Measurement of Regional Myocardial Perfusion in Man with 133Xenon and a Scintillation Camera

Cannon, Paul J.; Dell, Ralph B.; Dwyer, Edward M.

doi:10.1172/jci106891

Cited by 120 publications

(31 citation statements)

References 35 publications

(54 reference statements)

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“…The method has been described in detail and illustrated previously (6,8,12 (13), and p is the specific gravity of the tissue (1.05).…”

Section: Methodsmentioning

confidence: 99%

“…This technique provides quantitative estimates of capillary perfusion in multiple regions of the heart after the radioisotope is injected into a coronary artery (6,8,12). Computer analysis of the multiple local "3Xe washout curves provides both accurate estimates of tracer clearance from heart muscle and statistical assessments of the accuracy of the measurements.…”

Section: Regional Myocardial Perfusion and Coronary Arteriographic Lementioning

confidence: 99%

“…The technique used to measure blood flow in the present study employs a scintillation camera comprised of multiple collimated individual detectors to externally monitor 'Xe washout curves from many areas of the myocardium (8). Regional myocardial blood flow rates in different areas of the heart are computed by the Kety formula (8,9).…”

Section: Introductionmentioning

confidence: 99%

“…Regional myocardial blood flow rates in different areas of the heart are computed by the Kety formula (8,9). Spatial separation of myocardial regions permits areas of myocardial underperfusion to be represented in the mean LV blood flow which is calculated by averaging the many regional perfusion rates measured in a given ventricle.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between regional myocardial perfusion at rest and arteriographic lesions in patients with coronary atherosclerosis.

Cannon¹,

Schmidt²,

Weiss³

et al. 1975

J. Clin. Invest.

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AB STRA CT Measurements of mean left ventricular (LV) and regional myocardial blood flow rates were made at rest in 161 patients with '=Xe and a multiplecrystal scintillation camera. Myocardial perfusion rates were correlated with assessments of the degree of coronary artery disease made from the arteriograms obtained during the same studies. In patients with normal coronary arteries without heart failure, the presence of hypertension, aortic stenosis, or aortic insufficiency was not associated with changes in mean LV perfusion from the control value of 61±7 ml/100 g min. However, mean LV perfusion was significantly reduced in patients with normal coronary arteries who had cardiomyopathy and impaired ventricular performance. Mean LV perfusion was not significantly different from control valtues in patients with "mild" coronary artery disease (< 50% obstruction) or in patients with significant isolated disease (> 50% obstruction) of the left anterior descending (LAD) artery. Significant reductions in mean LV perfusion were found in patients with > 50% obstruction of two coronary arteries (LAD + right or LAD + circumflex) and in patients with triple-vessel disease.The average perfusion rate for regions distal to LAD obstructions in patients with isolated LAD disease was not lower than the LAD perfusion in control patients, but was significantly reduced in patients with LAD + right coronary artery disease (43±14 ml/100 g.min).In the latter group average perfusion distal to the LAD lesion was significantly lower than the average regional perfusion rate for the remainder of the LV. However, The data demonstrate that the presence of radiograplhically "mild" or significant isolated LAD coronary disease is not associated with reductions in mean LV perfusion at rest, but that mean LV perfusion is reduced in the presence of significant disease of two or three coronary arteries. None of the patients experienced angina dturing the resting studies and most had clinical evidence of ventricular failure. The observation of depressed LV perfusion in this group, as in the patients with cardiomvopathy, raises the possibility that a lowered resting blood supply may be adequate for a reduced level of per-formance of a diseased ventricle. The lack of selective reductions of regional perfusion at rest in the majority of the patients with LAD lesions suggests that regional myocardial blood flow must be measured during an intervention which increases myocardial oxygen consumption in order to assess the physiological significance of lesions which are observed at coronary arteriography.

