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Biomedical subjects

J Taki

Publications and source records attributed to J Taki.

At least 109 records · Page 6Linked to original sources
PubMed1995

[Evaluation of myocardial fatty acid metabolism in the area of fill-in after thallium reinjection in patients with prior myocardial infarction].

Myocardial fatty acid utilization in the area with thallium fill-in after reinjection was assessed using 123I-labeled 15-(p-iodophenyl)3R,S-methylpentadecanoic acid (BMIPP). We studied 22 patients with prior myocardial infarction that revealed persistent defects on standard exercise-redistribution thallium imaging. In each patient, exercise-redistribution-reinjection thallium imaging was performed. Within two weeks of the thallium study, resting BMIPP imaging was performed 20 min after injection of BMIPP (148 MBq). Following qualitative analysis of the obtained thallium and BMIPP images, quantitative analysis was performed on the basis of relative regional uptake. Of 199 myocardial segments that showed persistent defects on exercise-redistribution images, 73 segments showed apparent fill-in on the reinjection images (fill-in positive), and the remaining 126 segments did not (fill-in negative). When BMIPP images were compared with the corresponding thallium reinjection images, reduced BMIPP uptake compared with thallium were frequently observed in the area of fill-in positive segments (65 of 73 segments, 89%). Quantitative analysis also showed decrease in BMIPP activity compared to thallium activity in the area of fill-in (49.7 +/- 16.1 vs. 65.8 +/- 16.0%, p < 0.001). In contrast, only 24 of the 126 fill-in negative segments (19%) showed lower BMIPP uptake than thallium. These results suggest that impaired fatty acid utilization in the area of thallium new fill-in after reinjection already exists at resting condition.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Value of 123I-BMIPP scintigraphy in patients with ischemic heart disease: comparison with exercise 201Tl SPECT].

To evaluate 123I labeled beta-methyl-branched fatty acid (BMIPP) myocardial uptake at rest in the segment with and without stress induced ischemia in patients with coronary artery disease, 123I-beta-methyl-branched fatty acid myocardial scintigraphy was performed at rest and was compared with the findings of stress-reinjection 201Tl myocardial scintigraphy in 31 patients with coronary artery disease. In 159 ischemic myocardial segments, equally decreased uptake on both reinjection 201Tl and fatty acid images was observed in 64 segments, more severely decreased uptake of fatty acid in 76 segments, and more severely decreased uptake of reinjection thallium in 19 segments. On the other hand, in 53 non-reversible defects, each patterns was observed in 41, 3, and 9 segments respectively. When comparing the ischemic segments with more reduced uptake of fatty acid than reinjection thallium (Group 1) and the ischemic segments with equally or less reduced fatty acid uptake than reinjection thallium (Group 2), wall motion was more severely impaired in Group 1 than in Group 2 (severe hypo- to dyskinesis was present in 32 of 54 segments in group 1 and in 21 of 75 segments in group 2, p < 0.005). In conclusion, in patients with coronary artery disease, resting fatty acid uptake was frequently more reduced than reinjection 201Tl in the segments with stress induced ischemia and wall motion was more impaired in these segments. BMIPP myocardial imaging may provide information on metabolic alterations at rest independent of perfusion abnormalities in patients with coronary artery disease.

Aged↗
PubMed1995

[Effect of scatter correction on quantification of myocardial SPECT and application to dual-energy acquisition using triple-energy window method].

Triple-energy window (TEW) method is a simple and practical approach for correcting Compton scatter in single-photon emission tracer studies. The fraction of scatter correction, with a point source or 30 ml-syringe placed under the camera, was measured by the TEW method. The scatter fraction was 55% for 201Tl, 29% for 99mTc, 57% for 123I. Composite energy spectra were generated and separated by the TEW method. Combination of 99mTc and 201Tl was separated well, and 201Tl and 123I were separated within an error of 10%; whereas asymmetric photopeak energy window was necessary for separating 123I and 99mTc. By applying this method to myocardial SPECT study, the effect of scatter elimination was investigated in each myocardial wall by polar may and profile curve analysis. The effect of scatter was higher in the septum and the inferior wall. The count ratio relative to the anterior wall including scatter was 9% higher in 123I, 7-8% higher in 99mTc and 6% higher in 201Tl. Apparent count loss after scatter correction was 30% for 123I, 13% for 99mTc and 38% for 201Tl. Image contrast, as defined myocardium-to-left ventricular cavity count ratio, improved by scatter correction. Since the influence of Compton scatter was significant in cardiac planar and SPECT studies; the degree of scatter fraction should be kept in mind both in quantification and visual interpretation.

