Abstract
Regional systolic left ventricular performance after myocardial infarction was assessed from 216 radionuclide angiograms performed in 170 patients. Recording of first transit of an intravenously injected bolus of technetium-99m pertechnetate was made by a multicrystal scintillation camera at a framing rate of 20 per second. The RAO view was used and a simultaneous ECG was employed. Statistics adequate for resolving regional events were obtained by a compact bolus input and phasic summation into one representative cycle of data obtained during left ventricular passage. Emphasis was given to imaging of regional systolic left ventricular function: perimeter images of end-systole and end-diastole, regional stroke volume images and ejection fraction images were processed. New trend images are presented that reflect total systolic contraction and improve image quality: regional rate of decrease and increase images, wall motion trend images and regional mean transit time images.
In 96% of the cases, correspondence was found between the electrocardiographic location of the infarct and the region of major wall motion and ejection disorder. Akinesia and/or dyskinesia were seen in 77% of the cases; a ventricular aneurysm was found in 11%. Additional areas of wall motion anomalies were shown by 70%. Image analysis, nuclear image signs and their diagnostic meaning, as well as the indications for this nontraumatic examination in coronary heart disease are discussed. Relevant information for medical or surgical therapy can be obtained from early and follow-up studies in patients with unstable, progressive angina, ischemic electrocardiographic signs and those who have had myocardial infarctions.
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Adam, W.E., Meyer, G., Bitter, F., et al.: Kamera-Kinematographie des Herzens. Fortschr. Geb. Röntgenstr. Nukleartmed. 123: 19–26, 1975
Ashburn, W.L.: Non-Traumatic Evaluation of Left Ventricular Ejection Fraction by Radionuclide Angiography: Analysis Based on the First Nuclear Passage. International Symposium, Myocardial Blood Flow, Clinical Aspects, Munich, July 1976
Jones, R.H.: Radionuclide hemodynamic studies in adults and children. In: Recent Advances in Nuclear Medicine: Technical and Clinical Aspects. Atlanta, Southeast Chapter of the Society of Nuclear Medicine, 1975, pp. 717–719
Pierson, R.N., Vandyke, D.C.: Analysis of left ventricular function. In: Quantitative Nuclear Cardiography, edited by R.N. Pierson, J.P. Kriss, R.H. Jones, W.J. MacIntyre, New York, Wiley, 1975, pp. 123–154
Pitt, B., Strauss, H.W.: Myocardial imaging in the noninvasive evaluation of patients with suspected ischemic heart disease. Am. J. Cardiol. 37: 797–806, 1976
Schelbert, H.R., Henning, H., Ashburn, W.L., Verba, J.W., Karliner, J.W., O'Rourke, R.A.: Serial measurements of left ventricular ejection fraction by radionuclide angiography early and late after myocardial infarction. Am. J. Cardiol. 38: 407–415, 1976
Steele, P., Kirch, D., Lefree, M., Battock, D.: Measurement of right and left ventricular ejection fractions by radionuclide angiocardiography in coronary artery disease. Chest 70: 51–56, 1976
Strauss, H.W., Pico, P., Pitt, B.: Radioactive tracers in the evaluation of ischemic heart disease. In: Proceedings of the First World Congress of Nuclear Medicine. Tokyo, World Federation of Nuclear Medicine and Biology, 1974, pp. 1018–1022
Marshall, R.C., Freedman, G.S., Costia, J.C., Cohen, L.S., Gottschalk, A., Zaret, B.L.: Determination of left ventricular fraction and regional wall motion from first-pass, radionuclide angiocardiograms using a computerized multi-crystal scintillation camera. Proceedings of the 23rd Annual Meeting of the Society of Nuclear Medicine, 1976
Schad, N.: Nichtinvasive Darstellung der Wandbewegung und Schlagvolumenverteilung des linken Ventrikels nach Myokardinfarkt. Fortschr. Röntgenstr. 124: 201–206, 1976
Schad, N.: Nontraumatic assessment of left ventricular wall motion and regional stroke volume after myocardial infarction. J. Nucl. Med. 18: 333–341, 1977
Allen, C.H., Dizon, M.B., McMillen, F.F.: A sequential dynamic method of cardiovascular scanning using radioactivity and the autofluoroscope. In: Clinical Dynamic Function Studies with Radionuclides, edited by M.N. Croll, L.W. Brady, H.R. Tatem, T. Honda, New York, Meredith, 1972, pp. 85–97
Jones, R.H., Sabiston, D.C., Bates., B.B., et al.: Quantitative radionuclide angiocardiography for determination of chamber to chamber cardiac transit times. Am. J. Cardiol. 30: 855–864, 1972
Schelbert, H., Verba, J.W., Johnson, A.D., et al.: Non-traumatic determination of left ventricular ejection fraction by radionuclide angiocardiography. Circulation 51: 902–909, 1975
Reindl, P., Schad, N.: Untersuchungen zur Injectionstechnik für die Radiokardiographie. 12. Internationale Jahrestagung der Ges. f. Nuklearmedizin. Munich. Gesellschaft für Nuklear-medizin, 1974
Noelpp, U., Schad, N., Rösler, H.: Gradientenszintigraphie. (in press)
Pitt, B.: Right and left ventricular ejection fraction Chest 70: 321–22, 1976
Howe, W.R., Jones, R.H., Sabiston, D.C.: Radionuclide assessment of left ventricular function following cardiac surgery. Surgical Forum 27: 253–255, 1976
Stinson, E.B., Billingham, M.E.: Correlative study of regional left ventricular histology and contractile function. Am. J. Cardiol. 39: 378–383, 1977
Bodenheimer, M.M., Banka, V.S., Helfant, R.H.: Reversible asynergy and its determinants. Chest 69: 87–91, 1976
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Schad, N., Nickel, O. Radionuclide angiography of the heart in coronary heart disease: Where do we stand?. Cardiovasc Radiol 1, 27–35 (1978). https://doi.org/10.1007/BF02551970
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DOI: https://doi.org/10.1007/BF02551970