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Biomedical subjects

D S Berman

Publications and source records attributed to D S Berman.

277 records · Page 16Linked to original sources
PubMedDate not supplied

Serial changes on quantitative myocardial perfusion SPECT in patients undergoing revascularization or conservative therapy.

BACKGROUND: Little is known about changes of myocardial perfusion in patients undergoing coronary revascularization or medical therapy. The purpose of this observational study was to assess the long-term effects of revascularization or conservative therapy on serial quantitative myocardial perfusion single photon emission computed tomography (SPECT). METHODS AND RESULTS: The study population consisted of 421 patients who underwent serial rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion SPECT with at least a 1-year interval between the 2 studies and who had abnormal quantitative scan results on the first stress SPECT. The mean interval between scans was 32.7 +/- 15.9 months. Patients were divided into 3 groups according to stress defect extent: group 1 had small stress defects (4%-10%, n = 145), group 2 had intermediate stress defects (>10%-20%, n = 144), and group 3 had extensive stress defects (>20%, n = 132) at baseline. Forty patients in group 1, 44 in group 2, and 54 in group 3 underwent coronary revascularization between 2 SPECT studies; the others had conservative therapy. In group 3 patients with revascularization, stress defect extent and reversible defect extent were remarkably reduced (14.5% +/- 13.6% and 13.1% +/- 12.5%, respectively; both P <.0001), with greater improvement in those patients reporting increased use of cardiac medications; resting defect extent was slightly reduced (1.9% +/- 6.4%, P <.05). In group 3 patients with conservative therapy, a small reduction in stress defect extent was noted (2.3% +/- 8.3%, P <.05). In group 2, there were modest, similar reductions in reversible defect extent in both the patients with revascularization (2.7% +/- 7.7%, P <.05) and those with conservative therapy (1.8% +/- 7.3%, P <.05), as well as a small but significant reduction in stress defect extent in those with conservative therapy (2.1% +/- 8.2%, P <.05). In group 1 patients, no significant changes in stress, rest, or reversible defect extent were found with either therapy. CONCLUSIONS: The findings of this study show that improvement in quantitative myocardial perfusion abnormalities over time occurs in some patients with either revascularization or conservative therapy and suggest that, in patients with extensive defects, greater improvement may be seen in those who undergo revascularization.

Adenosine↗
PubMedDate not supplied

Thallium myocardial scintigraphy and its use in the assessment of coronary artery disease.

Since coronary artery disease often first manifests as sudden death or myocardial infarction before symptoms develop, the early detection of disease may identify patients at risk for an acute event. Stress redistribution thallium-201 scintigraphy provides a useful, noninvasive method for assessing the presence of CAD as well as for evaluating the extent of disease. The principles and methods of thallium scintigraphy are described herein in addition to its clinical application. The availability of noninvasive thallium-201 scintigraphy has added to the physician's ability to accurately diagnose CAD, to objectively evaluate the effects of coronary artery bypass surgery, and to assess patients with acute myocardial infarction.

Adult↗
PubMedDate not supplied

Nuclear cardiology in the evaluation of therapy and ventricular function in ischemic heart disease.

The advent of nuclear cardiology has resulted in a veritable explosion of new techniques for evaluating coronary artery disease. Most of these new techniques for detecting myocardial performance, myocardial perfusion patterns, shunt detection, and infarct detection can be done in sequential noninvasive fashion so that patient may be selected earlier in their disease when the benefits of surgical and medical therapy may be restorative rather than reparative. It is hoped this new medical technology will satisfy the desire of Mackenzie for "comparative evaluation of medical remedies and different modes of treatment of disease by the lynx-eyed scrutiny of dispassionate analysis."

Coronary Disease↗
PubMedDate not supplied

A new constant infusion radioisotopic technique for the noninvasive determination of cardiac output.

A constant infusion radioisotopic method for the noninvasive determination of cardiac output is introduced and validated in a series of 22 patients by comparison with simultaneous dye dilution or Fick measurements. The new bedside radioisotopic technique utilizes peripheral venous infusion of indium-113m, detection by a single external probe, and analysis of the time-concentration curve by a specially designed, multivariate computer model. The technique is entirely atraumatic, requiring neither injection into the central circulation nor intra-arterial cannulation. The correlation coefficient was 0.72 (p less than 0.001) between the radioisotopic and standard methods for cardiac output determinations. In addition, results in five patients with valvular regurgitation or intracardiac shunts support the validity of the constant infusion radioisotopic technique in these clinical settings in which the standard dye dilution methods for determining cardiac output are invalid. The techniques is applicable in a variety of clinical conditions in which the invasive techniques for cardiac output measurement are either impractical or not available.

Adult↗