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Biomedical subjects

A Cuocolo

Publications and source records attributed to A Cuocolo.

At least 55 records · Page 3Linked to original sources
PubMed1996

Influence of digitalis on left ventricular functional response to exercise in congestive heart failure.

This was a double-blind, placebo-controlled, crossover study designed to determine the influence of digitalis treatment on left ventricular (LV) response to physical exercise in patients with congestive heart failure (CHF). In 10 patients with CHF (ejection fraction 29 +/- 2%), LV function was assessed during upright bicycle exercise using an ambulatory radionuclide detector for continuous noninvasive monitoring of cardiac function. Exercise was performed during control conditions and after a 3-week treatment with digoxin (0.25 mg/day orally) or placebo. Ten normal volunteers matched for sex and age constituted the control group. In normals, exercise ejection fraction and end-diastolic volume increased (both p <0.001), while end-systolic volume decreased progressively (p <0.001). In control conditions, patients with CHF had a sharp increase in heart rate during exercise, while ejection fraction did not change; both end-diastolic and end-systolic volumes increased significantly (both p <0.001) during exercise. During digoxin treatment, heart rate response to exercise recorded in patients with CHF was comparable to that recorded in normal subjects. In addition, a significant increase in ejection fraction during exercise was detected (P <0.001), and the increase in end-systolic volume was significantly smaller than that observed in control conditions (p <0.05). When patients received placebo, the responses of LV function to exercise were comparable to those observed in control conditions. These findings demonstrate that digitalis has a favorable influence on LV functional adaptation to exercise in CHF.

Adult↗
PubMed1996

Nuclear medicine and cardiology: the position of the Union of European Medical Specialists/Section of Nuclear Medicine.

This paper summarizes a communication presented at the Second International Conference of Nuclear Cardiology, held in Cannes on 23-26 April 1995. The general evolution of nuclear medicine in Europe is examined within the context of European Union Directives, and the role of the Union of European Medical Specialists/Section of Nuclear Medicine is discussed. Thereafter consideration is given to the technical aspects of cardiovascular nuclear medicine procedures, and the situation with respect to such procedures in European countries is examined. In most European countries, nuclear medicine is a recognized specialty, while "nuclear cardiology" does not exist in its own right. In general, only nuclear medicine specialists have the responsibility for radionuclide studies, and most cardiovascular studies are performed under the direct responsibility of a licensed nuclear medicine specialist.

Cardiology↗
PubMed1996

Quantitative exercise technetium-99m tetrofosmin myocardial tomography for the identification and localization of coronary artery disease.

The aim of this study was to evaluate the accuracy of quantitative 1-day exercise-rest technetium-99m tetrofosmin tomography in the identification of patients with coronary artery disease (CAD) and in the detection of individual stenosed coronary vessels. Sixty-one patients with suspected CAD who underwent coronary angiography and 13 normal volunteers were studied. All patients were submitted to two i.v. injections of 99mTc-tetrofosmin, one at peak exercise (370 MBq) and the other (1110 MBq) at rest 3 h after exercise (images 15-30 min after injection for both studies). All patients with CAD (>/=50% luminal stenosis) (n=50) had an abnormal 99mTc-tetrofosmin tomogram. Only one patient without significant coronary narrowing showed abnormal findings. Overall sensitivity, specificity and diagnostic accuracy in the detection of individual stenosed vessels were 77%, 93% and 85%, respectively. Sensitivity and diagnostic accuracy in the identification of individuals stenosed coronary vessels were significantly higher (P<0.05) in patients with single-vessel disease (n=21) than in those with multivessel disease (n=29). Sensitivity, specificity and accuracy for detecting individual diseased vessels were similar in patients without previous myocardial infarction (n=26) and in those with previous myocardial infarction (n=35). In myocardial territories related to non-infarcted areas (n=128), sensitivity and specificity in the detection of stenosed vessels were 70% and 95%, respectively. In infarcted areas (n=55), sensitivity and specificity in the detection of stenosed vessels were 85% (P=NS vs non-infarcted areas) and 75% (P<0.05 vs non-infarcted areas), respectively. Finally, sensitivity was significantly lower (P<0.05) in vascular territories supplied by vessels with moderate stenosis (50%-75%) than in those supplied by vessels with severe stenosis (>75%). The results of this study demonstrate that quantitative 1-day exercise-rest 99mTc-tetrofosmin single-photon emission tomographic imaging is a suitable and accurate technique to identify patients with CAD and to detect individual stenosed coronary vessels.

