Etude faite chez 13 sujets. La ventriculographie radioisotopique semble etre une methode bonne dans le diagnostic de l'insuffisance tricuspide et peut etre d'un grand interet dans le traitement de la maladie
Diastolic function was evaluated in 13 patients with hypertrophic cardiomyopathy and 10 normal subjects of comparable age. Time-activity curves were used to derive peak filling rate, time to peak filling rate and average filling velocity during the first third of diastole. Left ventricular ejection fraction was significantly higher in patients with hypertrophic cardiomyopathy. Time to peak filling rate and filling velocity during the first third of diastole were significantly lower in patients compared to controls. Thus, radionuclide techniques can be used to evaluate diastolic filling in clinical practice.
Normal myocardial cells actively uptake the radioisotope Thallium-201 and its myocardial distribution is a reflection of the existent regional coronary artery blood flow at the moment of the examination. Thallium-201 reaches quickly a high intracellular concentration and then leaves myocardial cells in a mean time of 4 to 8 h. In the presence of significant coronary artery disease, uptake and elimination rates of Thallium-201 are delayed in ischemic tissue, compared to normal tissue. This leads to regional differences in relative concentrations which allow to identify viable areas with insufficient coronary flow in conditions of vasodilatation induced by exercise or pharmacologic means. This phenomenon does not occur in the irreversibly damaged myocardium, and affected areas fail to uptake the radioisotope. Clinical applications of this test are: 1.--Search for coronary artery disease. 2.--Assessment of patients with known coronary artery disease. 3.--Evaluation of patients after revascularization procedures. 4.--Assessment of coronary risk before peripheral vascular surgery. 5.--Detection of viable myocardium. 6.--Assessment of coronary reserve in patients with angor and normal coronary vessels.
The yield of exercise thallium-201 scintigram was studied in a group of 101 patients with suspected coronary artery disease or with a history of an old acute myocardial infarction. The thallium perfusion imaging was performed with planar technology and was interpreted visually. Its results were compared with conventional exercise testing and the results of a coronary arteriography performed within 30 days. Global sensitivity for conventional exercise testing was 60.4%, which increased to 78.2% with the thallium study. Specificity was raised from 47.2 to 84.8%. In patients with one, two or three vessel disease, thallium scintigram was abnormal in 95.1%, 96.6% and 100% respectively (NS).
A 24 year old female with a stage III-B Hodgkin disease involving the mediastinum was subjected to chemotherapy and supradiaphragmatic radiotherapy. A year later she developed heart failure. LV dilatation and decreased systolic function with anteroseptal and lateral hypokinesia and a small pericardial effusion were shown by X Ray and echocardiography. An initial clinical diagnosis of radiation heart disease was changed to myocardial involvement by Hodgkin disease after performing and endomyocardial biopsy.
Resumen:Objetivo: Evaluar los resultados alejados de la val-vuloplastia mitral percutanea (VMP), y analizar los factores asociados con eventos y reestenosis tardia. Metodos y resultados: De 252 VPM realizadas entre diciembre de 1987 y diciembre de 2006, 245 pacientes tuvieron un minimo de 6 meses de segui-miento y evaluacion ecocardiografica antes y despues del procedimiento (97%). La edad media fue de 46,3 ± 11,37 anos, las mujeres fueron 83,6%. La media de seguimiento fue de 35,25 ± 28,84 meses, rango 6-132. La muerte cardiovascular, y el reemplazo de la valvula mitral o una segunda VMP fueron considerados como marcadores de peor resultado. El area de la valvula mitral aumento de 1,0 ± 0,17 cm2 a 1,71 ± 0,31 cm2 (p 8 (p = 0,03). Cinco pacientes fallecieron (2,04%), 22 (8,9%) requirieron reemplazo de la valvula mitral y 11 (4,5%) una segunda VMP. No encontramos variables clinicas o ecocardiograficas capaces de predecir estos eventos.
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