RESUMEN
BACKGROUND: Previous studies have shown that gated single photon emission computed tomography (SPECT) technetium 99-labeled sestamibi imaging provides accurate and reproducible measurement of left ventricular (LV) ejection fraction (EF), wall motion, and thickening. This study examined the reliability of gated SPECT sestamibi imaging in measuring LV end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV). METHODS AND RESULTS: Gated SPECT measurements were compared with an independent nongeometric method based on thermodilution SV and first-pass radionuclide angiographic EF (using a multicrystal gamma camera). Twenty-four patients aged 58+/-11 years underwent cardiac catheterization and coronary angiography for evaluation of chest pain syndromes. None had primary valvular disease, intracardiac shunts, or atrial fibrillation. RESULTS: The correlation between the two methods were as follows: EDV: r = 0.89, P<.001; ESV: r = .938, P<.001; SV: r = 0.577, P<.001. Bland-Altman plots showed mean differences (+/-standard deviation [SD]) for EDV of -14.3+/-33.3 mL, for ESV of -0.4+/-23.7 mL, and for SV of -13.9+/-15.2 mL. The reproducibility of measuring EDV and ESV by gated SPECT was very high (r = 0.99 each). CONCLUSION: Gated 99mTc-labeled sestamibi SPECT provides reproducible LV volume measurements. With validation of volume measurement, gated SPECT provides comprehensive assessment of regional and global LV function. This information is important in many patient groups such as those with ischemic cardiomyopathy, concomitant coronary and valve disease, and those who have had myocardial infarction. It will also be useful to assess the incremental value of LV volumes in risk assessment.
Asunto(s)
Imagen de Acumulación Sanguínea de Compuerta , Radiofármacos , Volumen Sistólico , Tecnecio Tc 99m Sestamibi , Tomografía Computarizada de Emisión de Fotón Único , Gasto Cardíaco , Volumen Cardíaco , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Termodilución , Ventriculografía de Primer PasoAsunto(s)
Enfermedad Coronaria/cirugía , Corazón/diagnóstico por imagen , Anastomosis Interna Mamario-Coronaria , Terapia por Láser , Tomografía Computarizada de Emisión de Fotón Único , Anciano , Enfermedad Coronaria/diagnóstico por imagen , Prueba de Esfuerzo , Frecuencia Cardíaca , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Radiofármacos , Tecnecio Tc 99m SestamibiRESUMEN
We identified a biatrial myxoma using transesophageal echocardiography whose right atrial component was missed with conventional transthoracic techniques. Identifying the biatrial component directs a safer approach to right heart catheterization. Infected biatrial myxomas are both rare and successfully managed using prolonged intravenous antibiotic therapy followed by resection. Atrial septal defects created during the resection of an infected myxoma may be safely repaired using a prosthetic patch.