The feasibility of repeated left ventricular ejection fraction analysis with sequential single-dose radionuclide ventriculography

Vleuten, Pieter A. van der; Slart, Riemer H. J. A.; Tio, René A.; Horst, Iwan C. C. van der; Veldhuisen, Dirk-Jan van; Dierckx, Rudi; Zijlstra, Felix

doi:10.1097/01.mnm.0000172742.44111.6d

Cited by 10 publications

(5 citation statements)

References 21 publications

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“…All LVEF values were generated without decimals and are highly reproducible. 12 The cut-off value of LVEF <45% was considered to indicate a significantly depressed systolic LV function. 12 All measurements were carried out in one day.…”

Section: Measurementsmentioning

confidence: 99%

Cardiac assessment of patients with late stage Duchenne muscular dystrophy

Bockel¹,

Lind²,

Zijlstra³

et al. 2009

NHJL

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Background. Duchenne muscular dystrophy (DMD) patients used to die mainly from pulmonary problems. However, as advances in respiratory care increase life expectancy, mortality due to cardiomyopathy rises. Echocardiography remains the standard diagnostic modality for cardiomyopathy in DMD patients, but is hampered by scoliosis and poor echocardiographic acoustic windows in adult DMD patients. Multigated cardiac radionuclide ventriculography (MUGA) does not suffer from these limitations. N-terminal proBNP (NTproBNP) has shown to be a diagnostic factor for heart failure. We present our initial experience with plasma NT-proBNP measurement in the routine screening and diagnosis of cardiomyopathy in adult mechanically ventilated DMD patients.Methods. Retrospective study, 13 patients. Echocardiography classified left ventricular (LV) function as preserved or depressed. NT-proBNP was determined using immunoassay. LV ejection fraction (LVEF) was determined using MUGA.Results. Median (range) NT-proBNP was 73 (25 to 463) ng/l. Six patients had an NT-proBNP >125 ng/l. Seven patients showed an LVEF <45% on MUGA. DMD patients with depressed LV function (n=4) as assessed by echocardiography had significantly higher median NT-proBNP than those (n=9) with preserved LV function: 346 (266 to 463) ng/l versus 69 (25 to 257) ng/l (p=0.003). NT-proBNP significantly correlated with depressed LV function on echocardiogram and with LVEF determined by MUGA.Conclusion. Although image quality of MUGA is superior to echocardiography, the combination of echocardiography and NT-proBNP achieves similar results in the evaluation of left ventricular function and is less time consuming and burdensome for our patients. We advise to add NT-proBNP to echocardiography in the routine cardiac assessment of DMD patients. (Neth Heart J 2009;17:232-7.).

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Section: Measurementsmentioning

confidence: 99%

Cardiac assessment of patients with late stage Duchenne muscular dystrophy

Bockel¹,

Lind²,

Zijlstra³

et al. 2009

NHJL

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“…Specifically, data on RNV are collected over several hundreds of cardiac cycles, body habitus does not affect acquisition (many of these patients are obese), and intra- and interobserver variabilities are minimal; and hence, the results are highly reproducible. 11 Moreover, the generally reduced heart rate variability in our patient cohort with DAN contributed to improved time resolution of the method. On the other hand, LV mass assessment is not possible with RNV, and this is a limitation of the method.…”

Section: Discussionmentioning

confidence: 85%

“…Left ventricular function was assessed by RNV, which is an operator-independent modality, offering highly reproducible and reliable measurements. 11…”

