Radionuclide evaluation of peripheral circulatory dynamics: New clinical application of blood pool scintigraphy for measuring limb venous volume, capacity, and blood flow

Clements, Ian P.; Strelow, David A.; Becker, GJ; Vlietstra, Ronald E.; Brown, Michael L.

doi:10.1016/0002-8703(81)90480-4

Cited by 26 publications

(13 citation statements)

References 6 publications

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“…Equilibrium blood pool radionuclide angiography was used to quantitate the changes of regional blood volume in the abdomen. [15][16][17] Labeling of the red blood cells was achieved by intravenous injection of 16 mg stannous pyrophosphate followed 20 to 30 min later by 20 mCi of 99mTc pertechnetate. Static 60 sec scintigrams of the entire abdomen were recorded (at intervals outlined below) with a gamma camera (Model DYNA-MO 4, Picker, Northford, CT) equipped with a diverging collimator and interfaced to a mobile nuclear medicine computer (Model DPS-2800, ADAC Laboratories, San Jose, CA).…”

Section: Methodsmentioning

confidence: 99%

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Modulation of vascular capacitance by angiotensin and nitroprusside: a mechanism of changes in pericardial pressure.

et al. 1987

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The aim ofthe present study was to test the hypothesis that vasoactive drugs may modify left ventricular diastolic function by shifting blood between the systemic vascular bed and the heart, thereby changing pericardial and left ventricular pressure. The experiments were done in 10 open-chest, anesthetized, previously splenectomized dogs in which changes in pericardial surface pressure in response to intravenous sodium nitroprusside and angiotensin were related to changes in blood volume in the abdominal region. Blood volume was determined by blood pool scintigraphy (99mTc) and regions of interest were drawn in the liver and in the mesenteric area. Angiotensin was infused at rates that were adjusted to increase mean aortic pressure by 20 and 30 mm Hg, and nitroprusside was infused at rates to decrease mean aortic pressure by 30 and 50 mm Hg. Angiotensin increased pericardial pressure by 3 and 5 mm Hg at the respective doses and there were increments in left ventricular end-diastolic pressure (LVEDP) and left ventricular diameter (sonomicrometry). Angiotensin decreased blood volume in the mesenteric region by 14% and 17%, but did not significantly change blood volume in the liver region. Angiotensin increased portal venous pressure and decreased mesenteric blood volume, suggesting decreased mesenteric venous compliance. Nitroprusside had opposite effects: pericardial pressure was decreased by 5.5 and 6.5 mm Hg by the respective doses. The doses of nitroprusside increased blood volume in the mesenteric region by 14% and 20%, but did not significantly change blood volume in the liver region. Nitroprusside decreased portal pressure and increased mesenteric blood volume, suggesting increased mesenteric venous compliance. Changes in pericardial pressure with the two drugs varied inversely with changes in blood volume in the mesenteric region. In conclusion, angiotensin and nitroprusside change LVEDP by changing pericardial pressure. The two drugs had opposite effects on venous capacitance in the abdominal region. Changes in pericardial pressure varied inversely with changes in mesenteric blood volume. Thus, we propose that the mechanism whereby vasoactive drugs alter pericardial pressure is by shifting blood between the systemic venous bed and the heart, thereby changing heart size and necessarily pericardial pressure. Circulation 76, No. 4, 875-883, 1987

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Section: Methodsmentioning

confidence: 99%

“…15. 16 Experimental protocol. The following variables were recorded: pressures in the left ventricle, the aorta, the portal vein, and the inferior vena cava, pericardial surface pressure, anteroposterior diameter of the left ventricle, and vascular volumes in mesenteric and hepatic regions.…”

Section: Methodsmentioning

confidence: 99%

Modulation of vascular capacitance by angiotensin and nitroprusside: a mechanism of changes in pericardial pressure.

et al. 1987

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“…Changes in arterial tone can be assessed by relating changes in pressure to changes in flow to give a measure of systemic vascular resistance, but changes in venous tone are more difficult to assess. Strain gauge plethysmography (Whitney, 1953) has been the traditional method but this technique can be inaccurate and is cumbersome and difficult to perform (Clements et al, 1981). Radionuclides are being used increasingly to examine drug affects on the heart (Muir et al, 1981) and two recent reports suggest that changes in peripheral or 'venous' vascular volume may also be determined by a modified equilibrium blood pool method using a gamma camera (Clements et al, 1981;Rutlen et al, 1981).…”

