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[Quantitative gated nuclear cardiography in coronary artery disease after administration of isosorbiddinitrate
Insights
Quantitative gated nuclear cardiography effectively differentiates cardiac dysfunction in coronary artery disease (CAD) patients. It assesses left ventricular function and regional wall motion, identifying reversible and irreversible abnormalities.
Area of Science:
- Nuclear Cardiology
- Cardiovascular Imaging
- Medical Diagnostics
Context:
- Coronary artery disease (CAD) significantly impacts left ventricular (LV) function.
- Assessing LV volume changes and regional wall motion is crucial for diagnosing and managing CAD.
- Isosorbide dinitrate is used to evaluate the response of LV function to vasodilation.
Purpose:
- To evaluate the utility of quantitative gated nuclear cardiography in assessing left ventricular function and regional wall motion in patients with CAD.
- To compare LV function and wall motion between CAD patients and healthy controls.
- To determine if nuclear cardiography can differentiate between various degrees of asynergy (hypokinesia, akinesia, aneurysm) in CAD patients.
Summary:
- 19 CAD patients and 8 controls underwent quantitative gated nuclear cardiography before and after sublingual isosorbide dinitrate.
- Measurements included ejection fraction, maximal systolic ejection rate, and maximal diastolic filling rate.
- Regional wall motion abnormalities were assessed using cinemode display and functional scintigrams.
Impact:
- Quantitative gated nuclear cardiography clearly distinguished between control subjects and CAD patients.
- The technique identified differences in LV function and wall motion based on the severity of asynergy (hypokinesia vs. akinesia/aneurysm).
- This method provides valuable information on both overall LV function and local wall motion, aiding in the assessment of reversible and irreversible myocardial dysfunction.
Abstract:
The change in left ventricular volume during a representative cardiac cycle was assessed in 19 patients with CAD and 8 control subjects before and after 10 mg isosorbiddinitrate sublingually. 15mCi99mTc-HSA were administered intravenously. After the tracer had equilibrated, the precordial changes of activity were measured with a gamma-camera connected to a computer. In order to determine the overall left-ventricular function from volume curves, the ejection fraction, the maximal systolic ejection rate and the maximal diastolic filling rate of the left ventricle were measured. For the assessment of regional wall motion abnormalities the volume changes were observed in a cinemode on a colour video display. In addition the relative changes of regional EF, regional stroke volume and the timing of endsystole were recorded as a functional scintigram. The results showed very clear differences between control subjects and patients with CAD. Furthermore differences existed between patients with hypokinesia and those with akinesia or aneurysm. The results emphasize that quantitative gated nuclear cardiography not only provides information concerning the left ventricular function but also allows the assessment of local wall motion as to reversible or irreversible asynergy.