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  • 1
    Electronic Resource
    Electronic Resource
    350 Main Street , Malden , MA 02148 , USA. , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiac surgery 18 (2003), S. 0 
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract A prospective study of myocardial blood perfusion after coronary artery bypass graft (CABG) was conducted in two groups of patients. In group 1, a two-year assessment by exercise thallium myocardial scintigraphy without medical treatment was performed in 122 patients who consecutively underwent CABG with exclusive use of both internal mammary arteries (IMA) and gastroepiploic artery (GEA). In group 2, myocardial function and perfusion were determined by radionuclide investigations performed before and one year after CABG in 100 patients with preoperative LV dysfunction (defined as LV ejection fraction (LVEF) less than 0.40), comparing results of myocardial revascularization performed with either exclusive arterial grafts (arterial group, 54 patients) or one arterial graft (IMA) associated with a sequential vein graft (vein group, 46 patients). In group 1, 21% of patients presented silent residual electric ischemia during exercise stress testing and 26% had reversible scintigraphic ischemic defect despite complete revascularization, 18% of those in the inferior wall bypassed with GEA and 8% in the anterior wall bypassed with the right IMA. In group 2, the significant preoperative ischemia significantly decreased in both the vein group and the arterial group. LV function was significantly improved in the vein group; in contrast there was no modification of LV function in the arterial group. A multivariate analysis showed that the surgical technique used and the preoperative LVEF were independent prognostic factors of the postoperative myocardial outcome, with a positive impact of the vein use on the postoperative myocardial function recovery. It is important to recognize that arterial grafts have some limitations in the ability to supply blood flow for coronary circulation that may induce postoperatively silent residual myocardial ischemia and a lack of LV function recovery.(J Card Surg 2003;18:147-152)
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0843
    Keywords: Key words Anthracyclines ; Doxorubicin ; Cardiotoxicity ; Positron emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: The aim was to investigate in patients receiving doxorubicin whether any alteration in myocardial oxidative metabolism or blood flow as assessed by positron emission tomography (PET) could be observed either after the first dose of the drug, or during its chronic administration. Methods: Six female non-heart-failure cancer patients treated with doxorubicin were included in a longitudinal study. Resting radionuclide cineangiography and PET scanning with carbon-11 acetate were performed the day before the initiation of doxorubicin treatment at a dosage of 50 mg/m2 every 3 weeks, and 3 weeks after the cumulative administration of 300 mg/m2 (chronic toxicity). In addition, PET was performed 24 h after the first administration of doxorubicin (evaluation of acute toxicity). Myocardial oxidative metabolism and blood flow were assessed by PET (acute and chronic toxicity), and left ventricular ejection fraction was measured by radionuclide angiography (chronic toxicity). Results: Using PET for both acute and chronic toxicity evaluations, no significant effect of doxorubicin was observed either on the flux through the tricarboxylic acid (TCA) cycle or on myocardial blood flow. However, systolic left ventricular function showed a small but significant impairment after the administration of 300 mg/m2 of doxorubicin. Conclusions: Other hypotheses should be explored to better explain the predominant mechanisms of the cardiotoxicity of anthracyclines in humans.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-0743
    Keywords: coronary artery disease ; myocardial perfusion scintigraphy ; stress testing ; thallium-201 ; 99m Tc-teboroxime
