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Myocardial perfusion

Fig. 3. Structures of myocardial perfusion agents (a) Tc(I)(MIBI)g -sestamibi), where MIBI = 2-methoxyisobutylisonitrile (b)... Fig. 3. Structures of myocardial perfusion agents (a) Tc(I)(MIBI)g -sestamibi), where MIBI = 2-methoxyisobutylisonitrile (b)...
Technetium-9 9m sestamibi is used in myocardial perfusion imaging for the evaluation of ischemic heart disease. It is prepared from a lyophilized kit containing tetrakis(2-methoxy isobutyl isonittile) copper(I) tetrafluoroborate stored under nitrogen. Upon reconstitution with up to 5.6 GBq (150 mCi) of 99mTc pertechnetate, the product is formed by boiling for 10 minutes. [Pg.483]

Technetium-99m tetrafosmin ( Tc-(V)02 (l,2-bis(bis(2-ethoxyethyl)phosphino)ethane) (see Fig. 3d)) is a myocardial perfusion agent. It is used as an adjunct in the diagnosis and localization of myocardial ischemia and/or infarction. [Pg.484]

Stress myocardial perfusion imaging with the radionuclides technetium-99m sestamibi or thallium-201 allows for the identification of multivessel disease and assessment of myocardial viability. [Pg.68]

Fig. 4. Lipophilic-cationic( +1) myocardial perfusion imaging agents A) 99mTc-tetrofosmin R = -CH2CH,0CH,CH3 B), 9"Tc = sestamibi R=C=NCH,C (OCHJ (CH,), Q 99mTc-furifosmin R = -CH2CH2OCH2CH3... Fig. 4. Lipophilic-cationic( +1) myocardial perfusion imaging agents A) 99mTc-tetrofosmin R = -CH2CH,0CH,CH3 B), 9"Tc = sestamibi R=C=NCH,C (OCHJ (CH,), Q 99mTc-furifosmin R = -CH2CH2OCH2CH3...
Exercise tolerance (stress) testing (ETT) is recommended for patients with an intermediate probability of CAD. Results correlate well with the likelihood of progressing to angina, occurrence of acute MI, and cardiovascular death. Ischemic ST-segment depression during ETT is an independent risk factor for cardiovascular events and mortality. Thallium myocardial perfusion scintigraphy may be used in conjunction with ETT to detect reversible and irreversible defects in blood flow to the myocardium. [Pg.146]

Complex 65 (Cardiolite), 99mTc(I)-sestamibi, is used for myocardial perfusion imaging. It was designed on the basis that lipophilic cationic complexes behave as potassium mimics and are taken up by the myocardium (281). The sequential metabolism of the six methoxy groups of 65 to hydroxyl groups in the liver leads to formation of 99mTc complexes with greater hydrophilicity which are not retained in myocardial tissues (282). [Pg.230]

Thus, the nitrates enable myocardial flow resistance to be reduced even in the presence of coronary sclerosis with angina pectoris. In angina due to coronary spasm, arterial dilation overcomes the vasospasm and restores myocardial perfusion to normal. O2 demand falls because of the ensuing decrease in the two variables that determine systolic wall tension (afterload) ventricular filling volume and aortic blood pressure. [Pg.308]

Nuclear imaging techniques, like single photon emission tomography (SPECT) and positron emission tomography (PET), directly assess myocardial perfusion, cell membrane integrity, cellular metabolism, and the molecular mechanisms of ischemic viable or necrotic myocardium, thereby indicating revascularization procedures or not. [Pg.14]

The well established phenomenon of perfusion-contraction matching [15] is an adaptive myocardial response to chronically diminished perfusion. Therefore, analyzing this adaptive process requires simultaneous study of myocardial perfusion,... [Pg.15]

Figure 2.1 illustrates normal myocardial perfusion by PET using Rubidium ( Rb) at rest and after dipyridamole stress in 3D views. A coronary arterial map is overlaid on the perfusion image or alternatively an arterial distribution map as a precise perfusion atlas of the coronary artery tree and all its secondary and tertiary branches [25]. [Pg.15]

Fig. 2.1 Normal myocardial perfusion by positron emission tomography using Rubidium ( Rb) at rest and after dipyridamole stress in 3D views. Coronary arterial... Fig. 2.1 Normal myocardial perfusion by positron emission tomography using Rubidium ( Rb) at rest and after dipyridamole stress in 3D views. Coronary arterial...
Concomitant with PET imaging of FDG, myocardial perfusion is imaged with "N-ammonia [61-63] or with Rb [64]. The combined perfusion FDG images demonstrate several patterns ... [Pg.18]

Indications for radionuclide imaging in these patients are detailed in current ACC/AHA guidelines [68] and ACCF/ASNC appropriateness criteria for SPECT myocardial perfusion imaging [69]. While a detailed discussion of these indications is beyond the purpose of this text, for patients with advanced... [Pg.21]

Johnson NP, Gould KL. Clinical evaluation of a new concept resting myocardial perfusion heterogeneity quantified by markovian analysis of PET identifies coronary microvascular dysfunction and early atherosclerosis in 1,034 subjects. J Nucl Med 2005 46 1427-1437... [Pg.32]

Ross J, Jr. Myocardial perfusion-contraction matching. Implications for coronary heart disease and hibernation. Circulation 1991 83 1076-1083... [Pg.32]

Kirkeeide RL, Gould KL, Parsel L. Assessment of coronary stenoses by myocardial perfusion imaging during... [Pg.32]

Nakagawa Y, Nakagawa K, Sdringola S, Mullani N, Gould KL. A precise, three-dimensional atlas of myocardial perfusion correlated with coronary arterio-graphic anatomy. I Nucl Cardiol 2001 8 580-590... [Pg.33]

He ZX, Verani MS. Evaluation of myocardial viability by myocardial perfusion imaging should nitrates be used J Nucl Cardiol 1998 5 527-532... [Pg.33]

Berman DS, Kiat H, Friedman JD, Wang FP, van TK, Matzer L et al. Separate acquisition rest thallium-201/ stress technetium-99m sestamibi dual-isotope myocardial perfusion single-photon emission computed tomography a clinical validation study. J Am Coll Cardiol 1993 22 1455-1464... [Pg.33]

Brown KA. Prognostic value of myocardial perfusion imaging state of the art and new developments. J Nucl Cardiol 1996 3 516-537... [Pg.34]

Sdringola S, Nakagawa K, Nakagawa Y, Yusuf SW, Boccalandro F, Mullani N et al. Combined intense lifestyle and pharmacologic lipid treatment further reduce coronary events and myocardial perfusion abnormalities compared with usual-care cholesterol-lowering drugs in coronary artery disease. J Am Coll Cardiol 2003 41 263-272... [Pg.35]

Loghin C, Sdringola S, Gould KL. Common artifacts in PET myocardial perfusion images due to attenuation-emission misregistration clinical significance, causes, and solutions. J Nucl Med 2004 45 1029-1039... [Pg.36]

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