Abstract 2404: ECG Estimate Of Ischemic Acuteness and Time from Pain Onset for Predicting Myocardial Salvage in Patients Undergoing Primary Percutaneous Coronary Intervention

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Henrik Engblom ◽  
Bo Heden ◽  
Erik Hedstrom ◽  
Galen Wagner ◽  
Håkan Arheden
Keyword(s):  
Symptom Onset ◽  
Single Photon ◽  
Photon Emission ◽  
Coronary Intervention ◽  
Emission Computed Tomography ◽  
Myocardial Salvage ◽  
Coronary Syndrome ◽  
99Mtc Tetrofosmin ◽  
First Time ◽  
The Relationship

Background: The potential for salvage of jeopardized myocardium during coronary occlusion decreases as the duration of persistent ischemia is prolonged. Thus, it is important to be able to assess the acuteness of ischemia as a patient presents with signs of acute coronary syndrome. The aim of this study was to compare ECG estimate of ischemic acuteness and time from pain onset for predicting myocardial salvage in patients with first-time myocardial infarction (MI). Methods: Thirteen patients with acutely revascularized first-time MI were studied. All patients had 99mTc tetrofosmin injected and an ECG recorded prior to the PCI. TIMI III flow was obtained in all patients. Single photon emission computed tomography (SPECT) was undertaken within 3 hours of the PCI to assess the myocardium at risk (MaR). Delayed contrast-enhanced magnetic resonance imaging (DE-MRI) was performed 1 week after admission for assessment of infarct size (IS) and infarct transmurality (IT). A salvage index was calculated as (MaR-IS)/MaR. The acuteness of ischemia was estimated both from patient history and from the Anderson-Wilkins (AW) acuteness score of the pre-PCI ECG. Results: The figure shows the relationship between time of symptom onset and salvage index (A) and IT (C) as well as the relationship between AW acuteness score and salvage index (B) and IT (D). The time of symptom onset did not correlate with salvage index or IT. The AW acuteness score, however, showed a significant relationship with both salvage index and IT. Conclusions: The initial ECG changes are superior to time from symptom onset to PCI for predicting myocardial salvage and IT in patients undergoing PCI of first-time MI.

Abstract 15252: Segmental Myocardial Perfusion Improves after Repeated Intramyocardial Cell Injection

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Imke Mann ◽  
Sander F Rodrigo ◽  
Jan van Ramshorst ◽  
Saskia L Beeres ◽  
Jaap J Zwaginga ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Bone Marrow Mononuclear Cell ◽  
Repeated Injection ◽  
Refractory Angina ◽  
Rest Perfusion ◽  
Refractory Angina Pectoris ◽  
First Time

Introduction: We previously demonstrated that intramyocardial bone marrow mononuclear cell (MNC) injection improves segmental myocardial perfusion. This study was designed to evaluate in patients with recurrent refractory angina the effect of repeated injection on segmental myocardial perfusion. Methods: Twenty-one patients with recurrent refractory angina pectoris, who received 100x10^6 autologous MNC intramyocardially using the NOGA-system for a second time, were enrolled. Single-photon emission computed tomography was performed at baseline and 3 months after both injection procedures. The myocardium was divided into 17 segments and in both stress and rest images, segmental tracer activity was categorized on a 4-point scale. (1=>75%; 2=50%-74%; 3=25%-49%; 4=<25%) Segments demonstrating increased perfusion of at least 1 point in stress or rest perfusion were categorized as improved. Results: The second injection procedure was 4.6 ± 2.5 years after the first. In total, 139 segments were injected for the first time during either of the procedures, of which 80(58%) segments improved. Repeated injection in the same segment was performed in 45 segments. Of these segments, 18(40%) improved, less than after a first injection (P=0.030). Repeatedly injected segments can be subdivided in 29 previously responding segments (improved after the first injection) and 16 previously non-responding segments (not improved after the first injection). Of the responding segments, 13(45%) segments improved after repeated injection and of the non-responding segments, 5(31%) segments improved. This difference was not significant (P=.476). Conclusions: Segmental myocardial perfusion can improve after repeated intramyocardial MNC injection independently of the effect of the first injection, but the first injection is more effective.

Uptake of 99mTc-exametazime shown by single photon emission computed tomography before and after lithium withdrawal in bipolar patients: Associations with mania

1997 ◽  
Vol 170 (5) ◽  
pp. 426-430 ◽  
Author(s):  
Guy M. Goodwin ◽  
Jonathan T. O. Cavanagh ◽  
M. F. Glabus ◽  
R. F. Kehoe ◽  
R. E. O'Carroll ◽  
...  
Keyword(s):  
Single Photon ◽  
Photon Emission ◽  
Brain Perfusion ◽  
Anterior Cingulate ◽  
Emission Computed Tomography ◽  
Manic Symptoms ◽  
Before And After ◽  
Bipolar Patients ◽  
The Relationship ◽  
Lithium Withdrawal

BackgroundEarly manic relapse following lithium discontinuation offers an important opportunity to investigate the relationship between symptoms, effects of treatment and regional brain activation in bipolar affective disorder.MethodFourteen stable bipolar patients on lithium were examined with neuropsychological measures, clinical ratings and single photon emission computed tomography (SPECT) before and after acute double-blind withdrawal of lithium. Brain perfusion maps were spatially transformed into standard stereotactic space and compared pixel-by-pixel. A parametric analysis was used to examine the change in brain perfusion on lithium withdrawal, and the relationship between symptom severity and brain perfusion separately both between and within subjects.ResultsLithium withdrawal was associated with an important redistribution of brain perfusion, with increases in inferior posterior regions and decreases in limbic areas, particularly anterior cingulate cortex. Seven of the 14 patients developed manic symptoms during the placebo phase, correlating with relative increases in perfusion of superior anterior cingulate and possibly left orbito-frontal cortex.ConclusionsThe important effect of lithium withdrawal on brain perfusion implies that after withdrawal of lithium, the brain develops an abnormal state of activity in limbic cortex. The structures involved did not co-localise with those apparently modulated by manic symptoms.

