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Continuous monitoring of LV function during exercise: A preliminary study of reproducibility
JOURNAL OF NUCLEARCARDIOLOGY Volume 2, Number 2, Part 2
Abstracts Wednesday morning, April 26, 1995
S101
P18-401
P18-403
A "GEOMETRI(' - (:OLNI" BA~ED" (GCB) h~TI-IOD pI~I)R QUANTIFICATION OF LEFT VENTRICIJ~AR \;()LL~MES
EFFECTS OF REST AND EXERCISE ON CARDIAC VOLUMES DETERMINATIONS BY COUNT-BASED METHOD FROM Tc-99m-HSA AND Tc-99m-RED BLOOD CELLS GATED VENTRICULOGRAPHY
M. Veljovic, V. Bosnlakovic, D. Markovic. D. Sobic, S Pavlovi4, N K 6 ~ Y 6 ~ C T S ~ i c . Institute of Nuclear M6dicine, CCS, Belgrade, Yugoslavia 'An orimnal method for quantification of left ventricular (LV) voltan6" based on rhdionuclide ventricum~apny was developed. COunt based data were combinea with the geome[ric based ones assuming a prolate ellipsoid LV shape (with identical short axes). The following equation for computing LV volume was developed. V = 2 * M 2 9 D * Ccot/Cmax
(1) where:
V = LV volume (cc) M = Calibrated pixel size (cm): Ctot = Total counts in LV ROI (cts)3 Cma.x ='Maximum pixel counts in LV ROI (cts); D = "ROI" drawn short axis of prolate ellipsoid in LAO 45 (cm). Physical experiments wit5 heart shaped phantoms were used to compare OCB with the method assuming a ball LV shape CBLV) developed by Massardo et al. The true volumes of cylindrical and ellipsoid phantoms of t 12.5 cc and of 190.5 co, were computed to be 114 cc and 196 cc by GCB and 168 cc and 180 cc by B L V . respectively. Seveh normals (EF=61.14 _+ 3.02%) and 6 pt.4 wit,/ dilatd~d cardiomvopathy (DClvl) (EF=31.3 :_~ 7 . 6 % ) w e r e studied. Mean values of end diastolic LV volume (EDV), stroke volume (SV) and cardiac output (CO) in nonfials aS cardiac indices (C I) were found to be 60.85 • 5.93 ml /mz : 36.85 _+ 4.48 ml/m2 and 2.35 ~_:(3.52 1/mimm2 . respectivelv.in DCM pts CI values ofEDV. SV and CO were: 1"14.2 +_4 3 7 ml m2 , 32.'8 +_ 13.5 ml/m2 and 2.64 • l/min/m2 , respectively A good correlation of (GCB) method was obiainedwith gated Blood pool SPECT (r=090, tot EDV) and contrast ventricuk~graphy (r=098, for EDV).
Topuzovic N, Rusic A, Brlosic R, Krstonosic B, Karner I Dept. Nuclear Medicine, Clinical Hospital, Osijek, Croatia The aim of this study was to investigate the changes in blood activity dudng rest, exercise and recovery penods and its influence on cardiac volume. 13 patients underwent radionudide ventdculography with Tc-99m-HSA (Group I), and 17 patients with Tc-99m-labeled red blood cells (Group II) for clinically indicated rest-stress studies. Left ventncular volumes were determined by a count-based method using corrected counts rate in blood samples obtained dunng rest, peak exercise and after recovery. In Group I at stress, the blood activity decreased 12.6 + 5.4 % (p< 0.05) compared to the rest level, and increased 25.1 + 6.4 % (p< 0.001) above resting in Group II. This had a profound effects on cardiac volumes determinations if only rest blood aliquot was used: during exercise the cardiac volumes Significantly decreased adiflcially in Group I (22.1 + 9.6 %, p<0.05), but in Group II was signit'r overestimated (32.1 + 10.3%, p< 0.001). The changes in blood activity between the stress and recovery were not significantly different for both Group. In conclusion, taking only one blood sample as aliquot in rest-stress studies lead to erroneous estimation of cardiac volume due to significant changes in blood radioactivity dudng exercise.