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A series of 30 patients (25 males, 5 females, age=28–73 years) with a clinical indication of thallium-201 stress/4 hours redistribution scintigraphy has been studied using stress/rest (n=7) or rest/stress (n=23) protocols with technetium-99 m teboroxime (CARDIOTEC, Squibb Diagnostics) in order to assess the clinical usefulness of this new molecule and to compare it to thallium. In all cases coronary artery disease was known or highly suspected, with a history of myocardial infarction in 18 cases (subacute n=6, remote n=12) and/or previous by-pass surgery or PTC A in 5 cases. Medical treatment was not discontinued at the time of stress testing. Coronary angiography was available for 27 patients. Exercise tests for both tracers were carried out on an ergometric bicycle during the same day and the levels of exercise achieved for the thallium studies were very similar to those achieved for teboroxime. Imaging was performed in three planar projections and sudies were evaluated using a model with 4 territories: septal and anterior assumed to correspond to the LAD artery, lateral and latero-posterior (=LCX), inferior and posterior (=RCA) and apex. Classification of results was: normal, ischemic, infarcted and infarcted with ischemia. With reference to the thallium-201 results, agreement was found in 86% (37/43) of normal regions and in 82% (63/77) of abnormal regions. Relative to documented coronary artery lesions (27 patients) sensitivity and specificity of thallium and teboroxime for exact correspondence between arteries and territories were, respectively: thallium, se=71%, sp=64%, teboroxime, se=67%, sp=75%. These results indicate the ability of Cardiotec to evaluate myocardial perfusion with an important time saving since the complete study durations (stress and rest) were: thallium=4h 34 min −22 min and teboroxime=1 h 57 min −41 min.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1619-7089
    Keywords: Thoracic duct ; Lymphoscintigraphy ; Chylous effusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Imaging of the thoracic duct is usually performed by radiological lymphography. However, this procedure, which uses an oil based dye injected directly into the lymph channels, has some adverse effects. In this paper we note that lymphoscintigraphy, a physiological and non invasive method, may visualize thoracic duct abnormalities, and might be particularly useful when radiological lymphography is contraindicated.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 18 (1991), S. 732-739 
    ISSN: 1619-7089
    Keywords: Myocarddial perfusion scintigraphy ; Thallium-201 ; Technetium-99m teboroxime ; Coronary artery disease ; Stress testing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to evaluate the clinical value of a new myocardial perfusion tracer, a series of 30 patients (25 male, 5 female, mean age 56 years) referred for thallium 201 stress/redistribution scintigraphy has been studied using stress/rest (n = 7) or rest/stress (n = 23) protocols with technetium 99m teboroxime (Cardiotec SQUIBB). In all cases coronary artery disease was known or highly probable, with a history of myocardial infarction in 18 cases. Medical treatment was not discontinued at the time of stress testing, and coronary angiography was available in 27 patients. Exercise tests for both tracers were carried out on a bicycle ergometer during the same day, and the levels of exercise achieved for the201Tl study were very similar to those achieved for 99mTc-teboroxime. Studies performed in three planar projections were evaluated using a model with four territories septal and anterior assumed to correspond to the left anterior descending artery, lateral and lateroposterior (left circonflex), inferior and posterior (right coronary artery) and apex. Classification of results was normal, ischaemic, infarcted and infarcted with ischaemia. On comparison with the201Tl results, agreement was found in 86% (37/43) of normal regions and in 82% (63/77) of abnormal regions. Relative to documented coronary artery lesions (27 patients), sensitivity and specificity of201Tl and99mTc-teboroxime for exact correspondence between arteries and territories were respectively:201Tl: sensitivity 64%, specificity 60%;99mTc-teboroxime: sensitivity 62%, specificity 77%. These results, obtained in a given clinical context, indicate the ability of Cardiotec to evaluate myocardial perfusion with a significant saving in time, since the complete study duration (stress and rest) was:201Tl, 4 h 35 min±21 min;99mTc-teboroxime, 1 h 52 min ±29 min. Nevertheless, the high liver uptake was responsible for 68% of non-evauble inferior segments and the limited acquisition time makes the applicability of SPET questionable.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 16 (1990), S. 119-119 
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1619-7089
    Keywords: Emission tomography ; Gated blood pool ; Phase analysis ; Ventricular function ; Arrhythmias
