[The microcirculation of the myocardium based on scintigraphic data using labelled microspheres].

The authors described an original procedure for the determination of the organ blood flow with the help of 99mTc-labeled microspheres of aggregated albumin. Some features of the myocardial microcirculation in patients with CHD and without it were determined as well as interrelationships between the major coronary blood flow and the state of the myocardial microcirculation in various groups of CHD patients. A group of 32 males was examined.

[Current methods of examination in the diagnosis of sarcoidosis of the heart].

Marked clinical or electrocardiographic changes, suggestive of heart disease, were only detected in 14 (7%) of 190 patients with sarcoidosis. Diffuse myocardial accumulation of 99mTc pyrophosphate (2+ or 3+) was seen in 12 (43%) of 28 patients with active sarcoidosis. Repeated scintigraphy showed normal values in 3 patients after a course of corticosteroid therapy.

[Tomoscintigraphic characteristics of the basic types of incorporation of 99mTc-pyrophosphate in the "myocardium" (phantom studies)].

The results of phantom studies have shown that tomoscintigraphy makes it possible to define the localization and size of RP diffuse incorporation in the "myocardium" and to differentiate between true and false-positive results. A rarefaction in the center of an image obtained on a transverse tomographic section should be regarded as a characteristic feature of true RP diffuse incorporations.

[Method of radionuclide determination of coronary blood flow: experimental verification and clinical testing].

For quantitative assessment of the coronary blood flow in diagnostic examination of CHD patients the authors have proposed a new method for determination of absolute values of the coronary blood flow by intragastric administration of 99m Tc-labeled human serum albumin microspheres with subsequent whole body scintigraphy and comparison of scintillation count intensity over the heart area and the whole body. The results of experiments on 13 rabbits for verification of the method and the results of clinical testing in 20 patients were presented. The proposed method was shown to ensure adequate assessment of the coronary blood flow in ml/min.

[Comprehensive radionuclide evaluation of the general circulation and the uteroplacental circulation in multiple pregnancy].

The paper is concerned with the results of the clinical testing of a combined method of assessment of the greater and uteroplacental circulation in 15 women with plural pregnancy. The method permits the detection of hemodynamic changes without increasing radiation exposure to the mother's body and fetuses, the determination of a type of plural pregnancy (monochorionic or dichorial twins), and the prediction of pregnancy outcome that is very important for the choice of appropriate and timely therapy.

[Functional reserves of myocardial perfusion in patients with chronic ischemic heart disease with varying degrees of damage of the coronary arteries].

A comparative study of data provided by coronaro-angiography and myocardial perfusion scintigraphy (resting and exercise tests), and clinical/electrocardiographic results of the exercise test in 102 chronic coronary patients demonstrated that non-invasive myocardial perfusion 201Tl scintigraphy combined with threshold bicycle-ergometric exercise adds considerably to the clinico-electrocardiographic assessment of the exercise test and thus helps to detect myocardial blood supply (perfusion) disorders in some of coronary patients with doubtful or negative test results. Reduced functional reserves of myocardial blood supply, as reflected in deficient perfusion at the peak of threshold exercise, are seen in all coronary patients with angiographically intact coronary arteries and in most patients with both the so-called "functionally-insignificant" and marked coronary arterial stenosis (94.7 and 88.

[Interrelation of the state of perfusion and the coronary vascular bed in patients with chronic ischemic heart disease].

Coronary angiographic and scintigraphic (using 201Tl) studies in 139 patients with verified diagnosis of chronic coronary heart disease demonstrated high sensitivity (85.6%) of myocardial perfusion scintigraphy with respect to detecting disorders of myocardial blood supply due to the stenosis of major coronary arteries and microcirculation disorders. False negative scintigraphic results in the screening for perfusion defects are commonly due to the shortcomings of semiquantitative assessment of the scintigrams.

[Correlation of myocardial scintigraphy findings with 201Tl and electrocardiography in evaluation of the state of the myocardium in patients with ischemic heart disease].