Case-Control Studies↗
PubMed1996

Improved left ventricular function after growth hormone replacement in patients with hypopituitarism: assessment with radionuclide angiography.

Prolonged growth hormone deficiency (GHD) leads to marked cardiac dysfunction; however, whether reversal of this abnormality may be achieved after specific replacement therapy has not yet been completely clarified. Fourteen patients with childhood-onset GHD (nine men and five women, mean age 27+/-4 years) and 12 normal control subjects underwent equilibrium radionuclide angiography under control conditions at rest. Patients with GHD were also studied 6 months after recombinant human (rh) GH treatment (0.05 IU/kg per day). Normal control subjects and patients with GHD did not differ with respect to age, gender and heart rate. In contrast, left ventricular ejection fraction (53%+/-9% vs 66%+/-6%, P <0.001), stroke volume index (41+/-11 vs 51+/-8 ml/m2, P <0.01) and cardiac index (2.8+/-0.6 vs 3.+/-0.5 l/min/m2, P <0.001) were significantly lower in GHD patients than in normal control subjects. None of the GHD patients showed adverse or side-effects during rhGH therapy; thus none required a reduction in GH dose during the treatment period. Heart rate and arterial blood pressure were not significantly modified by rhGH treatment. After 6 months of rhGH therapy a significant improvement in left ventricular ejection fraction (from 53%+/-9% to 59%+/-9%, P <0.01), stroke volume index (from 41+/-11 to 47+/-13 ml/m2, P <0.05) and cardiac index (from 2.8+/-0.6 to 3.3+/-0.8 l/min/m2, P <0.01) was observed in GHD patients. In conclusion, prolonged lack of GH leads to impaired left ventricular function at rest. Reversal of this abnormality may be observed after 6 months of specific replacement therapy in patients with childhood-onset GHD.

Adult↗
PubMed1996

Technetium-99m tetrofosmin imaging in thyroid diseases: comparison with Tc-99m-pertechnetate, thallium-201 and Tc-99m-methoxyisobutylisonitrile scans.

Technetium-99m tetrofosmin is a lipophilic phosphine used for myocardial perfusion imaging. Biodistribution studies have shown significant thyroid uptake of tetrofosmin and preliminary reports have suggested that tetrofosmin imaging may be of value in patients with thyroid cancer. In this study, tetrofosmin whole-body scintigraphy was performed in 35 patients with evidence of thyroid diseases. All patients underwent laboratory evaluation of thyroid function as well as 99mTc pertechnetate scan, thallium-201 (n=16) 99mTc-methoxyisobutylisonitrile (MIBI) (n=19) whole-body studies. Thyroid images were semi-quantitatively analysed by a 4-point score: 0=no significant uptake; 1=uptake increased as compared to background activity, but inferior to normal thyroid tissue; 2=uptake equal to normal thyroid tissue; 3=uptake superior to normal thyroid tissue. Pathology examinations were obtained. A total of 41 thyroid nodules were detected, of which 15 were goitre nodules, 13 adenomas and 13 malignant lesions. In goitre nodules, concordant results of tetrofosmin and pertechnetate uptake (score 1 or 0) were observed in the majority of lesions (87%). In function adenomas (n=10), both tetrofosmin uptake and pertechnetate uptake were score 3. In non-function adenomas (n=3), tetrofosmin uptake was score 3, while pertechnetate uptake was score 0. In six malignant lesions, tetrofosmin uptake was score 3, while pertechnetate uptake was score 0; in the other seven lesions, where a prevalence of goitre abnormalities was observed, results of tetrofosmin and pertechnetate uptake were similar (score 0 or 1). In seven (70%) of the ten patients with malignant nodules, whole-body tetrofosmin images showed increased abnormal uptake in a total of 28 extra-thyroid tumour sites, as subsequently confirmed by other techniques. When tetrofosmin images were compared to 201Tl and 99mTc-MIBI scans, concordant results were observed in all cases. In conclusion, tetrofosmin imaging may be particularly useful to characterize and stage patients with malignant thyroid nodules; it shows similar results to thallium but provides better image quality. Comparable findings were observed between tetrofosmin and MIBI studies. Thus, tetrofosmin may be an alternative to thallium and MIBI in the aforementioned patients.

Adenoma↗
PubMed1996

Cardiovascular aspects in acromegaly: effects of treatment.

