate skeletal-muscle injury due to exercise. We found increased muscle radionuclide concentration in 90% of the runners. The pattern of muscle uptake correlated with the regions of maximum pain. The detection of ...

Six patients with angina pectoris had reversible perfusion defects on stress and redistribution thallium imaging. Three patients had a positive electrocardiographic response to exercise. No significant coronary artery lesions were seen on coronary arteriography in any of the six patients. All had mild to moderate hypoxemia at rest and physiologic evidence of chronic ...

Beta-blocker therapy is used to decrease myocardial ischemia during exercise but may cause suboptimal diagnostic performance in exercise stress testing. The aim of the present study was to compare results of quantitative technetium-99-sestamibi single photon emission tomography (SPECT), following exercise stress test or pharmacological ...

This study evaluated the gender related long-term prognostic value of adenosine perfusion and dobutamine wall motion imaging as assessed during a combined single-session stress cardiac magnetic resonance (CMR) examination. In 717 patients a combined CMR stress examination was performed. Inducible perfusion deficits and wall motion ...

A 26-year-old man received extensive cardiac radiation in the course of treatment of mediastinal Hodgkin's disease, and six years later, he experienced an acute myocardial infarction. Angiographic studies demonstrated extensive atherosclerotic abnormalities in the coronary arterial system. It is suggested that radiation-induced injury was a ...

Patients Being Assessed With Nuclear Stress Testing of the Heart Using the Stress Agent Regadenoson (Lexiscan �).

Twenty patients with disturbances in impulse formation or conduction have been studied by means of His-bundle recordings. The patients with and without acute myocardial infarction were studied at rest and during atrial pacing before and after intravenous ...

Myocardial infarction is uncommon in persons with hyperthyroidism and also uncommon in the absence of demonstrable coronary artery disease. Cardiac catheterization and selective coronary angiography were performed in two men following apparent myocardial infarctions. Both patients were 33 years of age, thyrotoxic and angiographically free of coronary ...

an entire cardiac cycle, and characterize normal as well as detect abnormal myocardial function tracked over the entire cardiac cycle, which correctly determined the region of interest (ROI) for better, such as an infarction. Index Terms-- Contour, Elastography, Left ventricle, Myocardial strain, Tracking 1. INTRODUCTION

Fasting serum lipids and lipoprotein patterns were studied in 44 female survivors of acute myocardial infarction under the age of 45 years, and in 84 matched control subjects. Type II hyperlipoproteinaemia was present in 41 per cent of the myocardial infarction patients and in none of the controls. There was, however, no difference in the prevalence of the ...

BackgroundThe anthracycline doxorubicin (DOX) is an effective chemotherapeutic agent used to treat pediatric cancers, but is associated with cardiotoxicity which can manifest many years after the initial exposure. To date, very little is known about the mechanism of this late onset cardiotoxicity.Methods and ResultsTo understand this problem, we developed a pediatric model of late onset ...

Application of transaxial emission tomography (SPECT) to T1-201 myocardial perfusion imaging has reduced the difficulties inherent in planar imaging. However, SPECT reconstruction along the body axis still poses problems in orientation and interpretation of tangential slices. An alternate technique with SPECT reconstruction orthogonal to the long axis of the heart should allow ...

The ability of quantitative thallium-201 scintigraphy to predict the extent and location of coronary artery disease before hospital discharge after acute myocardial infarction was evaluated in 52 patients. All patients underwent coronary angiography and serial thallium-201 imaging either at rest (10 patients) or after submaximal exercise stress (42 ...

To assess plasma norepinephrine (NE) and epinephrine (E) concentrations at onset of exercise induced myocardial ischemia the authors studied 10 male patients (PTS), age = 56 +/- 8, with angiographically proven coronary disease during multistage supine bicycle exercise (BEX). All drugs were stopped 7 days before study. Data were obtained at rest and each BEX stage. End points ...

Despite enhanced quality of PET myocardial PERFUSION IMAGING (MPl), the images may be difficult to interpret. The purpose of this study was to develop and test new software for objective, quantitative analysis of PET Rb-82 MPl. Patients (Pts) received 40-80 mCi Rb-82 depending on body size. The new software compared each pixel with the normal file in terms of standard ...

Visual interpretation of stress-redistribution thallium-201 (/sup 201/Tl) scintigrams is subject to observer variability and is suboptimal for evaluation of extent of coronary artery disease (CAD). An objective, computerized technique has been developed that quantitatively expresses the relative space-time myocardial distribution of /sup 201/Tl. ...

Myocardial ischemia provoked in the laboratory during mental stress (MSI) in patients with stable coronary artery disease (CAD) predicts subsequent clinical events. The pathophysiology of MSI differs from that of exercise ischemia, and the mechanisms tying MSI to poor prognosis are not known. C-reactive protein (CRP) is a risk marker for cardiovascular ...