Combined first-pass and equilibrium radionuclide ventriculography and comparison with left ventricular/right ventricular stroke count ratio in mitral and aortic regurgitation

Klepzig, H; Standke, R.; Nickelsen, Thomas; Kunkel, B.; Maul, F. D.; Hör, G.; Kaltenbach, M.

doi:10.1016/0002-9149(85)90744-1

Cited by 11 publications

(5 citation statements)

References 19 publications

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“…Technetium-99 m-pyrophosphate scintigraphy was performed as described before after injection of 15 mCi (555 MBq) of the radiopharmaceutical into a peripheral vein [22,23]. First pass images were obtained in LAO 40 ° projection immediately after injection and planar scans were acquired 4-6h and 24h after injection (LAO 45 °, LAO 70 ° anterior views of the heart and posterior views of the kidney region) [15,17].…”

Section: Methodsmentioning

confidence: 99%

Is technetium-99 m-pyrophosphate scintigraphy valuable in the diagnosis of cardiac amyloidosis?

et al. 1990

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Amyloidosis is a systemic disease frequently involving the myocardium and leading to functional disturbances of the heart. Amyloidosis can mimic other cardiac diseases. A conclusive clinical diagnosis of cardiac involvement can only be made by a combination of different diagnostic methods. In 7 patients with myocardial amyloidosis we used a combined first-pass and static scintigraphy with technetium-99 m-pyrophosphate. There was only insignificant myocardial uptake of the tracer. The first-pass studies however revealed reduced systolic function in 4/7 patients and impaired diastolic function in 6/7 patients. Therefore, although cardiac amyloid could not be demonstrated in the static scintigraphy due to amyloid fibril amount and composition, myocardial functional abnormalities were seen in the first-pass study.

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Section: Methodsmentioning

confidence: 99%

Is technetium-99 m-pyrophosphate scintigraphy valuable in the diagnosis of cardiac amyloidosis?

et al. 1990

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“…2). No other clinical or exercise test data left ventricles were determined at rest and a ratio calculated [28][29][30]. This is considered a measure of the severity of the LV volume overload.…”

Section: Radionuclide Angiographymentioning

confidence: 99%

Rest versus Exercise Ejection Fraction and the Decision to Perform Valve Replacement in Aortic Regurgitation

Boucher¹,

Miller²,

Hutter³

1988

Am J Noninvas Cardiol

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To study the relationship between left ventricular ejection fraction (LVEF) and the decision to perform aortic valve replacement, the correlates of undergoing valve replacement were studied in 56 asymptomatic or mildly symptomatic patients with isolated severe chronic aortic regurgitation (AR) undergoing exercise radionuclide angiography. The need for valve replacement was not indicated on clinical grounds, because symptoms were either mild or absent. Of a variety of noninvasive laboratory variables, stepwise logistic regression analysis showed the rest LVEF to be the best correlate of performing valve replacement. Valve replacement was performed in 24 (43 %) of the patients including 5% of AR patients with rest LVEF of 0.50 or more, 40% of patients with rest LVEF of 0.41-0.49, and 88% of patients with rest LVEF of 0.40 or less, p < 0.001. Of the 20 patients within the intermediate rest LVEF range of 0.41-0.49, the 8 undergoing valve replacement had a similar rest LVEF, but a lower exercise LVEF and older age, compared to the 12 not undergoing valve replacement. In conclusion, rest LVEF alone strongly correlates with the decision to perform valve replacement in asymptomatic or mildly symptomatic AR. In the higher and lower LVEF ranges, the rest value is the best correlate of whether the patient will have surgery and little or no additonal information is provided by exercising the patient. Only in the intermediate LVEF range is this decision unpredictable by the rest value. Physicians appear to consider rest LVEF a powerful prognosticator as evidenced by the decision-making patterns observed.

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“…Frühere Untersuchungen zeigten die gute Reproduzierbarkeit der bestimmten Kammerund Regurgitationsvolumina sowie der Auswurffraktion (10); weiterhin belegte der Vergleich mit der angiographischen Referenzmethode die Verläßlichkeit der gewonnenen Meßwerte zur Beurteilung einer linksventrikulären Volumenbelastung (10). Kontrolluntersuchungen bei 22 Patienten ohne Hinweis auf Klappenerkrankungen zeigten, daß Regurgitationen bzw.…”

Section: Radionuklid-ventrikulographieunclassified

“…Kontrolluntersuchungen bei 22 Patienten ohne Hinweis auf Klappenerkrankungen zeigten, daß Regurgitationen bzw. Shunts ab Werten über 20% gemessen werden können (10). (11).…”

Section: Radionuklid-ventrikulographieunclassified

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Nuklearmedizinische Shunt-Bestimmung beim Ductus arteriosus Botalli

Klepzig¹,

Sievert²,

Standke³

et al. 1987

Nuklearmedizin

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ln 9 patients with patent ductus arteriosus, quantification of left-to-right shunt was performed with dye dilution curves after peripheral injection and with radionuclide ventriculography. The study was repeated within 7 days after successful transluminal occlusion of the ductus with an lvalon®-plug. Reproducubility of the method could be studied in one patient in whom reopening of the ductus occurred. Dye dilution curves were analyzed using the method of Carter et al. (2). Radionuclide ventriculography was performed as a combined first-pass and equilibrium study: effective stroke volume was derived from the first pass of the tracer through the heart; during the equilibrium phase left ventricular ejection fraction (EF) and left ventricular enddiastolic volume (EDV) were evaluated. The difference between total left ventricular stroke volume (product of EF and EDV) and effective stroke volume was taken as shunt volume. This volume as a fraction of total left ventricular-stroke volume resulted in percent left-to-right shunt. The sensitivity of the dye technique was 78%; a quantification of the shunt lesion was possible in 55% of all cases (shunt greater than 35%). The sensitivity of the radionuclide technique was 90%. The severity of the lesion could not be determined in one patient with a minimal shunt. After successful occlusion of the ductus, dye dilution curves normalized in all cases. Radionuclide ventriculography showed normalization in all but one patient. This patient with concomitant mitral regurgitation still showed moderate left ventricular volume overload. After occlusion, left ventricular enddiastolic volume significantly decreased (from 224 to 181 ml, p <0.05), effective cardiac output increased (from 6186 to 7476 ml, p <0.01) and ejection fraction remained unchanged (55 vs. 51 %). It is concluded, that combined first-pass and equilibrium radionuclide ventriculography permits reliable determination of left-to-right shunts in patients with patent ductus arteriosus. It provides important additional information concerning the follow-up of EF, EDV and cardiac output. This method is superior to dye dilution techniques

show abstract

Combined first-pass and equilibrium radionuclide ventriculography and comparison with left ventricular/right ventricular stroke count ratio in mitral and aortic regurgitation

Cited by 11 publications

References 19 publications

Is technetium-99 m-pyrophosphate scintigraphy valuable in the diagnosis of cardiac amyloidosis?

Is technetium-99 m-pyrophosphate scintigraphy valuable in the diagnosis of cardiac amyloidosis?

Rest versus Exercise Ejection Fraction and the Decision to Perform Valve Replacement in Aortic Regurgitation

Nuklearmedizinische Shunt-Bestimmung beim Ductus arteriosus Botalli

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