Patients with acromegaly have significant morbidity and mortality, associated with cardiovascular disease. Acromegaly is often complicated by other diseases such as diabetes mellitus, hypertension, and coronary artery disease, so the existence of acromegalic cardiomyopathy remains uncertain. Cardiac performance was investigated in patients with uncomplicated acromegaly. A subgroup of hypertensive acromegalics was also studied. In addition, the effects of chronic octreotide therapy or surgery on cardiac structure and function in acromegaly were studied. Twenty-six patients and 15 healthy controls underwent gated blood-pool cardiac scintigraphy and echocardiography at rest and during exercise. Echocardiography was repeated after 6 months of octreotide therapy (n = 11). Cardiac scintigraphy was repeated after 12 and 24 months of octreotide therapy (n = 10) or 12 to 24 months after surgery (n = 8). ECG, blood pressure, and heart rate were monitored during cardiac scintigraphy. Left ventricular mass (LVM) was calculated from the findings of the echocardiography. Serum growth hormone (GH) levels and plasma insulin-like growth factor-1 (IGF-1) levels were monitored. LVM index was significantly higher (P < .003) in acromegalics than controls and in hypertensive acromegalics than normotensives, but all other indices of cardiac function were similar. Chronic octreotide decreased GH and IGF-1 levels and improved the structural abnormalities as measured by echocardiography. Chronic octreotide or surgery did not alter cardiac function parameters. Thus, important changes in cardiac structure and function occur in uncomplicated acromegaly, and improvements can be demonstrated after chronic octreotide therapy. Heart disease in acromegaly appears to be secondary to high circulating GH levels.

Acromegaly↗
PubMed1996

Impaired cardiac reserve and exercise capacity in patients receiving long-term thyrotropin suppressive therapy with levothyroxine.

To assess cardiac function and exercise tolerance in patients receiving long term TSH-suppressive therapy with levothyroxine (L-T4), we studied maximal exercise capacity with a bicycle ergometer and left ventricular function at rest and during physical exercise by radionuclide angiography. The evaluation was performed in 10 patients receiving L-T4 therapy (2.31 +/- 0.13 microgram/kg) for 5-9 yr, presenting with effort dyspnea and symptoms of adrenergic overactivity, and 10 matched control subjects. The patients were reassessed after 4 months of administration of the selective beta-adrenergic blocker bisoprolol (4.25 +/- 0.4 mg/day); L-T4 therapy remained unchanged. The results showed that at rest, left ventricular diastolic filling was impaired in the patients (P < 0.05), whereas systolic function was unaltered. During submaximal physical exercise, left ventricular ejection fraction increased in the controls from 58 +/- 2% to 65 +/- 2% (P < 0.001), whereas in the patients it fell from 63 +/- 2% to 53 +/- 2% (P < 0.01), mainly because of increased end-systolic left ventricular volume (P < 0.05). Exercise capacity was markedly reduced in the patients in terms of both peak workload (P < 0.001) and exercise duration (P < 0.001). beta-Adrenergic blockade prevented both the fall in ejection fraction and the increase in end-systolic volume during exercise, and improved exercise tolerance. In conclusion, our data show that long term TSH-suppressive therapy with L-T4 is not as harmless as believed, because it may cause marked impairment of cardiac functional reserve and physical exercise capacity. Administration of a beta-blocking drug for 4 months caused significant improvement of cardiac performance and exercise tolerance.

Adrenergic beta-Antagonists↗
PubMed1996

Thallium-201 reverse redistribution at reinjection imaging correlated with coronary lesion, wall motion abnormality and tissue viability.

UNLABELLED: Previous studies based on standard stress-redistribution 201TI scintigraphy provided conflicting results about the clinical significance 201Tl reverse redistribution. Recent observations indicate that the majority of these defects normalize following reinjection reflecting viable myocardium. METHODS: In this study, the meaning of reverse redistribution occurring at reinjection imaging, its relation to standard 4-hr redistribution, coronary lesion, abnormal wall motion and tissue viability were assessed. A region with normal activity in the stress image was considered as having reverse redistribution if 201Tl activity at reinjection imaging was definitely abnormal with a decrease in relative tracer uptake >15% of the peak. From a series of 270 patients, 29 showed reverse redistribution. Of these 29 patients, 27 had evidence of previous myocardial infarction. Coronary lesions were detected in all but 1 patient. Average ejection fraction was 0.38 +/- 0.11. RESULTS: On a segmental basis, 50/377 regions showed the pattern of reverse redistribution. A significant coronary lesion (> or = 50%) was found in 78% of these regions; occlusion rate was 50%, and collateral circulation was found in 35% of occluded vessels. Hypokinesis or akinesis was present in 72% of segments. Tissue viability, defined as an uptake >55% of the peak, was found in 44% of these segments. The 50 segments showing reverse redistribution were divided into two groups according to an abnormal uptake also at 4-hr redistribution (group 1, 25 segments) or appearing only following reinjection (group 2,25 segments). Despite segments of group 1 showing a higher degree of coronary stenosis (80 +/- 32 versus 59 +/- 43%, p < 0.01), a similar rate of coronary occlusion, ventricular dysfunction and maintained viability was found in the two groups. CONCLUSION: Reverse redistribution in chronic coronary artery disease is frequently associated with significant coronary lesion, collateral-dependent dysfunctioning myocardium and preserved tissue viability. The occurrence of reverse redistribution following reinjection expands the indication for viability imaging to all patients with known coronary artery disease and regional wall motion abnormalities who undergo diagnostic and prognostic 201TI scintigraphy.

