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PubMed · 821414

[Selective coronary scintigraphy using labelled microspheres].

A Vacheron·P de Vernejoul·H Lafont·D Gambini·J P Metzger·F Hui Bon Hoa·M Fauchet·J Di Matteo
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Abstract

Selective intracoronary injection of microspheres labelled with radioactive substances which emit gamma rays with different energy levels (Indium 113 m and Technetium 99 m) allows us to explore by scintigraphic methods the areas of distribution of the two coronary arteries. Having been carefully calibrated, the particles are injected in limited numbers, and block the precapillary arterioles, where they gradually diminish in number. Scintigraphic examination is carried out in various projections (anteroposterior, left anterior oblique and right anterior oblique) immediately after coronary arteriography. Coronary scintigraphy allows us to establish the integrity of the distribution network of a coronary trunk which appears normal on coronary arteriography, to visualise the diminution of flow caused by a stenosed but patent trunk, and to visualise the extent of the collateral circulation and the quality of revascularisation achieved by an aorto-coronary bypass operation.

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Angina PectorisArrhythmias, CardiacCardiomyopathiesCoronary Artery BypassCoronary VesselsFemaleHeart Valve DiseasesHumansIndiumMaleMicrospheresMyocardial InfarctionRadionuclide ImagingTechnetiumComparative StudyEnglish AbstractJournal Article

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A Vacheron, P de Vernejoul, H Lafont, D Gambini, J P Metzger, F Hui Bon Hoa, M Fauchet, J Di Matteo. 1976. [Selective coronary scintigraphy using labelled microspheres].. https://pubmed.ncbi.nlm.nih.gov/821414/

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OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

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