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The standard deviation of the first harmonic Fourier phase histogram is an indicator of the contraction heterogeneity of the heart ventricles. This approach has been applied to analyse tomographic blood pool (99mTc) examinations in a group of 32 patients with angiographically verified mainly right (RV) but also left (LV) kinetic disorders in relation to severe ventricular arrhythmias and suspicion of arrhythmogenic right ventricular dysplasia (ARVD). The reference group consisted of ten patients with low probability of cardiac kinetic abnormalities. Thick tomographic slices including both ventricles have been reconstructed in the horizontal long axis orientation from a series of 32 gated projections recorded over a 360° rotation. Separately for each ventricle the Fourier phase histograms have been computed and characterized by their standard deviations (PSD). Normal values (mean±standard deviation, LV=11°±5°, RV=12°±5°) were significantly lower (P〈0.01 and P〈0.001) than those measured in abnormal cases (LV=19°±10° and RV=31°±17°). Detailed analysis of the data supports the hypothesis of a primary RV disease in ARVD, with secondary LV extension. PSD seems to be a good predictor of an organic cardiac disease underlying ventricular arrhythmias and may be used for screening the patients.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 18 (1991), S. 732-739 
    ISSN: 1619-7089
    Keywords: Myocarddial perfusion scintigraphy ; Thallium-201 ; Technetium-99m teboroxime ; Coronary artery disease ; Stress testing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to evaluate the clinical value of a new myocardial perfusion tracer, a series of 30 patients (25 male, 5 female, mean age 56 years) referred for thallium 201 stress/redistribution scintigraphy has been studied using stress/rest (n = 7) or rest/stress (n = 23) protocols with technetium 99m teboroxime (Cardiotec SQUIBB). In all cases coronary artery disease was known or highly probable, with a history of myocardial infarction in 18 cases. Medical treatment was not discontinued at the time of stress testing, and coronary angiography was available in 27 patients. Exercise tests for both tracers were carried out on a bicycle ergometer during the same day, and the levels of exercise achieved for the 201Tl study were very similar to those achieved for 99mTc-teboroxime. Studies performed in three planar projections were evaluated using a model with four territories septal and anterior assumed to correspond to the left anterior descending artery, lateral and lateroposterior (left circonflex), inferior and posterior (right coronary artery) and apex. Classification of results was normal, ischaemic, infarcted and infarcted with ischaemia. On comparison with the 201Tl results, agreement was found in 86% (37/43) of normal regions and in 82% (63/77) of abnormal regions. Relative to documented coronary artery lesions (27 patients), sensitivity and specificity of 201Tl and 99mTc-teboroxime for exact correspondence between arteries and territories were respectively: 201Tl: sensitivity 64%, specificity 60%; 99mTc-teboroxime: sensitivity 62%, specificity 77%. These results, obtained in a given clinical context, indicate the ability of Cardiotec to evaluate myocardial perfusion with a significant saving in time, since the complete study duration (stress and rest) was: 201Tl, 4 h 35 min±21 min; 99mTc-teboroxime, 1 h 52 min ±29 min. Nevertheless, the high liver uptake was responsible for 68% of non-evauble inferior segments and the limited acquisition time makes the applicability of SPET questionable.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Beat-to-beat left ventricular ejection was evaluated in a group of 20 patients with chronic atrial fibrillation using a computerized single probe detector. The reference group consisted of 10 patients with sinus rhythm. For each patient 30 successive cardiac cycles were analyzed and the relative variations of four parameters were assessed: R-R interval, diastolic and systolic time intervals, and ejection amplitude, corresponding to the left ventricular stroke volume. The mean variations were respectively 3.4%, 10.4%, 8.4%, and 11.8% in patients with sinus rhythm, and 21.9%, 37.9%, 10.6% and 30.5% in patients with atrial fibrillation. This demonstrates that changes in ejection are mainly related to the duration of the filling phase, with nearly constant systolic times. Correlations between R-R intervals and systolic ejection amplitudes were highly significant (P〈 0.001) in patients with atrial fibrillation in 85% of cases. This information complements the average ejection fraction obtained from multiple cycle superimposition.
    Type of Medium: Electronic Resource
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