Biomedical subjects

Ilona Kulakiene

Publications and source records attributed to Ilona Kulakiene.

6 recordsLinked to original sources

PubMed2006

[Evaluation of clinical parameters and myocardial perfusion scintigraphy findings in patients with suspected coronary artery disease, abnormal resting electrocardiogram, and noninterpretable exercise test].

UNLABELLED: The aim of this work was to estimate the impact of clinical variables on predicting stress myocardial perfusion abnormalities in patients with suspected coronary artery disease, abnormal resting electrocardiogram, and noninterpretable exercise test. MATERIAL AND METHODS: The clinical variables and stress myocardial perfusion data were analyzed in 370 patients (157 males and 213 females) with suspected coronary artery disease and abnormal resting electrocardiogram. All patients underwent (99m)Tc-methoxyisobutylisonitrile (MIBI) scintigraphy following a one-day protocol (stress-rest). The bicycle exercise test was considered noninterpretable when the age-predicted peak heart rate was not achieved, and ischemic signs were not detected. RESULTS: One hundred sixty (43.2%) patients had noninterpretable bicycle exercise test. Pathological stress myocardial perfusion defects (reversible and fixed) were more often present in patients with noninterpretable than in patients with informative exercise test (63.1 and 50.0%, respectively, p<0.01). Univariate analysis showed that reversible perfusion defects were more frequent in men than in women (p<0.00001, odds ratio 9.6), in patients with pre-existing left bundle-branch block (p<0.02, odds ratio 3.4), and in cases when sufficient working capacity (> or =150 W) was achieved (p<0.05, odds ratio 2.1). CONCLUSION: The myocardial perfusion defects were registered in 63.1% of patients with suspected coronary artery disease, abnormal resting electrocardiogram, and noninterpretable exercise test. The probability of reversible perfusion defects was higher in male patients, in patients with pre-existing left bundle-branch block and with sufficient working capacity (> or =150 W).

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PubMed2005

Prediction of decrease in myocardial perfusion defect size and severity during a 3-month follow-up by the degree of acute resolution of electrocardiographic changes.

Myocardial perfusion in infarct-related artery (IRA) distribution improves progressively until a few months after successful reperfusion therapy. We assessed the rate of electrocardiographic (ECG) stage dynamics to predict perfusion improvement after mechanical, thrombolytic, or spontaneous recanalization of IRA. Thirteen patients were divided into group A (n = 8, with > or = 2 ECG stages per 2-day change rate) and group B (n = 5, no rapid change of ECG stages). There were no significant technetium Tc 99m sestamibi scintigraphic differences between the groups 3 days after recanalization; however, after 3 months, perfusion deficit size (2.8 +/- 1.8 vs 4.8 +/- 1.2, P < or = .03) and severity (1.8 +/- 0.9 vs 3.0 +/- 0, P < or = .03) were smaller in group A vs group B. The prediction sensitivity of the method was 87.5% for decrease in size and 100% for decrease in severity of perfusion defect; the specificity was 80% and 100%, respectively. A change rate of 2 or more ECG stages per 2 days predicts follow-up improvement of myocardial perfusion after IRA recanalization.

Coronary Circulation↗

PubMed2004

[Prediction and evaluation of surgical treatment results of severe ischemic heart disease].

OBJECTIVES: To estimate myocardial perfusion in patients with severe coronary artery disease performing before and early after single-photon emission computed tomography coronary artery bypass grafting; to predict results of complete myocardial revascularisation by preoperative perfusion data. MATERIAL AND METHODS: Ten patients with stable coronary artery disease and resting left ventricular wall motion abnormalities (mean ejection fraction 31.8+/-6.4%, mean wall motion index 2.09+/-0.25) underwent (99m)Tc-MIBI single-photon emission computed tomography at rest and after nitrate administration before coronary artery bypass grafting and stress-rest single-photon emission computed tomography early (3 and 6 months) after surgery. We estimated myocardial perfusion, postoperative recovery and calculated scintigraphic indices. RESULTS: The mean number of distal anastomoses was 3.0+/-0.7 and all of the patients had complete myocardial revascularisation. Out of 84 revascularized segments with different degree of myocardial perfusion disorders, 49 (58.3%) segments improved after 3 months and 53 (63.1%) improved after 6 months postoperatively. Amount of segments with fixed perfusion defects increased from 60 preoperatively to 72 after 3 months and 67 after 6 months. Postoperative myocardial perfusion recovery was incomplete following 3 months, but after 6 months it nearly reached ultimate level. Postoperative index of myocardial perfusion recovery was found better than predicted preoperatively. CONCLUSIONS: Estimation of myocardial perfusion changes with single-photon emission computed tomography during early postoperative period, particularly after 6 months, confirms excellent and final results of complete surgical myocardial revascularization. Preoperative single-photon emission computed tomography after nitrate administration provides more information in prediction of postoperative results of complete myocardial revascularization. Estimation of function of fixed perfusion defects can help to predict correct results and to identify hibernating myocardium.

