Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Angiographically determined changes in segmental wall motion (SWM) and ejection fraction (EF) are sensitive indices of left ventricular (LV) function. To compare the effects of exercise on LV function, first pass radionuclide angiocardiography was used before and during maximal upright bicycle stress in patients with nonsignificantly stenosed coronary arteries, and in those with greater than 75% stenosis. Gamma camera acquisitions were made in the 30 degree RAO projection using a 20 mCi I.V. bolus of 99mTc-pertechnetate. In the control group (seven normals, one nonsignificant (CAD) the EF significantly increased between rest and exercise (0.65 +/- 0.03 to 0.81 +/- 0.03 (mean +/- SEM), p less than 0.005). In this group SWM measured over the two anterior and two inferoposterior segments uniformly increased. In the 11 patients with a history of angina and significant coronary artery obstruction, the EF did not change in three and significantly decreased in the remaining eight (0.57 +/- 0.04 to 0.45 +/- 0.03, p less than 0.005). In all 11 patients SWM either decreased or did not increase in the areas supplied by the significantly stenosed coronary arteries. Upright maximal stress angiocardiography appears to be well-suited for diagnosing ischemic heart disease and localizing the area of ischemic dysfunction.
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PMID:Effects of maximal exercise stress on left ventricular function in patients with coronary artery disease using first pass radionuclide angiocardiography: a rapid, noninvasive technique for determining ejection fraction and segmental wall motion. 75 25

Hemodynamic evaluation of coronary artery stenosis is indicated in patients with ischemic heart disease. For this purpose myocardial perfusion scans are performed. In our study myocardial scans were performed by selective injection of 60 to 80 muCi of (131)I-MAA in the right coronary artery and of 3 mCi of (99m)Tc-microspheres in the left coronary artery. Four views (RAO, LAO, AP, LLAT) were taken with an Anger-Camera and a computer-control-led color-coded display system (Picker Dyna-Came-ra 3C/12 and Kruppe Atlas Elektronik EPR 1100, medium energy collimator). Right and left coronary artery perfusion images were stored and two-colour image produced. Following computer processing (smoothing, normalization) the images were added and photographed in color. In comparision with scans and left-ventricular and coronary angiography the sensitivity of the nuclear medicine method was shown in cases with reduced perfusion. Therefore the perfusion scans seem to be useful in combination with angiography for the determination of therapy.
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PMID:[Invasive myocardial perfusion scan with (131)I-MAA and (99m)Tc-Microspheres (author's transl)]. 92 74

Dual gated (DG) cardiac single photon emission computed tomographic (SPECT) studies at end-diastole (ED) and end-systole (ES) were acquired in 27 ischaemic heart disease (IHD) patients after intravenous injection of 555-740 MBq 99Tcm-MIBI. Acquisition parameters were: 180 degrees from LPO to RAO, 32 projections, 64 x 64 matrix, 75 cardiac beats per projection, 80 ms at ED and 80 ms at ES for each cardiac cycle. A computer program was developed to calculate the ED and ES left ventricular (LV) volumes and LV ejection fraction (EF). The computational approach is interactive, semi-automatic and iterative with built-in visual quality control. Short axis slices are used with corresponding ED and ES slices processed as pairs from apex to base. Left ventricular cavity pixels are identified and summed on a slice-by-slice basis. Myocardial pixels are similarly identified. The computed LVEF and ED and ES volumes have been correlated with those from contrast ventriculography (CV). The mean calculated EF for 27 patients was 53.6 +/- 10.7% from DG SPECT versus 55.3 +/- 12.1% from CV (NS). The EF linear correlation coefficient was r = 0.97.
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PMID:Left ventricular ejection fraction and volumes calculated from dual gated SPECT myocardial imaging with 99Tcm-MIBI. 144 37

