Our data show that the addition of limited exercise to dipyridamole results in benefits during Tc-99m sestamibi imaging, increasing heart-to-liver activity ratio, preventing vasodilator-induced hypotension, and improving ECG sensitivity for the detection of ischemia. Furthermore, this protocol also provides an estimation of the patient's physical capacity and could be used as an alternative for patients undergoing dipyridamole infusion who are not completely unable to exercise.
Performing a second and a third cycle in RNC yielded an additional VUR diagnosis of 35.7%, as compared to performing only 1 cycle. The second cycle showed efficacy in all the groups, whereas the third cycle diagnosed more VUR only in group A. These results confirmed the importance of performing additional cycles in RNC for VUR diagnosis, both in children and adults.
Con lito de interesses:Não Contribuição dos autores: CAB coleta, tabulação, delineamento do estudo e elaboração e redação do manuscrito. AIJ orientação do projeto, delineamento do estudo e elaboração do manuscrito. RJRF orientação do projeto, delineamento do estudo e elaboração do manuscrito. Contato para correspondência: Cristiano Augusto Batista E-mail: batista.cristianoaugusto@gmail.
Abstract
Introduction:The assessment of myocardial viability in patients presenting coronary artery disease (CAD) and associated ventricular dysfunction is an important tool for selecting patients with ischemic cardiomyopathy who may benefit from myocardial revascularization. Case review: This is a hypertensive patient in regular use of medications and in follow-up at outpatient since 2011. He had an ischemic coronary event in 2013. Cardiac catheterization showed coronary lesions in the left anterior descending artery (LAD) and right coronary artery (RCA), which were treated with stents. The patient began to develop dyspnea on moderate exertion and undergoing myocardial scintigraphy with 99m Tc-sestamibi, which showed ischemia in the left ventricular anterior wall. Echocardiography showed no ventricular dysfunction. He was treated with optimization of medications. However, in the scintigraphic control examination, the ischemic area showed up as persistent hypoperfusion. A new cardiac catheterization showed stent restenosis. For evaluation of myocardial viability, we used a scintigraphy with thallium-201 that showed no tracer uptake in the left anterior descending artery territory. As the patient remained symptomatic, a new attempt of myocardial viability research with 18 F-Fluorodeoxyglucose was performed. This showed a viable left ventricular anterior wall. Conclusion: The report confirms the greater sensitivity of Positron-emission tomography/computed tomography with 18F-Fluorodeoxyglucose in detecting a viable myocardium.Descriptors: Radionuclide Imaging; Myocardial Perfusion Imaging; Thallium; Technetium Tc 99m Sestamibi; Fluorodeoxyglucose F18.
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