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PubMed2004

[When can normal stress myocardial perfusion scans be observed in patients with chest pain and known or suspected coronary artery disease?].

UNLABELLED: The aim of this study was to establish characteristic clinical data in patients with normal stress myocardial perfusion scans. MATERIAL AND METHODS: 99mMIBI scintigraphy was performed following a one-day protocol (stress-rest) in 806 patients (out of them 451 men) with suspected or known coronary artery disease. A bicycle exercise test response was estimated as pathological, non-pathological, borderline and non-informative. Myocardial perfusion was scored according to the size and severity of defect. RESULTS: Myocardial perfusion was normal in 287 (35.6%) patients. Univariate analysis showed, that normal stress myocardial perfusion scans more often were established in women than in men (p=0.00001, odds ratio 8.55), in patients with atypical anginal or non-anginal chest pain than with typical angina (p=0.0001, odds ratio 1.92), in patients without previous myocardial infarction (p=0.0001, odds ratio 3.28) and without myocardial revascularization (p=0.0001, odds ratio 3.28). The characteristic bicycle exercise test data for normal scans were non-pathological response vs pathological (p=0.00001, odds ratio 3.03) and reason of discontinuance - target heart rate achieved (85% of maximum) vs ischemic changes (p=0.0005, odds ratio 2.37). CONCLUSIONS: Normal stress myocardial perfusion scans were more often present in women, in patients with atypical angina or non-anginal chest pain, in patients without myocardial infarction and without myocardial revascularization. Achieved target heart rate and non-pathological response to exercise test were commonly observed in patients with normal perfusion scans.

Analysis of Variance↗

PubMed2003

[The diagnostic value of myocardial perfusion in diagnosis of ischemic cardiomyopathy and hypertensive heart disease].

UNLABELLED: Objective of this study was to detect regional myocardial perfusion defects performing (99m)Tc-MIBI myocardial perfusion imaging and to compare the results with echocardiography for differential diagnostics of the ischemic and hypertensive cardiomyopathy until coronary angiography will be performed. MATERIAL AND METHODS: In total 50 patients with cardiomegaly have been evaluated: 18 patients with hypertensive cardiomyopathy (I(st) group), 15 - with ischemic and hypertensive cardiomyopathy (II(nd) group) and 17 patients with ischemic cardiomyopathy (III(rd) group). All patients underwent 2D echocardiography examination and (99m)Tc-MIBI myocardial perfusion imaging before coronary angiography was done. RESULTS: Thickness of interventricular septum, myocardial mass and relative wall thickness were statistically significantly smaller in the III(rd) group of patients in comparison with the I(st) and the II(nd) group of patients. CONCLUSIONS: Logistic regression model including selected data from myocardial perfusion imaging with (99m)Tc-MIBI in combination with selected echocardiography data enables prognosis of coronary arteries stenosis with 91.2% sensitivity and 93.8% specificity.

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PubMed2002

[Estimation of myocardial perfusion changes after surgical revasculization with single-photon emission computed tomography].

OBJECTIVE: to estimate myocardial perfusion performing single-photon emission computed tomography before and in early period after coronary artery bypass grafting; to predict results of complete myocardial revascularisation by preoperative perfusion data. MATERIAL AND METHODS: Ten patients with stable coronary artery disease and resting left ventricular wall motion abnormalities (mean ejection fraction 37.7+/-6.5%, mean wall motion index 1.89+/-0.32) underwent 99mTc-MIBI myocardial perfusion single-photon emission computed tomography before and in early period (3 and 6 months) after coronary artery bypass grafting. We estimated myocardial perfusion, postoperative recovery and calculated scintigraphic indices. RESULTS: The mean number of distal anastomoses was 3.5+/-0.9 and all of patients had complete myocardial revascularization. Postoperatively 39 (66.1%) after 3 months and 45 (76.3%) after 6 months of 59 revasculared segments with different degree of myocardial perfusion disorders improved. Postoperative (after 6 months) index of myocardial perfusion recovery was found more than 2 times better than predicted preoperatively, because there was no estimation of hibernating myocardium preoperatively. CONCLUSIONS: Estimation of myocardial perfusion changes with single-photon emission computed tomography in early postoperative period, especially after 6 months, confirms the excellent and final results of complete surgical myocardial revascularization. Present protocol of myocardial perfusion investigation gives incomplete information in prediction of postoperative results of complete myocardial revascularization. Myocardial perfusion study performed after nitrate administration is the method of choice to predict correct results.

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