Adult↗
PubMed1994

Left ventricular dysfunction during exercise in patients with angina pectoris and angiographically normal coronary arteries (syndrome X)

Left ventricular function during exercise and recovery was investigated in patients with angina pectoris, ST segment depression during exercise and angiographically normal coronary arteries (syndrome X) using a continuous left ventricular function monitor with cadmium telluride detector (CdTe-VEST). Fourteen patients with syndrome X and 14 patients with atypical chest pain without ST segment depression during exercise and normal coronary arteries (control group) performed supine ergometric exercise after administration of 740-925 MBq of technetium-99m labelled red blood cells, and left ventricular function was monitored every 20 s using CdTe-VEST. Left ventricular ejection fraction (EF) response was impaired (< or = 5% increase from rest to peak exercise) in 11 or 14 patients with syndrome X but in none of the control patients. Resting EF was similar in the two groups (62.1% +/- 6.7% in patients with syndrome X, 61.9% +/- 6.2% in controls); however, EF increase from rest to peak exercise was lower in syndrome X (-3.1 +/- 9.5% vs 14.7% +/- 7.4%, P < 0.001). After cessation of exercise, all patients showed rapid EF increase over baseline and this EF overshoot was lower (19.3% +/- 8.3% vs 26.4% +/- 7.3%, P < 0.001) with the time to EF overshoot longer (114 +/- 43 s vs 74 +/- 43 s, P < 0.05) in patients with syndrome X. Thus, in patients with syndrome X, left ventricular dysfunction was frequently observed during exercise in spite of normal epicardial coronary arteries.

Adult↗
PubMed1994

Twenty-four-hour quantitative thallium imaging for predicting beneficial revascularization.

To determine the utility of 24-h thallium single-photon emission tomographic imaging for the assessment of myocardial viability, 40 patients with persistently decreased uptake on 3-h delayed imaging after exercise were studied before and after bypass surgery (n = 34) or coronary angioplasty (n = 6). Wall motion improvement after revascularization was also analysed in 23 patients with respect to the segments with and without 24-h redistribution. Of a total of 113 segments without redistribution at 3-h imaging after exercise, 62 (55%) demonstrated redistribution at 24 h. After revascularization 57 (92%) of these 62 segments revealed improvement of thallium uptake. On the other hand 40 (78%) of the 51 segments with persistently decreased thallium uptake until 24 h did not show improvement of uptake after revascularization. Of the 15 segments with > 50% relative thallium uptake and without redistribution on 24-h images, ten showed improvement of thallium uptake after revascularization. Hence higher uptake even without 24-h redistribution may indicate viability. Regional wall motion improved in 22 of 23 segments with redistribution on 24-h images, and did not improve after revascularization in 19 of 22 segments without redistribution at 24 h. These data suggest that 24-h late imaging with quantitative analysis may provide reliable information about reversible myocardial ischaemia in segments that demonstrate a fixed perfusion abnormality on conventional 3-h delayed imaging.

Angioplasty, Balloon, Coronary↗
PubMed1994

Intense accumulation of Tl-201 in carcinoid tumor of the thymus.

A case of carcinoid tumor of the thymus is presented in which Tl-201 SPECT demonstrated intense accumulation in the lesion. Conventional chest radiograph and CT scan in a 66-year-old man who had been experiencing cough and pain at the anterior part of the chest revealed a tumor in the anterior mediastinum, suggesting a thymoma. The tumor was clearly delineated in both early and delayed SPECT studies. On the delayed scan, the tumor was more prominently visualized with an extremely high uptake ratio of the lesion compared to the contralateral background; therefore, the tumor was believed to possess very prolonged Tl-201 retention. The pathological and immunohistochemical examinations confirmed that the area of intense Tl-201 uptake was rich in viable cells.

Aged↗
PubMed1994

Decreased 123I-MIBG uptake and increased clearance in various cardiac diseases.

123I-metaiodobenzylguanidine (MIBG), a tracer for sympathetic neuron integrity and function, was applied to 155 patients with various types of cardiac disease. The methods for quantification of MIBG and washout were studied as well as normal ranges. Heart-to-mediastinum average count ratio (H/M) correlated well with total heart count divided by injected activity (r = 0.60, P < 0.0001 and r = 0.72, P < 0.0001 for early and delayed images, respectively). Although as a whole left ventricular ejection fraction (LVEF) positively correlated with H/M ratio, decreased H/M ratio could be associated with normal LVEF, which may indicate that the MIBG activity was an independent variable compared with cardiac contractility. High washout rate was seen in various cardiac diseases, such as dilated cardiomyopathy, hypertrophic cardiomyopathy, ischaemic heart disease, hypertension, hypothyroidism and arrhythmia. The increased washout seems to be nonspecific to disease type, but is a common feature of damaged or failing myocardium.

3-Iodobenzylguanidine↗
PubMed1994

Relationship between various parameters derived from 123I-labelled beta-methyl-branched fatty acid whole-body scintigraphy and left ventricular ejection fraction in patients with ischaemic heart disease.

