The feasibility of using 123I-heptadecanoic acid (HDA) as a metabolic tracer was studied. Different administration routes of HDA were compared. An intracoronary bolus injection was given to calves (n = 3), and an intravenous injection was given to patients (n = 4). In addition, we examined the influence of 4-h halothane anesthesia in calves and in patients the impact of an insulin (1.5 IU/kg) + glucose (1.5 g/kg) infusion on the myocardial kinetics of HDA. Data were accumulated with a scintillation probe in calves (t = 50 min) and a gamma camera in patients (t = 70 min). In calves after an intracoronary bolus injection of HDA the myocardial time-activity curve could be described by two exponentials. The mean elimination half-time of the initial phase (ta 1/2) was 7.3 min and that of the second phase (tb 1/2) was 35 min. The ratio of the size of the initial and second component at to was 0.93. Halothane anesthesia prolonged the elimination half-times and reduced the component ratio. The biphasic behavior of the myocardial time-activity curve was maintained in patients after intravenous administration of HDA under basal conditions (initial ta 1/2 = 8.4 min). However, during infusion of insulin + glucose the decline in the myocardial activity was prolonged and monoexponential. This data shows that insulin glucose, interfering with fatty acid metabolism, influences the myocardial washout of HDA, and thus support its use as a metabolic tracer.
β-Thromboglobulin (βTG), platelet factor 4 (PF4), fibrinopeptide A (FPA), lactic dehydrogenase (LDH), and platelet count were evaluated in patients with bioprostheses and prosthetic heart valves. βTG and PF4 were significantly elevated in both patient groups (p < 0.001), whereas FPA was normal. There was no significant difference in plasma concentrations of βTG and PF4 between patients with prosthetic heart valves and bioprostheses. LDH levels were significantly (p < 0.001) higher and platelet count lower (p < 0.001) in patients with prosthetic cardiac valves. The data indicate that bioprostheses do not cause haemolysis or activation of the coagulation system. The findings that the plasma concentration of platelet-specific proteins were elevated, support the assumption that both types of valves cause platelet damage.
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