Abnormal myocardial 123I-MIBG accumulation is related to an impaired myocardial contractile reserve and down-regulation of SERCA2 mRNA in DCM. Myocardial 123I-MIBG scintigraphy can be useful in noninvasively evaluating myocardial contractile reserve in patients with mild to moderate DCM.

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spontaneous increase in the electrocardiographic (ECG) R-wave voltage after acute myocardial infarction (MI) is a unique phenomenon, and regeneration of R-waves or disappearance of Q-waves after acute ischemic events has been reported. [1][2][3][4][5][6][7] With the prevalence of interventional therapy, it is thought that this phenomenon is increasing, but little is known regarding the physiological mechanism involved.Patients with acute MI always undergo echocardiography in order to evaluate changes in wall motion, left ventricular (LV) cavity, and LV function over time. Myocardial scintigraphy provides important information about myocardial perfusion and/or metabolism. Specifically, a combined study of myocardial metabolic tracer with perfusion tracer provides clues about the myocardial status in the healing stage of MI. [8][9][10] Perfusion -metabolism mismatch of the Circulation Journal Vol. 70, November 2006 perfusion/metabolic dual-tracers represents impaired but viable myocardium in the risk area, which is involved in functional recovery after revascularization in patients with acute MI. 11-13 Therefore, both examinations are cardinal diagnostic modalities for patients after acute MI.In this study, we performed dual-isotope scintigraphy and echocardiography, and compared the findings with ECG results to determine the physiological mechanism of the increase in ECG R-wave voltage during the acute to the subacute phase after revascularization in patients with acute MI. Methods PopulationOne hundred and seventy-one consecutive patients with first onset of acute MI who underwent emergency coronary revascularization, dual-isotope scintigraphy, and echocardiography between January 1998 and March 2004 were retrospectively examined. Acute MI was diagnosed by typical chest pain for >30 min, ECG ST-elevation of ≥0.1 mV (1 mm) in at least 2 contiguous leads, and a characteristic rise in plasma creatine kinase-MB activity. All patients underwent emergency coronary angiography (CAG) immediately after the ECG diagnosis and subsequent coronary revascularization. In the emergency CAG, antegrade flow was characterized using the Thrombolysis In Myocardial Background The physiological mechanism of the increase in the electrocardiographic (ECG) R-wave voltage after revascularization in patients with acute myocardial infarction (MI) needs to be elucidated. Methods and ResultsOne hundred and thirty-eight MI patients (83: anterior MI, 45: inferior MI, 10: lateral MI) underwent ECG and echocardiography in both the acute and subacute phases after emergency revascularization, as well as a resting thallium-201/iodine-123 15-p-iodophenyl-3-(R,S)-methyl pentadecanoic acid myocardial scintigraphy in the acute phase. The total sum of the R-wave voltage (∑R) was calculated over multiple leads on ECG for each infarcted lesion. Scintigraphic defect on each tracer was expressed as the percentage (%) defect of the total left ventricular (LV) myocardium. The % defect-discordance on both images in the acute phase and the % increase in ∑R an...

Myocardial scintigraphy using 201Tl and 123I-BMIPP predicts future cardiac events in patients with AMI treated with primary PCI, and provides additional predictive value compared with the variables obtained with cardiac catheterisation alone.

The objective of this study is to determine whether sleep‐disordered breathing (SDB) is associated with hypertension in the Japanese working population. The target population included 2877 industrial workers, aged 18–60 years, who answered a sleeping‐related questionnaire during an annual health checkup. A total of 2512 responses were available for analysis. The questionnaire included the Epworth Sleepiness Scale and other items related to sleep habits. We determined the prevalence of SDB in the sample, including habitual snoring and obstructive sleep apnea syndrome. We also analyzed the data for any association of SDB with hypertension. There was a higher prevalence of habitual snoring (HS) in males (10.5%) than in females (4.7%). The prevalence of obstructive sleep apnea syndrome (OSAS) was 2.5 and 2.0% in males and females, respectively. There was an age‐dependent increase in the prevalence of both HS and OSAS in this working population. The mean body mass index (BMI) of individuals with SDB was 24.3 ± 3.1 kg/m2. Blood pressure in the SDB group was significantly higher than that in the non‐SDB group. After adjustment for obesity, sex, age and alcohol consumption, logistic regression analysis revealed an independent association between SDB and hypertension (systolic blood pressure higher than 180 mmHg; OR: 4.3, 95% CI: 1.7–10.8). Therefore, it was found that SDB is independently associated with hypertension in Japanese industrial workers.