Section: Introductionmentioning

confidence: 99%

Left Ventricular Systolic and Diastolic Function in Normotensive Type 2 Diabetic Patients With or Without Autonomic Neuropathy

et al. 2013

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We investigated the relation between diabetic autonomic neuropathy (DAN) and left ventricular (LV) function in 59 patients with type 2 diabetes mellitus (T2DM) free of coronary artery disease (CAD) or hypertension. Diabetic autonomic neuropathy was established by ≥2 abnormal autonomic nervous function tests. Left ventricular systolic and diastolic functions were assessed by resting radionuclide ventriculography. Compared with non-DAN patients (n=24), patients with DAN (n=35) had an increased adjusted atrial contribution to ventricular filling (A/V%, 30.1%±8.2% vs 26.5%±5.1%; P=.031), suggestive of diastolic dysfunction (DD). There were no differences between the 2 groups in peak filling rate, first 1/3 filling fraction, ejection fraction, cardiac output, and cardiac index. Patients with diabetic autonomic neuropathy had an increased heart rate (77.8±6.3 vs 69.3±3.3 bpm; P<.0001) and a higher rest LV workload (10,072±1165 vs 8606±1075 bpm mm Hg; P<.0001). Patients with DAN T2DM without CAD or hypertension have DD, increased A/V index, and a higher LV working load than non-DAN patients.

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“…Background activity ROIs were generated automatically. All LVEF values were generated without decimals and are highly reproducible [12]. …”

Section: Methodsmentioning

confidence: 99%

123I-Labelled metaiodobenzylguanidine for the evaluation of cardiac sympathetic denervation in early stage amyloidosis

Noordzij

Glaudemans

Rheenen

et al. 2012

Eur J Nucl Med Mol Imaging

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PurposeCardiac amyloidosis is a rare disorder, but it may lead to potentially life-threatening restrictive cardiomyopathy. Cardiac manifestations frequently occur in primary amyloidosis (AL) and familial amyloidosis (ATTR), but are uncommon in secondary amyloidosis (AA). Echocardiography is the method of choice for assessing cardiac amyloidosis. Amyloid deposits impair the function of sympathetic nerve endings. Disturbance of myocardial sympathetic innervations may play an important role in the remodelling process. 123I-MIBG can detect these innervation changes.MethodsPatients with biopsy-proven amyloidosis underwent general work-up, echocardiography and 123I-MIBG scintigraphy. Left ventricular internal dimensions and wall thickness were measured, and highly refractile cardiac echoes (sparkling) were analysed. Early (15 min) and late (4 h) heart-to-mediastinum ratio (HMR) and wash-out rate were determined after administration of MIBG.ResultsIncluded in the study were 61 patients (30 women and 31 men; mean age 62 years; 39 AL, 11 AA, 11 ATTR). Echocardiographic parameters were not significantly different between the groups. Sparkling was present in 72 % of ATTR patients, in 54 % of AL patients and in 45 % of AA patients. Mean late HMR in all patients was 2.3 ± 0.75, and the mean wash-out rate was 8.6 ± 14 % (the latter not significantly different between the patient groups). Late HMR was significantly lower in patients with echocardiographic signs of amyloidosis than in patients without (2.0 ± 0.70 versus 2.8 ± 0.58, p < 0.001). Wash-out rates were significantly higher in these patients (−3.3 ± 9.9 % vs. 17 ± 10 %, p < 0.001). In ATTR patients without echocardiographic signs of amyloidosis, HMR was lower than in patients with the other types (2.0 ± 0.59 vs. 2.9 ± 0.50, p = 0.007).ConclusionMIBG HMR is lower and wash-out rate is higher in patients with echocardiographic signs of amyloidosis. Also, 123I-MIBG scintigraphy can detect cardiac denervation in ATTR patients before signs of amyloidosis are evident on echocardiography.

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The feasibility of repeated left ventricular ejection fraction analysis with sequential single-dose radionuclide ventriculography

Abstract: Repeated radionuclide ventriculography with a 3 h interval using a single standard dose of 500 MBq of [Tc]pertechnetate is highly reproducible and will be useful for monitoring the effect of positive inotropic interventions.

Cited by 10 publications

References 21 publications

Cardiac assessment of patients with late stage Duchenne muscular dystrophy

Cardiac assessment of patients with late stage Duchenne muscular dystrophy

Left Ventricular Systolic and Diastolic Function in Normotensive Type 2 Diabetic Patients With or Without Autonomic Neuropathy

123I-Labelled metaiodobenzylguanidine for the evaluation of cardiac sympathetic denervation in early stage amyloidosis

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