The ability of 99Tcm-methoxyisobutylisonitrile (MIBI) single photon emission tomography (SPET) to detect myocardial ischaemia and necrosis was assessed in 56 patients (45 male, 11 female, aged 55 +/- 5 years), with clinically recognized ischaemic heart disease (IHD). All underwent coronary angiography (CA) and left ventriculography (LV). SPET images were obtained at rest and at peak exercise (Modified Bruce) 90 min after injection of 99Tcm-MIBI (650-850 MBq). Data were acquired in 30 min over 180 degrees (from 45 degrees RAO to 45 degrees LPO) with no correction for attenuation, using a 64 x 64 matrix. The presence of persistent (P) or reversible (R) perfusion defects (PD) was then correlated to the resting and exercise ECG and to the results of CA and LV. Of the 56 patients, 34 had reversible underperfusion (RPD), 46 persistent underperfusion (PPD) and 31 had both. The occurrence of RPD correlated well with the occurrence of exercise-induced ST segment depression and/or angina (27 patients of 34 patients, 79%) and with the presence of significant coronary artery disease (CAD) (33 of 44, 73%). In 45 of 46 patients (98%) PPD corresponded to akinetic or severely hypokinetic segments (LV) usually explored by ECG leads exhibiting diagnostic Q waves (42 of 46 patients, 91%). The scan was normal both at rest and after stress in four of 11 patients with no CAD, and in two of 45 patients with CAD. Finally, an abnormal resting scan was seen in seven of 11 patients with normal coronary arteries, of whom six had regional wall motion abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:99Tcm-MIBI single photon emission tomography (SPET) for detecting myocardial ischaemia and necrosis in patients with significant coronary artery disease. 146 70

Biplane 30-degree RAO and 60-degree LAO RV selective cineangiography was performed in 21 patients with significant ventricular arrhythmias (ventricular tachycardia in 14, salvos in three, and complex PVCs in seven) and a high presumption of arrhythmogenic RV dysplasia (ARVD), and in a control group of 10 presumed normal individuals. Comparing the two series revealed the lack of specificity of some angiographic images usually reported as suggestive signs of ARVD, such as slow dye evacuation of RV during the levophase and deep fissuring in the anterior wall with a "pile of plates" image. Inversely, localized morphologic and contraction abnormalities in the RV free wall were more sensitive and specific signs for diagnosis of ARVD; these were localized akinetic or dyskinetic bulges sometimes giving a true image of aneurysm (90%), wide and deep fissuring of the apex or of the inferior wall (33%), and large areas of akinesia. By order of frequency, these abnormalities were found on the apex in 71%, on the inferior wall in 52%, on the anterior wall in 48%, in the subtricuspid area in 38%, and on the pulmonary infundibulum in 33%. These localized lesions can suffice for the diagnosis of RV dysplasia in the absence of associated pathologies, such as ischemic heart disease or congenital defects. Usually a global RV systolic dysfunction is associated in ARVD, as confirmed by greater RV volumes (134 +/- 26 vs 79 +/- 10 ml/m2 for RVEDV, p less than 0.001; 76 +/- 34 vs 32 +/- 6 ml/m2 for RVESV, p less than 0.001), and lower RV ejection fraction (58 +/- 18% vs 47 +/- 8%, p less than 0.001) in the ARVD group compared to controls. Nevertheless, normal RV volumes and ejection fraction can be observed in some localized forms with mono- or bisegmental lesions in which RV systolic dysfunction is absent or moderate, and extensive forms with multiple segmental lesions where RV systolic dysfunction is constant and often severe. Six out of 21 patients in the ARVD group exhibited obvious global or segmental LV dysfunction, indicating the possibility of biventricular forms, as previously reported in other publications.
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PMID:Critical analysis of cineangiographic criteria for diagnosis of arrhythmogenic right ventricular dysplasia. 334 Nov 80

Left ventricular wall motion was analyzed in a spatial geometric manner assuming the quantitative vectors formed by the reference points' movement on two-dimensional echocardiogram in 58 normal subjects and 40 patients with ischemic heart disease. Long-axis, RAO-equivalent and short-axis views, termed sagittal, frontal, and horizontal planes, respectively, were visualized and two or three reference points were defined on each plane. The vectors of these points' movement were obtained from video-image tracings on each plane and systolic excursion and distortion angles of each pair of reference points were vectorially assessed. All vectors in myocardial infarction were directed towards the infarcted areas. Clockwise horizontal distortion of the left ventricle apex-to-base axis was observed in normal subjects, but it was slight (3.1 +/- 3.0 degrees: mean +/- SD at the papillary muscle horizontal section). However, larger horizontal distortion was observed in single coronary artery disease, which may lead to the erroneous segmental wall motion analysis using conventional cineangiography because of the overlap of the adjacent segments.
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PMID:[Left ventricular wall motion in ischemic heart disease quantitatively assessed by three-dimensional vectors of reference points in multi-directional two-dimensional echocardiography]. 406 49

