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Titolo:
N-13-ammonia myocardial blood flow and uptake - Relation to functional outcome of asynergic regions after revascularization
Autore:
Kitsiou, AN; Bacharach, SL; Bartlett, ML; Srinivasan, G; Summers, RM; Quyyumi, AA; Dilsizian, V;
Indirizzi:
NHLBI, Cardiol Branch, NIH, Bethesda, MD 20892 USA NHLBI Bethesda MD USA 20892 , Cardiol Branch, NIH, Bethesda, MD 20892 USA NIH, Dept Nucl Med, Bethesda, MD 20892 USA NIH Bethesda MD USA 20892NIH, Dept Nucl Med, Bethesda, MD 20892 USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 3, volume: 33, anno: 1999,
pagine: 678 - 686
SICI:
0735-1097(19990301)33:3<678:NMBFAU>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; LEFT-VENTRICULAR DYSFUNCTION; CELL-MEMBRANE INTEGRITY; N-13 AMMONIA; F-18 FLUORODEOXYGLUCOSE; VIABLE MYOCARDIUM; IDENTIFICATION; REINJECTION; METABOLISM; TOMOGRAPHY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Dilsizian, V NHLBI, Cardiol Branch, NIH, Bldg 10,Room 7B-15, Bethesda, MD 20892 USA NHLBI Bldg 10,Room 7B-15 Bethesda MD USA 20892 , MD 20892 USA
Citazione:
A.N. Kitsiou et al., "N-13-ammonia myocardial blood flow and uptake - Relation to functional outcome of asynergic regions after revascularization", J AM COL C, 33(3), 1999, pp. 678-686

Abstract

OBJECTIVES In this study we determined whether N-13-ammonia uptake measured late after injection provides additional insight into myocardial viability beyond its value as a myocardial blood flow tracer. BACKGROUND Myocardial accumulation of N-13-ammonia is dependent-on both regional blood flow and metabolic trapping. METHODS Twenty-six patients with chronic coronary artery disease and left ventricular dysfunction underwent prerevascularization N-13-ammonia and F-18-deoxyglucose (FDG) positron emission tomography, and thallium single-photon emission computed tomography Pre- and postrevascularization wall-motion abnormalities were assessed using gated cardiac magnetic resonance imaging or gated radionuclide angiography. RESULTS Wall motion improved in 61 of 107 (57%) initially asynergic regions and remained abnormal in 46 after revascularization. Mean absolute myocardial blood flow was significantly higher in regions that improved compared to regions that did not improve after revascularization (0.63 +/- 0.27 vs. 0.52 +/- 0.25 ml/min/g, p < 0.04). Similarly, the magnitude of late N-13-ammonia uptake and FDG uptake was significantly higher in regions that improved (90 +/- 20% and 94 +/- 25%, respectively) compared to regions that did not improve after revascularization (67 +/- 24% and 71 +/- 25%, p < 0.001 for both, respectively). However, late 13N-ammonia uptake was a significantlybetter predictor of functional improvement after revascularization (area under the receiver operating characteristic [ROC] curve = 0.79) when compared to absolute blood how (area under the ROC curve = 0.63, p < 0.05). In addition, there was a linear relationship between late 13N-ammonia uptake and FDG uptake (r = 0.68, p < 0.001) as well as thallium uptake (r = 0.76, p < 0.001) in all asynergic regions. CONCLUSIONS These data suggest that beyond its value as a perfusion tracer, late 13N-ammonia uptake provides useful information regarding functional recovery after revascularization. The parallel relationship among N-13-ammonia, FDG, and thallium uptake supports the concept that uptake of N-13-ammonia as measured from the late images may provide important insight regarding cell membrane integrity and myocardial viability. (C) 1999 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 20:04:43