Section: Introductionmentioning

confidence: 99%

“…Strain gauge plethysmography (Whitney, 1953) has been the traditional method but this technique can be inaccurate and is cumbersome and difficult to perform (Clements et al, 1981). Radionuclides are being used increasingly to examine drug affects on the heart (Muir et al, 1981) and two recent reports suggest that changes in peripheral or 'venous' vascular volume may also be determined by a modified equilibrium blood pool method using a gamma camera (Clements et al, 1981;Rutlen et al, 1981). However this technique precludes the simultaneous study of central haemodynamics unless two gamma cameras are available and can be suitably positioned in close proximity to each other.…”

Section: Introductionmentioning

confidence: 99%

A radionuclide method for the simultaneous study of the effects of drugs on central and peripheral haemodynamics.

Wathen¹,

Hannan²,

Adie³

et al. 1983

Brit J Clinical Pharma

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(GTN) have been contrasted using radionuclide techniques. 2 Following intravenous injection of technetium-99m labelled human serum albumin, radionuclide ventriculography was performed by the equilibrium blood pool method using a mobile gamma camera. Simultaneous measurements of 'peripheral venous volume' were made using a collimated scintillation probe positioned above the patient's calf. 3 Ten patients with angina pectoris were studied at rest, after sublingual administration of 0.5 mg GTN and after intravenous administration of 10 mg hydralazine. 4 GTN caused a mean reduction in the end diastolic volume of the left ventricle of 14.6% + 4.5% (P < 0.005) but ejection fraction increased by 0.034 + 0.007 (P < 0.005) so that stroke volume was only reduced by 4.9% ± 5.0% (NS). There was a mean increase in heart rate of 10.8 ± 2.3 beats/min (P < 0.001) but no significant change in cardiac output. The calculated systemic vascular resistance fell by 10.0% ± 5.4% (P < 0.05). Associated with these changes there was a mean increase of 9.6% ± 1.5% (P < 0.05) in the counts from the calf. 5 Hydralazine caused a significant reduction in blood pressure and increase in heart rate. Enddiastolic volume was reduced by 6.0% ± 2.7% but there was a mean increase in ejection fraction of 0.058 ± 0.010 (P < 0.001) so that in this instance stroke volume increased by 9.0% + 3.7% (P < 0.05) and cardiac output increased by 16.4% ± 4.4% (P < 0.005). The calculated systemic vascular resistance fell by 18.9% ± 3.8% (P < 0.001). Despite these haemodynamic changes there was no significant change in counts from the calf. 6 The results confirm that GTN has a predominant venodilator effect while hydralazine acts largely on the arterial bed. These relatively simple radionuclide methods will allow a more detailed assessment of the cardiovascular effects of drugs.

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“…Captopril (and by implication enalapril) reduces venous tone by up to 50% in patients with heart failure (Awan & Mason, 1982;Cowley et al, 1982;Faxon et al, 1981). Recently, using non-invasive radionuclide techniques (Clements et al, 1981;Wathen et al, 1983) captopril was shown to produce a 16% increase in peripheral venous volume, far more than the 11% increase following glyceryl trinitrate. Furthermore the fall in mean arterial blood pressure when commencing captopril correlated Letters to the Editors Br.…”

mentioning

confidence: 99%

'First dose' hypotension and venodilatation [letter]

Capewell

1991

Brit J Clinical Pharma

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Radionuclide evaluation of peripheral circulatory dynamics: New clinical application of blood pool scintigraphy for measuring limb venous volume, capacity, and blood flow

Cited by 26 publications

References 6 publications

Modulation of vascular capacitance by angiotensin and nitroprusside: a mechanism of changes in pericardial pressure.

Modulation of vascular capacitance by angiotensin and nitroprusside: a mechanism of changes in pericardial pressure.

A radionuclide method for the simultaneous study of the effects of drugs on central and peripheral haemodynamics.

'First dose' hypotension and venodilatation [letter]

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