Left ventricular ejection fraction, myocardial blood flow and hemodynamic variables in adenosine and regadenoson vasodilator 82-Rubidium PET

2021 ◽  
Author(s):  
Simon M. Frey ◽  
Ursina Honegger ◽  
Olivier F. Clerc ◽  
Federico Caobelli ◽  
Philip Haaf ◽  
...  
Keyword(s):  
Blood Flow ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Myocardial Blood Flow ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Hemodynamic Variables

scholarly journals Influence of adenosine and regadenoson on left ventricular ejection fraction, myocardial blood flow and hemodynamics in vasodilator 82-Rubidium PET

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
S Frey ◽  
U Honegger ◽  
OF Clerc ◽  
F Caobelli ◽  
PH Haaf ◽  
...  
Keyword(s):  
Blood Flow ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Myocardial Blood Flow ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Flow Reserve ◽  
Positron Emission

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Most 82Rubidium-(Rb)-Positron emission tomography (PET) studies for myocardial perfusion, dipyridamole was used as vasodilator. Less data is available for adenosine and regadenoson. Purpose Therefore, the aim was to evaluate the influence of adenosine and regadenoson on left ventricular ejection fraction (LVEF), myocardial blood flow (MBF) and hemodynamics in vasodilator 82Rb-PET. Methods Consecutive patients (n = 2299) with suspected or known coronary artery disease (CAD) undergoing 82Rb-PET were studied and compared according to CAD status and normal/abnormal PET (abnormal defined as summed stress score ≥4). Differences between stress and rest values (LVEF, MBF, hemodynamics) were calculated. The threshold of stress LVEF able to exclude a relevant ischemia (as defined by ≥10% myocardium ischemic based on SDS score) was assessed. Results Rest and stress LVEF differed significantly depending on CAD status and scan results. In patients with suspected CAD, rest/stress LVEF were 68 ± 12% and 73 ± 12% (p < 0.001), in patients with prior CAD 60 ± 14% and 63 ± 15% (p < 0.001). LVEF during stress increased 5 ± 6% in normal compared to 1 ± 8% in abnormal PET (p < 0.001). Global rest MBF (rMBF), stress MBF (sMBF) and myocardial flow reserve (sMBF/rMBF) were significantly higher in suspected CAD patients compared to prior CAD patients (1.3 ± 0.5, 3.3 ± 0.9, 2.6 ± 0.8 and 1.2 ± 0.4, 2.6 ± 0.8, 2.4 ± 0.8 ml/g/min, respectively, p < 0.001), and in normal versus abnormal scans, irrespective of CAD status (no CAD: 1.4 ± 0.5, 3.5 ± 0.8, 2.8 ± 0.8 and 1.2 ± 0.8, 2.5 ± 0.8, 2.2 ± 0.7; known CAD: 1.3 ± 0.4, 3.1 ± 0.8, 2.7 ± 0.8 and 1.1 ± 0.4, 2.3 ± 0.7, 2.2 ± 0.7 ml/g/min, respectively, p < 0.001). LVEF and hemodynamic values were similar for adenosine and regadenoson stress. Stress LVEF ≥70% excluded relevant ischemia with a negative predictive value (NPV) of 94% (CI 92-95%). Conclusions Rest/stress LVEF, LVEF reserve and MBF values are lower in abnormal compared with normal scans. Adenosine and regadenoson seem to have similar effect on stress LVEF, MBF and hemodynamics. A stress LVEF ≥70% has a high NPV to exclude relevant ischemia.

Intra-aortic balloon pumping increases renal blood flow in patients with low left ventricular ejection fraction

Perfusion ◽  
2008 ◽  
Vol 23 (4) ◽  
pp. 223-226 ◽  
Author(s):  
E Sloth ◽  
P Sprogøe ◽  
C Lindskov ◽  
A Hørlyck ◽  
J Solvig ◽  
...  
Keyword(s):  
Blood Flow ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Creatinine Clearance ◽  
Renal Blood Flow ◽  
Velocity Profiles ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Intra-aortic balloon pumping (IABP) has, for decades, been one of the key treatment modalities following impaired cardiac function after cardiac surgery. IABP increases cardiac output, decreases oxygen consumption of the heart and relieves the left ventricle. However, a number of complications have been reported in connection with IABP treatment. Only a few studies have evaluated renal blood flow and the purpose of this prospective study was to evaluate whether renal blood flow was affected by IABP treatment in high-risk patients. After approval from the county ethical committee and informed consent, seven consecutive patients with low left ventricular ejection fraction and scheduled for preoperative IABP treatment were allocated to the study. Assessment of renal blood flow was based on ultrasound spectral Doppler estimation of the flow velocity profiles in the interlobar kidney arteries. The result was described as balloon index (BI), which is maximal systolic velocity divided by the temporal mean velocity. Typical velocity profiles were demonstrated in all patients before, during and after IABP. BI measurement changed with time (p <0.05). BI was lower during IABP compared to both pre-IABP and post-IABP (p <0.025), indicating a higher renal blood flow. No statistically significant changes were seen in s-creatinine or creatinine clearance. Assuming unchanged diameter of kidney arteries and no considerable decrease in renal resistance and/or compliance, we conclude that the interlobar renal blood flow was significantly increased during IABP treatment, measured by ultrasound Doppler technique, but without a simultaneously significant change in creatinine clearance.

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