The authors evaluated the reproducibility of measurements of ventricular dimensions obtained with cine magnetic resonance (MR) imaging performed on two occasions in 11 healthy subjects. Two reviewers analyzed the studies in a blinded fashion to determine interobserver and interstudy variability of measurements of left ventricular (LV) mass, volume, ejection fraction, and systolic wall stress. LV mass showed good reproducibility between studies, with 3.6% and 3.8% variability for LV end-systolic mass for the two observers. LV end-diastolic volume varied by 5.2% and 3.9%, and LV end-systolic volume, by 9.7% and 0.9%. Variability for LV ejection fraction was 5.0% and 4.9%. The largest interstudy variability was end-systolic wall stress, 11.1% and 13.5%, which was due mostly to changes in arterial pressure between the two studies. It is concluded that anatomic and functional measurements from cine MR images are reproducible between studies. The small interstudy variability is likely related to the fact the measurements are derived directly from cine MR images that encompass the entire heart rather than depend on measurements of only sample images and the use of geometric models.

Ghrelin is a novel growth hormone؊releasing peptide isolated from human and rat stomach that induces weight gain by increasing food intake and reducing fat utilization. Although recent data indicate that ghrelin is downregulated in human adult obesity, the characteristics of human obesity are heterogeneous, especially in children and adolescents, and depend on the distribution of subcutaneous and visceral fat tissue. We measured fasting plasma ghrelin concentrations by radioimmunoassay in 49 obese Japanese children and adolescents (38 boys and 11 girls; mean age 10.2 ؎ 2.8 years; BMI 28.0 ؎ 4.5 kg/m 2 , percent overweight 56.0 ؎ 20.7%), and analyzed associations of their ghrelin concentrations with their body composition, insulin resistance, and adipocytokine concentrations. Fasting plasma ghrelin levels were negatively correlated with BMI and waist circumference, but not with percent overweight or percent body fat, whereas fasting leptin levels were positively correlated with all of the following parameters: BMI, waist circumference, percent overweight, and percent body fat. Plasma ghrelin levels were negatively correlated with fasting immunoreactive insulin, homeostasis model assessment insulin resistance index, and quantitative insulin sensitivity check index values. There was no correlation between plasma ghrelin and leptin, but ghrelin was negatively correlated with the PAI-1 concentrations. The results suggest that the downregulation of ghrelin secretion may be a consequence of higher insulin resistance associated with visceral fat accumulation and elevated PAI-1 concentrations, and not a consequence of total body fat accumulation associated with elevated leptin concentrations.

velocity mapping-velocity-encoded cine (VEC) MR-was assessed by comparing VEC Richard Sernelka1MR data with independent measurements in a flow phantom and in human subjects. Elvse Foster

The quality of 18 F-FDG PET/CT images of overweight patients is often degraded. We evaluated the effect of optimizing injected dose or acquisition time on the quality of images of overweight patients using lutetium oxyorthosilicate PET/CT with high-performance detector electronics. Methods: We initially retrospectively measured radioactivity concentrations and signal-to-noise ratios (SNRs) in the liver relative to body weight for 80 patients who had undergone 18 F-FDG PET/CT according to our standard protocol (injected dose, 3.7 MBq/kg; acquisition time, 2 min/bed position). The patients were grouped (n 5 20 per group) according to baseline body weight as G1 (#59 kg), G2 (60-69 kg), G3 (70-84 kg), and G4 ($85 kg). We compared the SNRs of G1 with those of G2, G3, and G4 and calculated the ratio squared as a factor to correct the acquisition parameters for overweight patients. We then prospectively enrolled 120 patients according to the same body weight criteria. We multiplied the correction factors to optimize injected doses or acquisition times and defined dose-adjusted groups (n 5 20 per group) and timeadjusted groups (n 5 20 per group). G2 dose was defined as 5.59 6 0.19 MBq/kg, G3 dose as 7.29 6 0.33 MBq/kg, and G4 dose as 8.88 6 0.43 MBq/kg. G2 time was defined as 3 min/bed position, G3 time as 4 min/bed position, and G4 time as 5 min/ bed position. Results: Although liver activities did not significantly differ among G1 through G4 irrespective of patient weight, SNR progressively decreased as patient weight increased. The liver activities of G2 dose, G3 dose, and G4 dose were, respectively, 1.4-, 1.9-, and 2.5-fold higher than those of the baseline counterparts. Nevertheless, the increased liver activities of G2 dose, G3 dose, and G4 dose did not significantly affect SNR, compared with the baseline groups. In contrast, the SNR of G4 time was significantly higher than that of G4. Conclusion: Our findings suggest that the quality of images acquired from heavier patients can be maintained only by scanning for longer periods. Increasing the dose per kilogram of body weight did not improve the quality of lutetium oxyorthosilicate PET/CT images.