P18-402
P18-404
CONTINUOUS MONITORING OF LV FUNCTION DURING EXERCISE: A PRELIMINARY STUDY OF REPRODUCIBILITY. Cioglia G, L a i C, M e r c u r o G, M a n c a MR, Cherchi A. I n s t o f C a r d i o l o g y , Univ of Cagliari, Italy The cardiac response to exerclse was assessed with an ambulatory ventricular function monitor (VEST), in 13 patients with stable angxna pectoris. Data recording started while the subjects sat quietly o n b i c y c l e ergometer a n d c o n t i nued during maximal symptom-limited exercise. After 1 hour of rest, the stress test was repeated. In 9 subjects the exercise was repetead the day after. We studied left ventricular e3ection fraction (EF), r e l a t i v e end diastolic and systolic volume (EDV, ESV), relative cardiac output (CO). rest 20% 40% 60% 80%100% 2R 5R EF exl 49 51 52 51 48 45 59 59 ex2 51 53 54 55 53 47 59 61 day a 48 51 53 50 47 41 59 59 day b 47 52 55 54 52 42 58 62 No statistically significant differences were observed between EF measured during the first and the second exercise a n d in d i f f e r e n t days.
R A D I O I S O T O P I C E V A L U A T I O N O F A D R U G E F F E C T O N LEFT VENTRICULAR FUNCTION:
Does peHndopril improve the left ventricular function in pa//ents with congestive heart failure ? A.E.Deamrgah M.D.*, t, Bernay M.D. *, T.Ba~o~hi M.D.*, E . Oncel M.D. ** O. SaC.an M_D.**. Departmmts of Nuclear Medicine*~d Cardiology**, Facility of Medicine, Ondokuzmayxs University, S ~ , TURKEY The aim of this study was to investigate the effe~ of perindoprfl which is an ansiote~asin-convertin 8 enzyme inhibitor on lea't ventrioalar function in patients with congestive heart failure (CH:F). A total of 15 patients with CHF ( New York H e , ~ Association Class 2 - 3 ) (range: 36 - 68 yrs : mean age: 52.3 :t: 4.2 yrs ) were exmnmed using radionuclide ventriculography (RNV) and edaoc~dibsraphy (EC) . /Mter a baseline RNV and EC were madeataken , the patients Were treated with 75 nag ( 3 x 25 m 8 ) pea'indopril orally per day. EC and RNV were repeated eight to twelve weeks after the onset of the therapy. The calculated mema left ventrioxlar diastolic attd systolic fimctlon values on RNV before ~ald a f ~ treatment Were ; Ejection fractlon (%) 35.14 • 1.54 to 36.5 :t: l.86 ( normal values = >= 50 % ) , Peak filling rate ( E D V / s e c ) 1.44 • 0.16 to 1.84 • 0A8 ( normal values = 3.3 • 0.6) , Time to peak filling ( msec ) 330 • 7.1 to 280 • 18 ( normal values = 136 • 22), Peak emptying r u t e ( E D V / s e c ) 1.707 :e 0.071to I.77 • 0.13 ( n o r m a l v a l u e s = 2.7:i:0.5), Time to peak emptying ( ~ ) 280 • 7 to 260 • 5 ( normal values = 182 • 44 ) . The ejection fraction values measured on EC were : 31.57 9 2 . 2 1 % to 32.45 -i: 2.64 % . There was not a signific,,mt ditference between the pre- sad post-treatment ejection fraction values with both methods ( p > 0.05 ). The peak filling and eantayin 8 p~ameters measured on RNV before mid after treatment were also not si~aificsmtly different ( p > 0.05 ) . In conclusion, both RNV and EC deanonstrated that there was no lmprovemaent in left ventr~.cular ejection fraction aRer perindopril treatment. The systolic ~md diastolic peak filling parameters calculated by RNV confirmed the absence ofldt ventricul~ function improveanent.
