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[Evaluation of left ventricular function using 99mTc-diethylenetriamine-pentaacetic acid-human serum albumin
Insights
A new blood pool agent, 99mTc-DTPA-HSA, enables convenient ECG-gated scintigraphy for assessing left ventricular ejection fraction (LVEF). This agent is stable and clears slowly, allowing for repeat LVEF measurements in patients, such as those with pacemakers.
Area of Science:
- Nuclear Medicine
- Cardiovascular Imaging
- Radiopharmaceutical Development
Background:
- ECG-gated blood pool scintigraphy is crucial for evaluating cardiac function.
- Development of novel, stable blood pool agents is needed for improved diagnostic capabilities.
Purpose of the Study:
- To evaluate the utility of a new blood pool agent, 99mTc-DTPA-HSA, for ECG-gated blood pool scintigraphy.
- To assess the correlation of left ventricular ejection fraction (LVEF) measurements with echocardiography.
- To investigate changes in LVEF in pacemaker patients.
Main Methods:
- Utilized 99mTc-DTPA-HSA for ECG-gated blood pool scintigraphy in healthy volunteers and patients.
- Acquired planar and SPECT images to visualize cardiac contractility.
- Calculated LVEF from LV volume curves and compared with echocardiography.
- Evaluated LVEF changes in relation to pacemaker pacing rates.
Main Results:
- 99mTc-DTPA-HSA demonstrated slow blood pool clearance (half-time 420 min) and stable labeling.
- Gated blood pool studies successfully visualized cardiac contractility.
- Calculated LVEF correlated well with echocardiography (US).
- LVEF showed a trend of decrease with increased pacing rates in pacemaker patients, though individual responses varied.
Conclusions:
- 99mTc-DTPA-HSA is a convenient and effective blood pool agent for gated scintigraphy.
- Its stable labeling and slow clearance facilitate repeat LVEF measurements under various conditions.
- The agent shows promise for assessing cardiac function, especially in pacemaker-dependent patients.
Abstract:
A newly developed blood pool agent 99mTc-DTPA-HSA (Japan Mediphysics, Inc.) was used for ECG gated blood pool scintigraphy. The radiopharmaceutical remained in the blood pool with disappearance half time of 420 min in a healthy subject. The gated blood pool study in the same subject clearly demonstrated contracting left ventricle and right ventricle both with planar and SPECT images. Three healthy volunteers and 14 patients were included in the study, in that gated blood pool images were successfully obtained. The left ventricular ejection fraction (LVEF) calculated by the analysis of LV volume curves correlated well with those obtained by echocardiography (US). In 11 patients with implanted pacemaker for complete atrioventricular block and sick sinus syndrome changes of LVEF were evaluated in relation to pacing rates. The mean LVEF at pacing rate of 60/min was 58.5%, which decreased to 54.4% at 100/min pacing rate. However, changes of LVEF in individual patient did not show same pattern. We conclude that 99mTc-DTPA-HSA is a convenient blood pool scanning agent which does not require time consuming labeling preparations. Stable labeling and slow blood clearance allows its use for repeat measurements of LVEF in different conditions in a patient such as with pacemaker.