Myocardial perfusion imaging with thallium chloride has been found to be effective in the clinical evaluation of patients with myocardial infarction. However, conventional myocardial perfusion imaging of the myocardium showing the postero-septal and antero-lateral wall cannot be obtained clearly by the conventional collimator due to the inevitable distance between the collimator and the heart. In contrast, 30, 60-degree RAO images were obtained clearly using slant-hole collimator with the collimator closely contact with the heart, which enables us to observe the postero-septal and antero-lateral walls of the myocardium. As a result, we obtained myocardial perfusion images every 30-degrees in a radial direction. By dividing RAO images into 12 segments, we compared perfusion defect in the myocardial scintigram with akinesis detected by echocardiography and contrast left ventriculography segmentally and referred to the character and accuracy of these three examinations. As a result, these three methods well agreed in cases with myocardial infarction of single vessel disease, but did not always agree in cases with triple vessel disease. The character of each method was as follows: 1) Left ventriculography, which gives direct information concerning wall motion of the left ventricle, was most sensitive to detect ischemic lesions, but had a tendency to overestimate hypokinesis of wall motion due to its invasive nature. 2) In myocardial scintigraphy, when hypoperfusion is associated with perfusion defect, we occasionally diagnose mistakenly the hypoperfusion area as normal because the scintigraphic evaluation is based on the relative distribution of perfusion. To avoid such underestimation, exercise myocardial scintigraphy should be performed and myocardial ischemia should be evaluated by comparing exercise images with redistribution images. Moreover, we studied extension of perfusion defect in the anterior and infero-posterior infarction groups. In anterior myocardial infarction, perfusion defect extended beyond the apex and reached the point one-third away from the apex to the base. In infero-posterior myocardial infarction, perfusion defect extended into the apex but did not exceed the apex. It seemed that the most suitable point to make the boundary between apical and infero-posterior areas was the point one-third away from the apex to the base along the inferior half of the RAO image of the myocardium.
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PMID:[Evaluation of myocardial ischemia by (RAO) long-axial myocardial imaging using slant-hole collimator]. 711 85

Illustrated by a case report, which was rather suggestive of coronary ischemic heart disease, the principle characteristics of apical hypertrophic cardiomyopathy are outlined. Outside East Asia, it remains a very uncommon variant of hypertrophic cardiomyopathy. The electrocardiogram in basal conditions showed giant negative T-waves (-14 mm) in the precordial leads, while the ventriculogram in RAO projection revealed the typical, so called "ace of spades" configuration. Based on the present literature and the follow-up of these patients a review of apical hypertrophic cardiomyopathy is presented. One of the most important consequences of the identification of this variant seems to be the rather good prognosis when compared to other forms of hypertrophic cardiomyopathy.
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PMID:Apical hypertrophic cardiomyopathy. 821 71

To evaluate left ventricular (LV) wall motion stereoscopically from all directions and to calculate the LV volume by three-dimensional (3D) imaging. 99mTc-DTPA human serum albumin-multigated cardiac pool-single photon emission computed tomography (99mTc-MUGA-SPECT) was performed. A new data processing program was developed with the Application Visualization System-Medical Viewer (AVS-MV) based on images obtained from 99mTc-MUGA-SPECT. In patients with previous myocardial infarction, LV function and LV wall motion were evaluated by 3D-99mTc-MUGA imaging. The LV end-diastolic volume (LVEDV) and end-systolic volume (LVESV) were obtained from 3D-99mTc-MUGA images by the surface rendering method, and the left ventricular ejection fraction (LVEF) was calculated at thresholds of 35% (T1), 40% (T2), 45% (T3), and 50% (T4). There was a strong correlation between the LV volume calculated by 3D-99mTc-MUGA imaging at a threshold of 40% and that determined by contrast left ventriculography (LVEDV: 194.7 +/- 36.0 ml vs. 198.7 +/- 39.1 ml, r = 0.791, p < 0.001; LVESV: 91.6 +/- 44.5 ml vs. 93.3 +/- 41.3 ml, r = 0.953, p < 0.001), respectively. When compared with the LVEF data obtained by left ventriculography, significant correlations were found for 3D images reconstructed at each threshold (T1: r = 0.966; T2: r = 0.962; T3: r = 0.958; and T4: r = 0.955). In addition, when LV wall motion obtained by 3D-99mTc-MUGA imaging (LAT and LAO views) was compared with the results obtained by left ventriculography (RAO and LAO views), there was good agreement. 3D-99mTc-MUGA imaging was superior in allowing evaluation of LV wall motion in all directions and in assessment of LV function, since data acquisition and image reconstruction could be done within a short time with the three-detector imaging system and AVS-MV. This method appears to be very useful for the observation of both LV wall motion and LV function in patients with ischemic heart disease, because it is a noninvasive examination.
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PMID:Evaluation of left ventricular wall motion and function in patients with previous myocardial infarction by three-dimensional 99mTc-HSAD multigated cardiac pool imaging. 921 93