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Detection of early systolic dysfunction in ischemia by sequential radionuclide imaging of ejection rates

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Abstract

The effectiveness of sequential imaging of early regional left ventricular contraction in the detection of ischémie abnormalities was assessed in 47 patients (15 with previous infarction) with angiographically proven coronary artery disease, and 11 normal volunteers, undergoing first pass radionuclide angiography with a multielement gamma camera at rest and at peak exercise. Global left ventricular hemodynamic parameters, and functional images of regional ejection fraction and ejection rate were compared to 6 pairs of sequential rate images showing the decrease and the increase of regional left ventricular volume during a time-interval of 80–280 ms (at rest) and 50–175 ms (at stress) from end-diastole. Diagnostic accuracy of sequential images (67–91%) was higher than that of ejection rate image (71–72%), and of global hemodynamic parameters (33–60%), in the detection of coronary patients. Regional sensitivity of stress sequential increase and decrease image achieved 77% and 100%, respectively. During early systole sensitivity of sequential decrease and increase images approached 100% even at rest, subsequently decreasing because of normalizing contraction. Thus, the analysis of early systolic dysfunction provided by dynamic sequential functional images of ejection rates proved to be an effective diagnostic tool in the detection of myocardial ischémie dysfunction.

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Abbreviations

CAD:

coronary artery disease

LAD:

left anterior descending artery

LCx:

left circumflex artery

LV:

left ventricle

RCA:

right coronary artery

References

  1. 1.

    Johnson LL, Ellis K, Schmidt D, Weiss MB, Cannon PJ. Volume ejected in early systole. A sensitive index of left ventricular performance in coronary artery disease. Circulation 1975; 52: 378–89.

  2. 2.

    Ciavolella M, Tomai F, Vicchio D, Ruscitti G, Giannitti C, Scali D, Schad N, Reale A. Single-day combined evaluation of regional myocardial perfusion and function at rest and peak exercise with99mTc-MIBI in patients with coronary artery disease. Int J Cardiac Imaging 1993; 9: 99–111.

  3. 3.

    Schad N, Nickel O. Assessment of left ventricularperformance by functional images. In: Hipona FA, (ed). Heart. New York: Grune & Stratton, 1984: 143–68.

  4. 4.

    Schad N, Bruzzone F. Functional imaging. In: Schad N, Andrews EJ, Fleming JW, (eds). Colour atlas of first pass functional imaging of the heart. Lancaster, UK: MTP Press, 1985: 7–18.

  5. 5.

    Nickel O. Technical notes. In: Schad N, Andrews EJ, Fleming JW, (eds). Colour atlas of first pass functional imaging of the heart. Lancaster, UK: MTP Press, 1985: 1–5.

  6. 6.

    Schad N. Non-traumatic assessment of left ventricular wall motion and regional stroke volume after myocardial infarction. J Nucl Med 1977; 18: 333–41.

  7. 7.

    Schad N, Bruzzone F, Romeo F. Systolic and diastolic functional imaging in evaluation of ischaemic heart disease. In: Schad N, Andrews EJ, Fleming JW, (eds). Colour atlas of first pass functional imaging of the heart. Lancaster, UK: MTP Press, 1985: 27–42.

  8. 8.

    Schad N, Romeo F, Fesl H, Nickel O. Noninvasive assessment of regional diastolic left ventricular function with first pass radionuclide functional imaging. Eur Heart J 1986;7: 609–20.

  9. 9.

    Nickel O, Schad N, Andrews EJ, Fleming JW, Mello M. Scintigraphic measurement of left ventricular volumes from the count-density distribution. J Nucl Med 1982; 23: 404–10.

  10. 10.

    Murray GL, Schad N, Ladd W, et al. Functional cardiac imaging in coronary disease: Increased sensitivity of first-pass radionuclide angiography utilizing sequential regional left ventricular early diastolic filling rate images. Cardiologia 1990; 35: 25–32.

  11. 11.

    Chierchia S, Lazzari M, Freedman SB, Brunelli C, Maseri A. Impairment of myocardial perfusion and function during painless myocardial ischemia. J Am Coll Cardiol 1983; 1: 924–30.

  12. 12.

    Breitenbuecher A, Pfisterer M, Hoffmann A, Burckhardt D. Long-term follow-up of patients with silent ischemia during exercise radionuclide angiography. J Am Coll Cardiol 1990; 15: 999–1003.

  13. 13.

    Gasperetti CM, Burwell LR, Beller GA. Prevalence and variables associated with silent myocardial ischemia on exercise Thallium-201 stress testing. J Am Coll Cardiol 1990; 16: 115–23.

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Schad, N., Murray, G.L., Ciavolella, M. et al. Detection of early systolic dysfunction in ischemia by sequential radionuclide imaging of ejection rates. Int J Cardiac Imag 10, 269–278 (1994). https://doi.org/10.1007/BF01137718

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Key words

  • coronary artery disease
  • first pass radionuclide angiography
  • ischemie dysfunction
  • sequential imaging