Velocity-encoded cine magnetic resonance (MR) imaging provides two-dimensional velocity maps of a cross-sectional area of a vessel. Pulmonary flow and flow patterns in the main pulmonary artery were analyzed with velocity-encoded cine MR imaging and Doppler echocardiography in 10 patients with pulmonary hypertension (PH), one patient with a dilated main pulmonary artery, and 10 healthy subjects, and these findings were compared. Peak systolic velocity measured with velocity-encoded cine MR imaging was similar to that measured with Doppler echocardiography in healthy subjects and in patients with PH. Velocity-encoded cine MR imaging demonstrated substantial differences in velocity across the vascular lumen in PH. The flow pattern in healthy subjects was different than that in patients with PH; the latter had lower peak systolic velocity and greater retrograde flow after middle to late systole. The retrograde flow observed in patients with PH reflected hemodynamic events, since it was inversely proportional to pulmonary flow volume and directly proportional to pulmonary resistance and cross-sectional area of the vessel. Velocity-encoded cine MR imaging demonstrates an inhomogeneous flow profile in PH and may serve as a noninvasive method to estimate pulmonary vascular resistance.

Tl and BMIPP uptake in the area of noncompaction observed before carvedilol disappeared after treatment. Impaired sympathetic neuronal function shown by MIBG recovered after treatment. Thus carvedilol had beneficial eVects on left ventricular function, hypertrophy, and both metabolic and adrenergic abnormalities in isolated left ventricular non-compaction. (Heart 2001;86:e4)

In patients with tetralogy of Fallot and pulmonary atresia, additional anomalies of the aortic arch, ductus arteriosus and pulmonary arteries are more common in patients with than in those without the 22q11 deletion.

The so-called "conotruncal anomaly face syndrome" (CTAFS) is characterized by a peculiar facial appearance associated with congenital heart disease (CHD), especially cardiac outflow tract defects such as tetralogy of Fallot (TOF), double outlet right ventricle (DORV), and truncus arteriosus (TAC). CTAFS and the DiGeorge anomaly (DGA) have many similar phenotypic characteristics, suggesting that they share a common cause. In many cases DGA is known to be associated with monosomy for a region of chromosome 22q11.2. Fifty CTAFS patients and 10 DGA patients, 11 parents couples and 10 mothers of CTAFS patients, and 3 parents couples and 2 mothers of DGA patients were examined by fluorescent in situ hybridization (FISH) using the N25 (D22S75) DGCR probe (Oncor). Monosomy for a region of 22q11.2 was found in 42 CTAFS, 9 DGA, 4 mothers, and 1 father who had CTAF without CHD. The remaining 8 CTAFS patients 1 DGA patient and 1 mother who had questionable CTAF without CHD, showed no such chromosome abnormality. For the control, 60 patients who had CHD without CTAF or other known malformation syndromes were examined and had no deletion of 22q11.2. Therefore, we conclude that CTAFS is a part of the CATCH 22 syndrome; cardiac defects, abnormal faces, thymic hypoplasia, cleft palate, and hypocalcemia (CATCH) resulting from 22q11.2 deletions.