Most Important Prognostic Values to Predict Major Adverse Cardiovascular, Cerebrovascular, and Renal Events in Patients with Chronic Kidney Disease Including Hemodialysis for 2 Years

Cardiology ◽  
2019 ◽  
Vol 142 (1) ◽  
pp. 14-23
Author(s):  
Takuji Toyama ◽  
Shu Kasama ◽  
Makito Sato ◽  
Hirokazu Sano ◽  
Tetsuya Ueda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
99Mtc Tetrofosmin ◽  
Cerebrovascular Events ◽  
Increased Risk ◽  
Free Rate

Patients with chronic kidney disease (CKD) have an increased risk of adverse cardiovascular/cerebrovascular events. The aim of this study is to clarify whether stress myocardial perfusion single-photon emission computed tomography (SPECT) could predict cardiovascular/cerebrovascular events. In the Gunma-CKD SPECT Study, a multicenter prospective cohort trial, 311 patients with CKD (estimated glomerular filtration rate < 60 min/mL/1.73 m2) including 50 patients on hemodialysis underwent stress 99mTc-tetrofosmin SPECT for suspected ischemic heart disease and were followed for 2 years. The primary endpoint was the occurrence of cardiac death (CD), while the secondary endpoint was major adverse cardiovascular/cerebrovascular and renal events (MACCRE). MACCRE occurred in 91 out of 286 patients (CD in 13 and other MACCRE in 78 patients). According to a multivariate Cox analysis, hemoglobin (Hb) and end-systolic volume (ESV) were associated with CD (p < 0.05), while the summed difference score, diabetes mellitus (DM), and Hb were associated with MACCRE (p < 0.05). Kaplan-Meier analysis showed that the CD-free rate was higher in patients with ESV < 105 mL (log-rank, p = 0.0013), Hb > 12 g (log-rank, p = 0.0036), and a summed stress score < 6 (log-rank, p = 0.0058). The MACCRE-free rate was higher in patients with SDS = 0 (log-rank, p = 0.0097), without DM (log-rank, p = 0.0091), and with Hb > 12 g (log-rank, p = 0.0023). Myocardial perfusion SPECT parameters as well as renal anemia and DM can be reliable prognostic markers in patients with CKD including hemodialysis.

scholarly journals SPECT for Differential Diagnosis of Dementia and Correlation of rCBF with Cognitive Impairment

1994 ◽  
Vol 21 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Alicia Osimani ◽  
Masanori Ichise ◽  
Dae-Gyun Chung ◽  
Janice M. Pogue ◽  
Morris Freedman
Keyword(s):  
Differential Diagnosis ◽  
Language Impairment ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Hmpao Spect ◽  
Clinical Diagnoses ◽  
Diagnosis Of Dementia ◽  
The Relationship ◽  
Differential Diagnosis Of Dementia

Abstract:99mTc-HM-PAO single photon emission computed tomography (SPECT) was used to image 30 patients referred for the assessment of dementia. SPECT images revealed various patterns of regional cerebral perfusion (rCBF) in the subgroups of patients with the clinical diagnoses of Alzheimer's disease (AD, n = 14), Pick's disease (n = 1), and multi-infarct dementia (n = 7). In three patients, SPECT clarified the clinical differential diagnostic possibilities. Using a relative rCBF quantification technique, the relationship between specific cognitive impairments and rCBF in the AD patients was determined. There was a significant correlation between language impairment and left hemisphere hypoperfusion, whereas, apraxia correlated with hypoperfusion in the left parietal region. Thus, HMPAO SPECT is useful as an aid in the differential diagnosis of dementia and the technique of relative rCBF quantification with SPECT may contribute to the understanding of the clinico-anatomical relations of cognitive deficits in dementia.

scholarly journals Long Term Follow up After Successful Recanalization of Coronary Artery Chronic Total Occlusion Using Antegrade Versus Retrograde Approach by Single Photon Emission Computed Tomography

2021 ◽  
pp. 1-27
Author(s):  
Abdulaziz Aboshahba ◽  
◽  
Ahmed H Almidany ◽  
Mamdouh Alttahan ◽  
◽  
...  
Keyword(s):  
Single Photon ◽  
Photon Emission ◽  
Coronary Intervention ◽  
Emission Computed Tomography ◽  
Success Rates ◽  
Total Occlusion ◽  
Chronic Total Occlusions ◽  
Percutaneous Coronary ◽  
Long Term Follow Up

Background: Coronary chronic total occlusions (CTOs) represent the most technically challenging lesion subset that interventional cardiologists face. CTOs are identified in up to one third of patients referred for coronary angiography and remain seriously undertreated with percutaneous techniques. The complexity of these procedures and the suboptimal success rates over a long period of time, along with the perception that CTOs are lesions with limited scope for recanalization, account for the underutilization of CTO Percutaneous Coronary Intervention (PCI).

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