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Radionuclide ventriculography evaluation of right and left ventricular performance in patients refered for lung transplantation
Journal of Nuclear Cardiology Volume 4, Number 1, Part 2
Abstracts Wednesday afternoon, April 9, | 997
100.53
100.55
ICRF-187 PREVENT C A R D I O T O X I C I T Y : A R A D I O N U C L I D E V E N T R I C U L O G R A P H Y STUDY.
RADIONUCLIDE VENTRICULOGRAPHY EVALUATION OF RIGHT AND LEFT VENTRICULAR PERFORMANCE IN PATIENTS REFERED FOR LUNG TRANSPLANTATION.
M.L.DeRimini,M.Orditura,D.Capobianco, L.Mansi-II Italy.
University
of
Naples-
ICRF-187 (I) has been p r o p o s e d to prevent Doxorubicin (D) induced c a r d i o t o x i c i t y . w e p e r f o r m e d RNV Rest/ Stress(R/S) in 16 o n c o l o g i c a l pts u n d e r g o i n g p o l i c h e m o t h e r a p y including D without CAD and with normal LV function. Studies were performed a f t e r 3 ( T l ) a n d 8(T2) cycles. I0 pts received only D(Grl), 6 pts (Gr2)underwent a 1000 mg/sqm standard dose of I before CT.In G r l at T2 R EF was normal, PFR(EDV/s) and P F R / P E R were d e c r e a s e d in 3 pts and TPFR was prolonged in 5pts. At T2 S 3 pts with septal h y p o k i n e s i a were observed. No a b n o r m a l i t i e s both at T1 and T2 were observed in Gr2. We confirm the role of I in c a r d i o p r o t e c t i o n in pts with CT and d i a s t o l i c function indexes as early m a r k e r of LV dysfunction.
S123
N Valli. C. Dromer, JL. Barat, L. Labbr, L. Bordenave, D. Ducassou, Bordeaux University hospital, departments of nuclear medicine and eardio thoracic surgery. If right ventricular (RV) dysfunction is common in patients with chronic lung disease, left ventricular (LV) dysfunction is still controversial. Nevertheless this alteration has to be considered in patients referred for lung transplantation (LT) to envisage a possible left catheterization and associated heart transplantation (HT). In 27 patients with lung parenchymal disease who were refered for ruT, we used radionuclide ventriculography (first pass and equilibrium) from which RV and LV ejection fraction (EF) and LV diastolic parameters were measured. The mean RVEF was significantly lower than the normal value and there was a significant inverse linear correlation between RVEF and right ventricular afterload. Mean LVEF was normal but we find a reduced LV diastolic function (LVDF). These data suggest that radionuclide ventriculography is a safe and reproducible mean to estimate PAP in patients refferred for LT and may contribute to the indication of associated HT in patients with elevated PCP and LV diastolic dysfunction.
100.54
100.56
DIABETES MELLITUS DETERIORATE LEFT VENTRICULAR FUNCTIONS UNDER LOW-DOSE DOBUTAMINE STRESS IN CAD PATIENTS: AN ASSESSMENT WITH RADIONUCLIDE ANGIOGRAPHY. SP Yang, CY Cheng, WL Chen, DA Wu, DJ Wang. TriSePcice General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
CONTINUOUS MONITORING OF LEFT VENTRICULAR FUNCTION (LVF) USING MOBILE GAMMA CAMERA (MGC) IN PATIENTS(PTS)UNDERGOING NONCARDIAC SURGERY J. Tian, M.Imbriaco, S.DJ. Yeh, A.H.Freiman, SM. Larson. Memorial Sloan-Kettering Cancer Center, New York, USA