Coronary Angiography↗
PubMed1996

[Tetrofosmin: a new compound labeled with 99mTc for the study of myocardial perfusion. Correlations with coronary anatomy in patients with suspected ischemic cardiopathy].

The aim of this study was to investigate the accuracy of quantitative one-day exercise-rest 99mTc tetrofosmin tomography in the identification of patients with suspected coronary artery disease (CAD) and in the detection of single stenosed coronary vessels. Sixty-one patients with suspected CAD and submitted to coronary angiography were examined. All patients were given 2 i.v. injections of 99mTc tetrofosmin, one at peak exercise (370 MBq) and the other (1110 MBq) at rest 3 hours after exercise (images 15-30 min after injection for both studies). All patients with CAD (> or = 50% luminal stenosis) (n = 50) had abnormal 99mTc tetrofosmin tomogram (100% sensitivity). Only one patient without CAD had abnormal 99mTc tetrofosmin tomogram (91% specificity). Overall sensitivity, specificity, and diagnostic accuracy in the detection of single stenosed vessels were 77%, 93% and 85%, respectively. No significant differences among single vascular areas were observed. Sensitivity and diagnostic accuracy in the identification of single stenosed coronary vessels were significantly higher (p < 0.05) in the patients with single-vessel disease (n = 21) than in those with multivessel disease (n = 29). Sensitivity, specificity and diagnostic accuracy in detecting single diseased vessels were similar in the patients without (n = 26) and in those with previous myocardial infarction (n = 35). The results of this study demonstrate that quantitative one-day exercise-rest 99mTc tetrofosmin SPECT imaging is a suitable and accurate technique to identify patients with suspected CAD and to detect single stenosed coronary vessels.

Adult↗
PubMed1996

[Computerized tomography with single photon emission (SPECT) with technetium-99m MIBI (99mTc-MIBI) in the identification of viable myocardium in patients with chronic ischemic cardiopathy and left ventricular dysfunction].

Resting 99mTc-MIBI cardiac imaging may be poorly accurate in identifying the presence of viable myocardium in patients with chronic coronary artery disease (CAD). In this study, we directly compared the results of resting 99mTc-MIBI SPECT with initial (1 hr) and delayed (5 hrs) images with those of 99mTc-MIBI SPECT after nitroglycerine (NTG) administration in 31 patients with chronic CAD. All patients also underwent rest-redistribution thallium-201 (201Tl) SPECT. In 8 patients, echocardiography was performed before and after coronary revascularization (Rev). Of 682 myocardial segments, 197 showed a marked reduction (< 50% of peak) in MIBI uptake on initial images. MIBI uptake (> or = 10%) was increased in 47 (24%) segments on delayed images (from 43 +/- 8% to 60 +/- 8%, p < 0.001) and in 54 (27%) segments after NTG (from 42 +/- 8% to 60 +/- 8%, p < 0.001). The results of delayed and NTG MIBI images were in agreement in most segments (n = 160, 81%). The results of delayed and NTG MIBI images were in disagreement in the remaining 37 (19%) segments. In particular, 15 segments showed reversible defects on delayed, but not on NTG MIBI images, while 22 on NTG, but not on delayed MIBI images. All the segments with reversible MIBI defects on delayed and/or NTG images were identified as viable on TI-201. In the 8 pts examined before and after Rev. 83% of segments with reversible MIBI defects on delayed images and 87% of those with reversible defects after NTG showed functional recovery after Rev; furthermore, in these patients a significant improvement in global left ventricular function was observed after Rev, as shown by ejection fraction values (from 42 +/- 7% to 47 +/- 7%, p < 0.01). These comparative results show that resting delayed and NTG MIBI imaging provide similar information to identify viable myocardium and to predict functional recovery after coronary Rev in chronic CAD.

