The aim of this study was to evaluate the relationship between congestive heart failure (CHF) and atrial fibrillation (AF) using iodine-123 metaiodobenzylguanidine (MIBG) scintigraphic imaging. Ninety-two AF patients (47 male and 45 female patients ; mean age, 67±13 years) who did not suffer from structural heart disease or myocardial ischemia underwent MIBG scintigraphy. Global MIBG uptake was assessed by measuring the heart-to-mediastinal ratio (H/M) and washout rate (WR) on planar images, and the abnormal score (AS) was calculated on delayed MIBG single photon emission computed tomography images. Echocardiography was performed within a week after MIBG scintigraphy, to measure left ventricular ejection fraction (EF) and deceleration time (DT) . The AF patients were divided into four groups : patients with permanent AF with (n = 23, group A) or without (n = 19, group B) a history of CHF, and patients with paroxysmal AF with (n =19, group C) or without (n = 39, group D) a history of CHF. Results : The H/M ratio was significantly lower in group A than in other groups (2.0 ± 0.6 vs. group B : 2.7 ± 0.6, group C : 2.3 ± 0.5, and group D : 2.6 ± 0.8, P < 0.05), and in group C than in group D (P < 0.05) . Similarly, the WR was significantly higher in group A than in groups B and C (45.9 ±2.0 vs. group B : 38.9 ± 1.9 and group C : 38.4 ± 2.3, P < 0.05) . The AS was the highest in group A (19.7 ± 8.2 vs. group B : 7.1 ± 6.6, P < 0.01; group C : 11.6 ± 10.6 and group D : 13.5 ± 9.0, P < 0.05) . The DT was significantly longer in group A than in groups B and D (222.0 ± 59.4 vs. group B : 179.5 ± 49.1, P < 0.05 and group D : 177.9 ± 37.1, P < 0.01), but did not differ between groups A and C (222.0 ± 59.4 vs. 197.4 ± 51.1) . There was no difference in EF among the groups. Although CHF with AF is associated with diastolic dysfunction, the progression to permanent AF from paroxysmal AF with CHF might be caused mainly by sympathetic nerve abnormality.
We evaluated the extent of reperfusion injury (RI) following successful coronary intervention quantitatively and non-invasively using technetium-99m pyrophosphate (Tc-PYP) /thallium-201 dual-isotope single photon emission computed tomography (SPECT) . Tc-PYP/thallium-201 SPECT was performed 48 hours after coronary intervention in 67 patients (62.6±12.1 yr) who had undergone successful coronary intervention (TIMI grade 3) in the infarct-affected left anterior descending coronary artery within 6 hours after acute anteroseptal myocardial infarction. The infarct-affected region, which was defined quantitatively by a>55% uptake of Tc-PYP, was considered as showing RI if the recovery of myocardial perfusion was defined quantitatively by <60% uptake of thallium-201. Left ventriculography was performed immediately after intervention and at the 6-month follow-up. These clinical parameters were compared between patients with and without RI. RI was presented in 32 of the 67 patients. Electrocardiographic ST-segment elevations did not return to normal immediately after intervention in the patients with RI as compared to the patients without RI (62.5% of 20 patients versus 25.7% of 9, P<0.01) . The patients with RI had larger infarcts (Unit/L) (5490±3002 versus 2506±2074, P<0.0001), more severe left ventricular function (43±11.8% versus 50.2±10.2%, P<0.05), and larger end-diastolic left ventricular dilatation at the 6-month follow-up (mL/m2) (101±27.2 versus 85.2±24.1, P<0.05) than the patients without RI. This study therefore demonstrates that RI occurring soon after successful coronary intervention following acute myocardial infarction can be detected quantitatively by overlap SPECT images of Tc-PYP/thallium-201.
1864 Objectives The three head gamma camera system (GCA-9300R, Toshiba) which was released in 2014 realizes high sensitivity and high resolution image acquisition. The aim of this study is to access the utility of clinical efficiency of high quality scans with this gamma camera system. Methods In 145 patients who received DAT scans from September 2014 to August 2015, 104 patients (M:F=42:62, age:74±14) who had definite diagnosis and didn9t show large ischemic change which seemed to affect the result of accumulation accounts in striatum were included in this study. Each patient was intravenously injected with 167MBq of I-123-FP-CIT. The mean imaging times post injection is 3 hours. Image reconstruction was performed without attenuation and scatter correction. We divided the materials into 4 groups, PD group (n=55), PS group (MSA,DLB,CBD)(n=20),control group (dementia without DLB, essential tremor) (n=23), undivided group which could not be classified in other three group (n=6). The ROC analysis between the abnormal (PR+ PS) group and control group was performed, and the specific banding ratio (SBR) and asymmetry index (AI) measured by the BOLT method were compared statistically. An analysis of SBR t-test was used and the Mann Whitney-U test was used in AI because it didn’t show normal distribution. Results In the ROC analysis, as to SBR, when threshold between abnormal and control group was defined as 2.94, the sensitivity was 91% and the specificity was 89% (P<0.00001), and the difference between PD group and PS group (P<0.0005), and between PS group and control group (P<0.05) showed apparently significant differences respectively.
The difference of AI between PD group and PS group showed significant difference (P Conclusions The DAT scan with three head gamma camera system can provide highly sensitive results clinically in diagnosis of PD and PS.