Heart uptake and clearance of 123I-15-(p-iodophenyl)-3(R,S)-methyl- pentadecanoic acid (BMIPP) by whole-body scintigraphy in relation to left ventricular ejection fraction (LVEF) was evaluated in 34 patients with ischaemic heart disease. At 45 and 210 min after injection, anterior whole-body images were obtained. In each patient, multigated blood pool scintigraphy was also performed, and LVEF was calculated. The percentage heart uptake of BMIPP did not have a significant correlation with LVEF (R = -0.299, NS). In contrast, there was a positive correlation between LVEF measured by multigated blood pool scintigraphy and BMIPP count density of the heart (R = 0.467, P = 0.005). Myocardial BMIPP washout rate also positively correlated with LVEF (R = 0.472, P = 0.005). In addition to these observations, there was a positive correlation between the BMIPP count density of the heart and myocardial BMIPP washout rate (R = 0.0543, P = 0.001). Thus, the BMIPP count density of the heart and myocardial BMIPP washout rate derived from BMIPP whole-body scintigraphy directly correlated with LVEF. However, the correlations between these parameters and LVEF were not strong enough to allow left ventricular dysfunction to be assessed precisely.

Adult↗
PubMed1994

[Quantitative analysis of 123I-BMIPP imaging in relation to exercise-redistribution 201Tl in patients with old myocardial infarction].

Myocardial kinetics of 123I-labeled 15-(p-iodophenyl)3R,S-methylpentadecanoic acid (BMIPP) was evaluated with BMIPP imaging in conjunction with stress-201Tl. We studied 20 patients with old myocardial infarction. BMIPP SPECT was obtained at 20 min and 3 h after injection. On a separate day, exercise stress-201Tl SPECT was performed at 10 min and 3 h after injection. Then, left ventricular myocardium was divided into 20 segments. For quantitative analysis, in each SPECT data, the maximum value (average counts per pixel) of all 20 myocardial segments was taken as 100%; the other values were calculated as a percentage of this maximum (Relative regional uptake, RRU). On the basis of stress-201Tl pattern, the myocardial segments were classified into 4 groups; normal 201Tl uptake, reversible 201Tl defect, fixed 201Tl defect and 201Tl defect with reverse redistribution. The 20 min BMIPP showed reduced activity compared with 3 h-201Tl (p < 0.001), especially in the area of 201Tl redistribution (50/111 segments, 45%), implicating impaired fatty acid utilization at resting condition. The washout rate of the segments with reversible 201Tl defect (-1.6 +/- 13.9%) was significantly lower than that of the segments with normal 201Tl uptake (9.0 +/- 9.8%) and fixed 201Tl defect (3.8 +/- 12.9%). Thus, BMIPP in combination with stress 201Tl imaging provides precise informations of impaired myocardial fatty acid utilization in patients with old myocardial infarction.

Adult↗
PubMed1994

Left ventricular functional reserve in nonobstructive hypertrophic cardiomyopathy: evaluation by continuous left ventricular function monitoring.

UNLABELLED: The cardiac functional response to exercise in patients with nonobstructive hypertrophic cardiomyopathy (HCM) was evaluated using a continuous ventricular function monitor with a cadmium telluride detector (CdTe-VEST). METHODS: Supine ergometric exercise was performed under CdTe-VEST monitoring in 41 patients with nonobstructive HCM (34 men and 7 women, age 18-72 yr, mean 51 yr) and 15 patients without cardiac disease (9 men and 6 women, age 36-56 yr, mean 49 yr). RESULTS: Although 20 of 41 patients with HCM maintained a LVEF above baseline at peak exercise (Group A), 21 did not show an EF increase at peak exercise (Group B). Exercise duration and work load in Group A were longer and higher, respectively, than in Group B. Resting EF in Group B (72 +/- 7.7%) was significantly higher than that in Group A (65 +/- 8.2%) and the control group (62 +/- 5.9%). The EF increase from baseline to EF overshoot during recovery and the time to EF overshoot were lower and longer, respectively, in Group B than in Group A and the control group. Septal wall thickness and the septum-to-posterior-wall-thickness ratio between Groups A and B were not different. ST-segment depression was observed in all 21 Group B patients and in 8 of the Group A patients. CONCLUSION: In patients with nonobstructive HCM, left ventricular dysfunction during exercise and during recovery was frequently observed but was not related to the degree of septal wall hypertrophy. The CdTe-VEST is a useful means to evaluate left ventricular functional reserve to exercise in patients with HCM.

Adolescent↗
PubMed1994

[123I-BMIPP whole-body scintigraphy in relation to left ventricular ejection fraction].