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“…The method has been described in detail and illustrated previously (6,8,12 (13), and p is the specific gravity of the tissue (1.05).…”

Section: Methodsmentioning

confidence: 99%

Section: Regional Myocardial Perfusion and Coronary Arteriographic Lementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The relationship between regional myocardial perfusion at rest and arteriographic lesions in patients with coronary atherosclerosis.

Cannon¹,

Schmidt²,

Weiss³

et al. 1975

J. Clin. Invest.

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show abstract

“…More information has been obtained with radioactive`33Xe and a scintillation camera that permits spatial resolution in flow measurements. 3 However, this technique requires intracoronary injections and has been validated only for perfusion rates less than 200 ml/min/100 g. 4 Pulsed Doppler ultrasonography of individual coronary arteries, coupled with the administration of the short-acting coronary vasodilator papaverine, permits the determination of myocardial flow reserve in terms of the ratio of myocardial flow velocities with and without papaverine. 2 This technique has been extensively studied.…”

mentioning

confidence: 99%

13N ammonia myocardial imaging at rest and with exercise in normal volunteers. Quantification of absolute myocardial perfusion with dynamic positron emission tomography.

Krivokapich¹,

Smith²,

Huang³

et al. 1989

Circulation

242

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Positron emission tomography (PET) was applied to the measurement of myocardial perfusion using the perfusion tracer 13N-labeled ammonia. 13N ammonia was delivered intravenously to 13 healthy volunteers both at rest and during supine bicycle exercise. Dynamic PET imaging was obtained in three cross-sectional planes for 10 minutes commencing with each injection. The left ventricle was divided into eight sectors, and a small region of interest was assigned to the left ventricular blood pool to obtain the arterial input function. The net extraction of 13N ammonia was obtained for each sector by dividing the tissue 13N concentration at 10 minutes by the integral of the input function from the time of injection to 10 minutes. With this approach for calculating net extractions, rest and exercise net extractions were not significantly different from each other. To obviate possible overestimation of the true 13N ammonia input function by contamination by '3N-labeled compounds other than 13N ammonia or by spillover from myocardium into blood pool, the net extractions were calculated using only the first 90 seconds of the blood and tissue time-activity curves. This approach for calculating net extractions yielded significant differences between rest and exercise, with an average ratio of exercise to rest of 1.38+0.34. Nonetheless, the increase was less than predicted from the average 2.7-2.8-fold increase in double product at peak exercise or the 1.7-fold increase in double product at 1 minute after exercise. However, when the first 90 seconds of dynamic data were fit with a two compartment tracer kinetic model, average perfusion rates of 0.75+±0.43 ml/min/g at rest and 1.50± 0.74 ml/min/g with exercise were obtained. This average increase in perfussion of 2.2-fold corresponded to similar average increases in double product. Thus, the noninvasive technique of PET imaging with 13N ammonia shows promise for future applications in determining absolute flows in patients with coronary artery disease. (Circulation 1989;80:1328-1337 T he reference standard for diagnosing coronary artery disease has long been considered to be coronary angiography. However, the limitations of this shadow technique, the variability of subjective readings of angiograms, and the variable relations of percent stenosis and coronary perfusion have emphasized the need for improved means to assess the functional severity of coronary

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Validation of Doppler FloWire for measurement of coronary flow reserve in humans

Dib

Bajwa

Shalev

et al. 1998

Cathet. Cardiovasc. Diagn.

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Measurement of Regional Myocardial Perfusion in Man with 133Xenon and a Scintillation Camera

Cited by 120 publications

References 35 publications

The relationship between regional myocardial perfusion at rest and arteriographic lesions in patients with coronary atherosclerosis.

The relationship between regional myocardial perfusion at rest and arteriographic lesions in patients with coronary atherosclerosis.

13N ammonia myocardial imaging at rest and with exercise in normal volunteers. Quantification of absolute myocardial perfusion with dynamic positron emission tomography.

Validation of Doppler FloWire for measurement of coronary flow reserve in humans

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