Diabetes-induced abnormalities in the myocardium are well accepted. This study is to evaluate the superimposed effect of diabetes mellitus (DM) on LV performance under pharmacologic stress in CAD patients. Fifteen normal subjects (N) and 30 CAD patients (18 without DM, C-DM; 12 with DM, C+DM) were included and underwent low-dose dobutamine stress (O, 5, 10, 15, and 20 i~g/kg/m!n) radionuclide angiography (RNA). The parameters of LV systolic function (ejection fraction, EF; peak ejection rate, PEF) and diastolic function (peak filling rate, PFR) at 0 (basal) and 20 p.glkg/min of dobutamine infusion were: N basal
20
C-DM basal 20
CAD+DM basal 20
EF 56+7 69+8a 56+5 55+_9 50+_7 52+_11 PER 3.1_+0.3 5.2+0.6b 2.6+_0.4 3.6+0.6a 2,5+-0.7 !3.0+0.9 PFR 2.7+0.5 4.0+0.7b 2.5+0.5 2.7_+0.8 2.3_+0.4 2.4+_0.8 a
General anesthesia and major surgical interventions are known to cause significant cardiac stress that may induce acute myocardial ischemia in pts with coronary artery disease (CAD). This study was to assess the value of MGC for the monitoring of LVF as a marker of myocardial ischemia in pts undergoing noncardiac surgery. Thirty-three pts ( 27 M, 6 F, mean age 70 + 9 yr ) underwent the monitoring of LVF for mean 4.2 -+ 1.4 hr (range 2 to 7 hr) and Holter electrocardiogram (ECG) for 24 hr within mean 14.8 + 4.9 (range 1 to 21)hr after noncardiac surgical procedures. MGC and Holter ECG were nermal in 9 pts with no history of CAD. In 24 pts with CAD, 17 pts had resting LV ejection fraction (EF) >- 50%. Fifteen of them showed no obvious changes during the monitoring of LVEF and ST segments. Two pts developed three asymptomatic episodes of transient decrease (12-14%) in LVEF associated with apical or global hypokinesis. One of these 3 episodes suggestive of ischemia was accompanied by ST segment depression on ECG. The remaining 7 pts had resting LVEF between 25-45% but no significant changes in serial LVEF and ST segments during the monitoring period. Our preliminary data shows that MGC identifies transient ischemic events in a small population of patients with CAD in the early hrs after surgery. Further studies are needed to determine whether the MGC is an useful imaging tool for the detection of perioperative myocardial dysfunction following major noncardiac surgery.
Abstracts Wednesday afternoon, April 9, | 997
100.53
100.55
ICRF-187 PREVENT C A R D I O T O X I C I T Y : A R A D I O N U C L I D E V E N T R I C U L O G R A P H Y STUDY.
RADIONUCLIDE VENTRICULOGRAPHY EVALUATION OF RIGHT AND LEFT VENTRICULAR PERFORMANCE IN PATIENTS REFERED FOR LUNG TRANSPLANTATION.
M.L.DeRimini,M.Orditura,D.Capobianco, L.Mansi-II Italy.
University
of
Naples-
ICRF-187 (I) has been p r o p o s e d to prevent Doxorubicin (D) induced c a r d i o t o x i c i t y . w e p e r f o r m e d RNV Rest/ Stress(R/S) in 16 o n c o l o g i c a l pts u n d e r g o i n g p o l i c h e m o t h e r a p y including D without CAD and with normal LV function. Studies were performed a f t e r 3 ( T l ) a n d 8(T2) cycles. I0 pts received only D(Grl), 6 pts (Gr2)underwent a 1000 mg/sqm standard dose of I before CT.In G r l at T2 R EF was normal, PFR(EDV/s) and P F R / P E R were d e c r e a s e d in 3 pts and TPFR was prolonged in 5pts. At T2 S 3 pts with septal h y p o k i n e s i a were observed. No a b n o r m a l i t i e s both at T1 and T2 were observed in Gr2. We confirm the role of I in c a r d i o p r o t e c t i o n in pts with CT and d i a s t o l i c function indexes as early m a r k e r of LV dysfunction.