Abstracts Wednesday morning, April 26, 1995
S101
P18-401
P18-403
A "GEOMETRI(' - (:OLNI" BA~ED" (GCB) h~TI-IOD pI~I)R QUANTIFICATION OF LEFT VENTRICIJ~AR \;()LL~MES
EFFECTS OF REST AND EXERCISE ON CARDIAC VOLUMES DETERMINATIONS BY COUNT-BASED METHOD FROM Tc-99m-HSA AND Tc-99m-RED BLOOD CELLS GATED VENTRICULOGRAPHY
M. Veljovic, V. Bosnlakovic, D. Markovic. D. Sobic, S Pavlovi4, N K 6 ~ Y 6 ~ C T S ~ i c . Institute of Nuclear M6dicine, CCS, Belgrade, Yugoslavia 'An orimnal method for quantification of left ventricular (LV) voltan6" based on rhdionuclide ventricum~apny was developed. COunt based data were combinea with the geome[ric based ones assuming a prolate ellipsoid LV shape (with identical short axes). The following equation for computing LV volume was developed. V = 2 * M 2 9 D * Ccot/Cmax
(1) where:
V = LV volume (cc) M = Calibrated pixel size (cm): Ctot = Total counts in LV ROI (cts)3 Cma.x ='Maximum pixel counts in LV ROI (cts); D = "ROI" drawn short axis of prolate ellipsoid in LAO 45 (cm). Physical experiments wit5 heart shaped phantoms were used to compare OCB with the method assuming a ball LV shape CBLV) developed by Massardo et al. The true volumes of cylindrical and ellipsoid phantoms of t 12.5 cc and of 190.5 co, were computed to be 114 cc and 196 cc by GCB and 168 cc and 180 cc by B L V . respectively. Seveh normals (EF=61.14 _+ 3.02%) and 6 pt.4 wit,/ dilatd~d cardiomvopathy (DClvl) (EF=31.3 :_~ 7 . 6 % ) w e r e studied. Mean values of end diastolic LV volume (EDV), stroke volume (SV) and cardiac output (CO) in nonfials aS cardiac indices (C I) were found to be 60.85 • 5.93 ml /mz : 36.85 _+ 4.48 ml/m2 and 2.35 ~_:(3.52 1/mimm2 . respectivelv.in DCM pts CI values ofEDV. SV and CO were: 1"14.2 +_4 3 7 ml m2 , 32.'8 +_ 13.5 ml/m2 and 2.64 • l/min/m2 , respectively A good correlation of (GCB) method was obiainedwith gated Blood pool SPECT (r=090, tot EDV) and contrast ventricuk~graphy (r=098, for EDV).
Topuzovic N, Rusic A, Brlosic R, Krstonosic B, Karner I Dept. Nuclear Medicine, Clinical Hospital, Osijek, Croatia The aim of this study was to investigate the changes in blood activity dudng rest, exercise and recovery penods and its influence on cardiac volume. 13 patients underwent radionudide ventdculography with Tc-99m-HSA (Group I), and 17 patients with Tc-99m-labeled red blood cells (Group II) for clinically indicated rest-stress studies. Left ventncular volumes were determined by a count-based method using corrected counts rate in blood samples obtained dunng rest, peak exercise and after recovery. In Group I at stress, the blood activity decreased 12.6 + 5.4 % (p< 0.05) compared to the rest level, and increased 25.1 + 6.4 % (p< 0.001) above resting in Group II. This had a profound effects on cardiac volumes determinations if only rest blood aliquot was used: during exercise the cardiac volumes Significantly decreased adiflcially in Group I (22.1 + 9.6 %, p<0.05), but in Group II was signit'r overestimated (32.1 + 10.3%, p< 0.001). The changes in blood activity between the stress and recovery were not significantly different for both Group. In conclusion, taking only one blood sample as aliquot in rest-stress studies lead to erroneous estimation of cardiac volume due to significant changes in blood radioactivity dudng exercise.