Adult↗
PubMed1996

Diagnostic imaging in patients with paragangliomas. Computed tomography, magnetic resonance and MIBG scintigraphy comparison.

OBJECTIVE: We compared iodine-131 metaiodobenzylguanidine (MIBG), computed tomography (CT) and magnetic resonance (MR) imaging studies in 40 patients with suspected or proven paragangliomas. PATIENTS: 21 patients were studied during the initial evaluation, while 19 were evaluated after surgery for paragangliomas. Furthermore, in 18 patients with benign (n = 10) or malignant (n = 8) tumors, MIBG uptake, MR signal intensity ratios (SIR) and CT parameters were analyzed. RESULTS: In patients studied during the initial evaluation, CT and MR had a significant (p < 0.05) higher diagnostic sensitivity (100% for both) compared to MIBG (82%); conversely, MIBG showed a higher specificity (100%) compared to CT and MR (50% for both); the accuracy of MIBG (86%), CT and MR (91% for both) were similar. In patients evaluated after surgery, MIBG and MR had slightly better sensitivity (85% for both) compared to CT (77%). MIBG showed again better specificity (100%) than CT and MR (83% for both); the accuracy of MIBG, MR and CT were respectively 90%, 84% and 79%. While no significant differences were observed in MR SIR and CT findings between benign and malignant tumors, MIBG uptake was significantly higher in malignant compared to benign lesions (p < 0.03). CONCLUSIONS: Our results suggest that CT and MR are particularly useful in the initial evaluation of patients with suspected paragangliomas. MIBG should be recommended during the post-surgical follow-up of such patients since recurrent, malignant or extra-adrenal disease frequently occur. Finally, while MR SIR and CT features are not able to distinguish malignant paragangliomas from benign tumors, MIBG uptake is higher in malignant lesions compared to benign tumors providing a diagnostic criterion to differentiate these lesions.

3-Iodobenzylguanidine↗
PubMed1996

[Left ventricular function in patients with chronic ischemic cardiopathy: relationship with the status of myocardial perfusion].

The aim of this study was the evaluation of left ventricular function compared to myocardial perfusion in patients with chronic coronary artery disease (CAD). Thirty-two patients with chronic CAD (27 men and 5 women, mean age 58 +/- 9 years) underwent radionuclide angiography and rest-redistribution thallium-201 (TI-201) single photon emission Computed Tomography (SPECT). Ejection fraction (EF, %), peak filling rate (PFR, end diastolic volume/second), and the coefficient of variation of the regional time to PFR (CV-TPFR, %) were computed. Patients with severe irreversible defects (i.e. with TI-201 uptake < 50%) had lower EF (42 +/- 7% vs 52 +/- 11%, p < 0.01) and lower PFR (1.9 +/- 0.4 vs 3.1 +/- 1.0, p < 0.0005) than those without. Patients with severe irreversible perfusion defects in the left anterior descending artery territory had lower EF (41 +/- 6% vs 50 +/- 11%, p < 0.01), lower PFR (1.8 +/- 0.3 vs 2.8 +/- 1.0, p < 0.005), and higher CV-TPFR (39 +/- 22 vs 13 +/- 7, p < 0.001) than those without. The results of the present study indicate that in patients with chronic CAD left ventricular systolic and diastolic function is more deteriorated when the left anterior descending artery is involved. Similarly, the presence of severe irreversible perfusion defects is clearly associated with significantly lower EF and PFR.

Adult↗
PubMed1995

Radionuclide monitoring of cardiac adaptations to volume loading in patients with dilated cardiomyopathy and mild heart failure. Effects of angiotensin-converting enzyme inhibition.