Heart uptake and clearance of 123I-15-(p-iodophenyl)-3(R,S)-methylpentadecanoic acid (BMIPP) by whole-body scintigraphy in relation to left ventricular injection fraction (LVEF) was evaluated in 19 patients with myocardial infarction. At 45 and 210 min after injection, anterior whole-body images were obtained with a single-headed gamma camera system. In each patient, gated blood pool scintigraphy was also performed, and LVEF was calculated. Percent washout from the heart from the 45 to the 210 min imaging positively correlated with LVEF (r = 0.61, p < 0.01), although percent uptake and count density of the heart at 45 min imaging did show any positive correlation with LVEF (r = -0.10 and r = 0.35, respectively). The count density did not correlated with the percent washout (r = 0.32, p = 0.18). Thus, some relationship between LVEF and washout rate of BMIPP from the heart was suggested by analysis of BMIPP whole-body scintigraphy in patients with myocardial infarction.

Adult↗
PubMed1994

Kinetics of iodine-123-BMIPP in patients with prior myocardial infarction: assessment with dynamic rest and stress images compared with stress thallium-201 SPECT.

UNLABELLED: Myocardial kinetics of 123I-labeled 15-(p-iodophenyl)3R, S-methylpentadecanoic acid (BMIPP) were evaluated with dynamic SPECT, and stress and rest BMIPP images were directly compared in conjunction with stress 201Tl. METHODS: We studied 26 patients with prior myocardial infarction. Two minutes after injection of BMIPP, dynamic data acquisition with a three-headed SPECT was started and continued for 12 min. Conventional SPECT images were obtained at 20 min and 3 hr after injection. On a separate day, exercise, stress 201Tl SPECT was performed at 10 min and 3 hr after injection. Exercise stress-BMIPP imaging was performed in 15 of the patients, and static SPECT images were obtained. RESULTS: With dynamic SPECT, early clearance of BMIPP from the myocardium was observed in the segments with reversible 201Tl defects, suggesting enhanced contribution of backdiffusion from BMIPP. In myocardial segments with reversible 201Tl defects, 20-min BMIPP images showed a higher frequency of reduced uptake when compared to 3-hr 201Tl (90/163) imaging. CONCLUSION: With BMIPP dynamic SPECT, an enhanced contribution of backdiffusion in the early phase from ischemic myocardium was suggested. When exercise stress BMIPP images were obtained, a more severe defect was observed than on rest BMIPP and stress 201Tl imaging, possibly due to decreased coronary blood flow and impaired fatty acid uptake induced by ischemia during exercise.

Exercise Test↗
PubMed1993

Left ventricular functional reserve in patients with syndrome X: evaluation by continuous ventricular function monitoring.

OBJECTIVES: The objective of this study was to evaluate cardiac functional reserve in patients with syndrome X. BACKGROUND: Syndrome X is characterized by stress-induced anginal pain and ST segment depression, normal findings on coronary angiography and normal left ventricular function at rest. Reduced coronary vasodilative reserve and abnormal myocardial lactate metabolism have been described in such patients. METHODS: To assess left ventricular functional reserve in patients with syndrome X, continuous radionuclide monitoring of left ventricular end-diastolic volume, end-systolic volume and ejection fraction was performed in 12 patients and 13 normal control subjects during supine bicycle ergometer exercise. RESULTS: In control subjects, end-diastolic volume increased at peak exercise from 100% to 106.5% (p < 0.01), end-systolic volume decreased from 39.1% to 22.6% (p < 0.01) and ejection fraction increased from 60.9% to 78.6% (p < 0.01). In patients with syndrome X, end-diastolic volume increased at peak exercise from 100% to 106% (p < 0.01), and end-systolic volume decreased at ST segment depression < or = 0.5 mm (the ST point) from 37% to 28.8% (p < 0.01) but increased at peak exercise to 44.7% (p < 0.01 vs. the ST point). Thus, ejection fraction increased at the ST point from 63% to 72.7% (p < 0.01) but decreased at peak exercise to 57.7% (p < 0.01 vs. the ST point and control subjects) in proportion to the degree of ST segment depression. In nine patients (75%), ejection fraction at peak exercise was lower than baseline values. All patients and control subjects showed a rapid ejection fraction increase just after exercise during the recovery period. The degree of ejection fraction "overshoot" in patients was similar to that in control subjects, but the interval from the end of exercise to the overshoot in patients was significantly longer than that in control subjects (118 vs. 65 s, p < 0.01). CONCLUSIONS: In patients with syndrome X subjected to exercise stress, left ventricular function remained normal before the onset of ST segment depression. Once ST segment depression appeared, left ventricular function deteriorated in proportion to the degree of depression, and reduced left ventricular function persisted into the recovery period. Continuous ventricular function monitoring is thus a useful predictor of reduced left ventricular functional reserve in patients with syndrome X.

Adult↗