P18-402
P18-404
CONTINUOUS MONITORING OF LV FUNCTION DURING EXERCISE: A PRELIMINARY STUDY OF REPRODUCIBILITY. Cioglia G, L a i C, M e r c u r o G, M a n c a MR, Cherchi A. I n s t o f C a r d i o l o g y , Univ of Cagliari, Italy The cardiac response to exerclse was assessed with an ambulatory ventricular function monitor (VEST), in 13 patients with stable angxna pectoris. Data recording started while the subjects sat quietly o n b i c y c l e ergometer a n d c o n t i nued during maximal symptom-limited exercise. After 1 hour of rest, the stress test was repeated. In 9 subjects the exercise was repetead the day after. We studied left ventricular e3ection fraction (EF), r e l a t i v e end diastolic and systolic volume (EDV, ESV), relative cardiac output (CO). rest 20% 40% 60% 80%100% 2R 5R EF exl 49 51 52 51 48 45 59 59 ex2 51 53 54 55 53 47 59 61 day a 48 51 53 50 47 41 59 59 day b 47 52 55 54 52 42 58 62 No statistically significant differences were observed between EF measured during the first and the second exercise a n d in d i f f e r e n t days.
R A D I O I S O T O P I C E V A L U A T I O N O F A D R U G E F F E C T O N LEFT VENTRICULAR FUNCTION:
Does peHndopril improve the left ventricular function in pa//ents with congestive heart failure ? A.E.Deamrgah M.D.*, t, Bernay M.D. *, T.Ba~o~hi M.D.*, E . Oncel M.D. ** O. SaC.an M_D.**. Departmmts of Nuclear Medicine*~d Cardiology**, Facility of Medicine, Ondokuzmayxs University, S ~ , TURKEY The aim of this study was to investigate the effe~ of perindoprfl which is an ansiote~asin-convertin 8 enzyme inhibitor on lea't ventrioalar function in patients with congestive heart failure (CH:F). A total of 15 patients with CHF ( New York H e , ~ Association Class 2 - 3 ) (range: 36 - 68 yrs : mean age: 52.3 :t: 4.2 yrs ) were exmnmed using radionuclide ventriculography (RNV) and edaoc~dibsraphy (EC) . /Mter a baseline RNV and EC were madeataken , the patients Were treated with 75 nag ( 3 x 25 m 8 ) pea'indopril orally per day. EC and RNV were repeated eight to twelve weeks after the onset of the therapy. The calculated mema left ventrioxlar diastolic attd systolic fimctlon values on RNV before ~ald a f ~ treatment Were ; Ejection fractlon (%) 35.14 • 1.54 to 36.5 :t: l.86 ( normal values = >= 50 % ) , Peak filling rate ( E D V / s e c ) 1.44 • 0.16 to 1.84 • 0A8 ( normal values = 3.3 • 0.6) , Time to peak filling ( msec ) 330 • 7.1 to 280 • 18 ( normal values = 136 • 22), Peak emptying r u t e ( E D V / s e c ) 1.707 :e 0.071to I.77 • 0.13 ( n o r m a l v a l u e s = 2.7:i:0.5), Time to peak emptying ( ~ ) 280 • 7 to 260 • 5 ( normal values = 182 • 44 ) . The ejection fraction values measured on EC were : 31.57 9 2 . 2 1 % to 32.45 -i: 2.64 % . There was not a signific,,mt ditference between the pre- sad post-treatment ejection fraction values with both methods ( p > 0.05 ). The peak filling and eantayin 8 p~ameters measured on RNV before mid after treatment were also not si~aificsmtly different ( p > 0.05 ) . In conclusion, both RNV and EC deanonstrated that there was no lmprovemaent in left ventr~.cular ejection fraction aRer perindopril treatment. The systolic ~md diastolic peak filling parameters calculated by RNV confirmed the absence ofldt ventricul~ function improveanent.