BACKGROUND: Cardiac adaptations to volume overload have been poorly investigated in heart failure. The aim of this study was to assess dynamic left ventricular responses to acute volume loading by continuous radionuclide monitoring in patients with asymptomatic to mildly symptomatic left ventricular dysfunction. METHODS AND RESULTS: Left ventricular end-diastolic (EDV) and end-systolic (ESV) volumes, ejection fraction (EF), and peak filling rate (PFR) were monitored by a radionuclide detector (Vest) before and during volume expansion (sodium chloride, 0.9%, 0.25 mL.kg-1.min-1 for 2 hours) in 10 patients with idiopathic dilated cardiomyopathy (DCM) and mild heart failure (New York Heart Association class I or II, ejection fraction < 50%). The patients were studied off treatment and after 6 to 8 weeks of oral treatment with enalapril (5 mg/d). A control group of 11 age- and sex-matched healthy volunteers (N group) was also studied. In the N group, volume loading caused prompt and sustained increases of EDV, EF, and PFR (all P < .001), whereas ESV was progressively reduced (P < .001), and heart rate and blood pressure did not change. In contrast, in DCM, EDV showed a smaller increase than in the N group (two-way ANOVA: F = 5.98, P < .001), ESV increased (P < .001), and EF and PFR remained unchanged. After enalapril, the cardiac adaptations to volume loading were restored to normal. In particular, EDV, EF, and PFR increased (P < .001), and ESV was reduced (P < .001). In 6 additional DCM patients studied before and after 6 to 8 weeks of placebo treatment, left ventricular responses to volume loading remained unchanged. CONCLUSIONS: Left ventricular dynamic adaptations to acute volume loading are compromised in patients with idiopathic DCM and mild heart failure. These impaired responses are ameliorated by treatment with enalapril.

Adult↗
PubMed1995

Assessment of systolic wall thickening using technetium-99m methoxyisobutylisonitrile in patients with coronary artery disease: relation to thallium-201 scintigraphy with re-injection.

The results of resting planar ECG-gated technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) imaging were compared with those of thallium-201 (Tl) re-injection after exercise-redistribution scintigraphy in 20 patients (19 men, 1 woman, mean age 53 +/- 10 years) with angiographically proven coronary artery disease. Eight normal subjects (seven men, one woman, mean age 50 +/- 8 years) constituted the control group. In these subjects, only resting 99mTc-MIBI imaging was performed. The standardized percent count increase from end-diastole to end-systole was calculated as an index of wall thickening in 13 segments for each study. Regional wall thickening index (WTI) and 99mTc-MIBI uptake were significantly different (P < 0.05) among segments classified as normal, reversible defects, irreversible defects with increased tracer uptake after re-injection (Re+) or irreversible defects with unchanged tracer uptake after re-injection (Re-) on Tl imaging. Furthermore, WTI and 99mTc-MIBI uptake were significantly higher (P < 0.05) in Re- segments with moderate reduction of Tl uptake (> or = 50% of peak activity) than in Re- segments with severe reduction of Tl uptake (< 50% of peak activity). A significant relationship between WTI and the results of Tl scintigraphy was observed (rho = 0.71, P < 0.0001). The percentage of Re- segments with severe reduction of WTI was significantly higher compared to Re+ segments (64% vs 3%, P < 0.01). Furthermore, compared with moderate Re- segments, a significantly higher percentage of severe Re- segments showed a severe reduction of WTI (86% vs 48%, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMed1995

Optimal determination of right ventricular filling dynamics in systemic hypertension.

To determine the optimal method of normalizing peak filling rate (PFR) determinations and apply it to the assessment of right ventricular (RV) and left ventricular (LV) filling characteristics and their interactions, 41 subjects with hypertension and 40 matched normals underwent echo-Doppler and nuclear study. Conventional normalization of PFR to end-diastolic volume (EDV) yielded poor correlations between nuclear- and echo-derived PFR (RV, r = 0.34; LV, r = 0.42), whereas nuclear and echo PFR normalized to stroke volume (SV) were closely correlated (RV, r = 0.87; LV, r = 0.92). Further, use of PFR normalized to SV revealed to close relation between RV and LV filling characteristics. Multivariate analysis confirmed that, in contrast to normalization to EDV or early to late filling-velocity ratios (E/A), peak filling rate normalized to SV was independent of ejection fraction and heart rate. In addition, RV filling impairment was related to LV filling impairment, and the effects of hypertension eliminated the independent influence of age on both LV and RV filling. In conclusion, normalization of PFR to SV may be preferable to use of EDV or E/A in evaluating RV and LV filling dynamics.

Adult↗
PubMed1995

The diagnosis of nonfunctioning pheochromocytoma. The role of I-123 MIBG imaging.

A patient with an asymptomatic nonsecreting left adrenal pheochromocytoma concentrated I-123 MIBG. Iodine-123 MIBG scintigraphy showed abnormal uptake in the left adrenal bed. The authors conclude that I-123 MIBG imaging may allow the in vivo diagnosis of non-functioning pheochromocytomas when there is no clinical evidence of disease and other laboratory measurements are not helpful for tumor diagnosis.

3-Iodobenzylguanidine↗