S123
N Valli. C. Dromer, JL. Barat, L. Labbr, L. Bordenave, D. Ducassou, Bordeaux University hospital, departments of nuclear medicine and eardio thoracic surgery. If right ventricular (RV) dysfunction is common in patients with chronic lung disease, left ventricular (LV) dysfunction is still controversial. Nevertheless this alteration has to be considered in patients referred for lung transplantation (LT) to envisage a possible left catheterization and associated heart transplantation (HT). In 27 patients with lung parenchymal disease who were refered for ruT, we used radionuclide ventriculography (first pass and equilibrium) from which RV and LV ejection fraction (EF) and LV diastolic parameters were measured. The mean RVEF was significantly lower than the normal value and there was a significant inverse linear correlation between RVEF and right ventricular afterload. Mean LVEF was normal but we find a reduced LV diastolic function (LVDF). These data suggest that radionuclide ventriculography is a safe and reproducible mean to estimate PAP in patients refferred for LT and may contribute to the indication of associated HT in patients with elevated PCP and LV diastolic dysfunction.
100.54
100.56
DIABETES MELLITUS DETERIORATE LEFT VENTRICULAR FUNCTIONS UNDER LOW-DOSE DOBUTAMINE STRESS IN CAD PATIENTS: AN ASSESSMENT WITH RADIONUCLIDE ANGIOGRAPHY. SP Yang, CY Cheng, WL Chen, DA Wu, DJ Wang. TriSePcice General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
CONTINUOUS MONITORING OF LEFT VENTRICULAR FUNCTION (LVF) USING MOBILE GAMMA CAMERA (MGC) IN PATIENTS(PTS)UNDERGOING NONCARDIAC SURGERY J. Tian, M.Imbriaco, S.DJ. Yeh, A.H.Freiman, SM. Larson. Memorial Sloan-Kettering Cancer Center, New York, USA
Diabetes-induced abnormalities in the myocardium are well accepted. This study is to evaluate the superimposed effect of diabetes mellitus (DM) on LV performance under pharmacologic stress in CAD patients. Fifteen normal subjects (N) and 30 CAD patients (18 without DM, C-DM; 12 with DM, C+DM) were included and underwent low-dose dobutamine stress (O, 5, 10, 15, and 20 i~g/kg/m!n) radionuclide angiography (RNA). The parameters of LV systolic function (ejection fraction, EF; peak ejection rate, PEF) and diastolic function (peak filling rate, PFR) at 0 (basal) and 20 p.glkg/min of dobutamine infusion were: N basal
20
C-DM basal 20
CAD+DM basal 20
EF 56+7 69+8a 56+5 55+_9 50+_7 52+_11 PER 3.1_+0.3 5.2+0.6b 2.6+_0.4 3.6+0.6a 2,5+-0.7 !3.0+0.9 PFR 2.7+0.5 4.0+0.7b 2.5+0.5 2.7_+0.8 2.3_+0.4 2.4+_0.8 a
General anesthesia and major surgical interventions are known to cause significant cardiac stress that may induce acute myocardial ischemia in pts with coronary artery disease (CAD). This study was to assess the value of MGC for the monitoring of LVF as a marker of myocardial ischemia in pts undergoing noncardiac surgery. Thirty-three pts ( 27 M, 6 F, mean age 70 + 9 yr ) underwent the monitoring of LVF for mean 4.2 -+ 1.4 hr (range 2 to 7 hr) and Holter electrocardiogram (ECG) for 24 hr within mean 14.8 + 4.9 (range 1 to 21)hr after noncardiac surgical procedures. MGC and Holter ECG were nermal in 9 pts with no history of CAD. In 24 pts with CAD, 17 pts had resting LV ejection fraction (EF) >- 50%. Fifteen of them showed no obvious changes during the monitoring of LVEF and ST segments. Two pts developed three asymptomatic episodes of transient decrease (12-14%) in LVEF associated with apical or global hypokinesis. One of these 3 episodes suggestive of ischemia was accompanied by ST segment depression on ECG. The remaining 7 pts had resting LVEF between 25-45% but no significant changes in serial LVEF and ST segments during the monitoring period. Our preliminary data shows that MGC identifies transient ischemic events in a small population of patients with CAD in the early hrs after surgery. Further studies are needed to determine whether the MGC is an useful imaging tool for the detection of perioperative myocardial dysfunction following major noncardiac surgery.