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  • 1
    ISSN: 1619-7089
    Keywords: Single-photon emission tomography ; Positron emission tomography ; Myocardial perfusion ; Myocardial viability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compare thallium-201 rest redistribution and fluorine-18 fluorodeoxyglucose ([18F]FDG) for the assessment of myocardial viability within technetium-99m methoxyisobutylisonitrile (MIBI) perfusion defects in 27 patients with chronic stable coronary artery disease. The following studies were performed: (1) stress99mTc-MIBI, (2) rest99mTc-MIBI, (3)201T1 rest-redistribution single-photon emission tomography, (4) [18F]FDG positron emission tomography. The left ventricle was devided into 11 segments on matched tomographic images. The segment with the highest activity at stress was taken as the reference (activity=100%). Perfusion defects at99mTc-MIBI rest were classified as severe (activity〈50%), moderate (activity 50%–60%) or mild (activity 60%–85%). Uptakes of [18F]FDG and rest-redistributed201Tl were recognized as significant if they exceeded 50% of that in the reference segment. Among the 33 segments with severe99mTc-MIBI rest perfusion defects, 21 had significant [18F]FDG and 10 significant rest-redistributed201Tl uptake. As regards the 37 segments with moderate defects, [18F]FDG was present in 29 and201Tl in 31, while of the 134 segments with mild defects, 128 showed [18F]FDG uptake, and 131,201Tl uptake. In conclusion, there is an inverse relationship between the severity of99mTc-MIBI perfusion defects and the uptake of rest-redistributed201Tl and [18F]FDG. Both tracers are adequate markers of viability in mild and moderate defects; in severe defects201Tl might underestimate the presence of viability as assessed by [18F]FDG.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    The international journal of cardiovascular imaging 3 (1988), S. 99-109 
    ISSN: 1573-0743
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Changes induced by nifedipine (10 mg s.l.) in the residual lumen diameter of significant (〉50%) coronary lesions were assessed angiographically in 69 patients with effort angina (Group 1), in 22 patients with mixed angina (Group 2), and in 14 patients with Prinzmetal angina (Group 3). These changes were related to the clinical response to treatment with the same drug (diary records, exercise testing, Holter monitoring). In Groups 1 and 2 segments of stenotic vessels showed either increase, decrease or no change in diameter with the calcium antagonist; in Group 3 the majority of the vessels showed compliant portions which invariably responded with dilatation. Nifedipine failed to improve cases with exertional (21% unchanged, 19% worsened) and mixed (41% exacerbated) forms; all patients with the Prinzmetal form had relief of the anginal episodes. In Group 1, the response to exercise tests were dissociated from the acute vasomotor pattern and the pressure-rate product failed to explain the clinical results. Fifty-two percent of the patients in Group 2 showed significant acute widening of critical stenoses as well as obvious improvement; patients in this group who did worse with treatment had reacted to nifedipine with narrowing of their critical stenoses. These data suggest that: the response to nifedipine of classic effort angina is probably the net result of an interaction of changes in myocardial oxygen consumption and supply; coronary vasomotion has a role in mixed angina and influences of nifedipine may be either favorable or unfavorable; stenotic lesions in the Prinzmetal form are quite sensitive to the relaxant action of calcium blockade and this probably represents a background to the highly positive clinical response to treatment.
    Type of Medium: Electronic Resource
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