One hundred and twenty-seven coronary heart disease patients with angina of effort and at rest were examined, using myocardial scintigraphy with 201Tl. The results obtained were compared with the ECG findings recorded at 12 conventional leads. Myocardial scintigraphy with 201Tl was shown to be a highly sensitive (91% sensitivity) and accurate method of detecting and locating the local impairments of the myocardial blood supply.

[Prognostic importance of a positive test of myocardial 99mTc-Sn-pyrophosphate accumulation in patients with stable stenocardia].

The paper reports the results of a retrospective study of the frequency of complications of chronic coronary disease in 51 patients with stable angina subjected to myocardial 99mTc-Sn-pyrophosphate scintigraphy at rest at first screening. In the group with positive scintigraphic results, myocardial infarction and death from cardiac causes was five times as frequent within the next five years as it was in the group where myocardial incorporation of the drug was not observed. The frequency of complications was higher in cases where positive scintigraphic results were combined with cardiomegaly and electrocardiographic signs of transitory ischemia.

[Semiquantitative assessment of myocardial scintigrams using 201Tl].

A program for an automated semiquantitative evaluation of myocardial scintigrams with 201Tl was proposed. Altogether 11 healthy subjects and 34 patients with acute myocardial infarction were examined. The patients have shown a significant decrease (p less than 0.

[Diagnostic possibilities of myocardial scintigraphy using T1-201 in acute myocardial infarction].

Myocardial scintigraphic investigation using 201T1 was performed in 36 patients with suspected acute myocardial infarction and 11 clinically normal controls. The scintigrams were assessed visually and using a computer program for semiquantitative assessment of 201T1 distribution across the myocardium. The control subjects' scintigrams show a comparatively even myocardial distribution of the label.

Changes in total and local contractility of the left ventricle, imaged by radionuclide ventriculography, in patients with ischaemic heart disease during submaximal exercise.

In 40 patients with chronic ischaemic heart disease [IHD) and 10 healthy subjects the total and local myocardial contractility was assessed during threshold-level exercise. The patients were subjected to radionuclide ventriculography in a modification recording the first passage of the radioindicator through the heart cavities. In the control subjects the exercise induced a 27% increase in the total ejection fraction, with increased contractility of all left ventricular segments.

[Kinetics of radioactive thallium chloride (201TlCl3) transport from the blood to myocardial tissue normally and in cardiac ischemia].

Extraction of 201TlCl3 diffusing into the heart tissue under conditions of its normal functioning and in the presence of ischemia was appraised on a model with isolated coronary perfusion of the myocardium by the dual-tracer method. From analysis of the discharge curve of the tracers used it is concluded whether or not microcirculation of the perfused area of the heart is uniform or heterogeneous. It was established that in myocardial ischemia, 201TlCl3 does not accumulate in the interstitium, which makes it possible to evaluate the zones with diminished inclusion of 201TlCl3 encountered in scanning of the heart as corresponding to diminished blood supply.

[Myocardial scintigraphy with pyrophosphate-99mTc in transitory myocardial ischemia in chronic ischemic heart disease].

Scintigraphy of the myocardium with pyrophosphate-99mTc was used in the examination of 45 patients with chronic ischemic heart disease and 3 patients with vegetovascular dystonia. A direct dependence of the character of the scintigram on the anginous attack was revealed. Accumulation of pyrophosphate-99mTc in the myocardium was observed in all patients with the agent injected just before the attack, during the attack or in the first 8 hours after it.

[State of general and renal hemodynamics in acute myocardial infarct].

The results of studying central and renal hemodynamics in 49 patients with a different course of myocardial infarction in the acute period (1st, 3rd, and 10th day) are analysed. It was established that on the 1st day the cardiac output decreases considerably in circulatory insufficiency and hardly changes in an uncomplicated course of the disease. The stroke output of the heart reduces significantly in all forms of the course of myocardial infarction.

[Hemodynamics in atrioventricular block in acute myocardial infarct and its changes under the influence of electric stimulation of the heart].

Hemodynamics was studied in the initial condition and against the background of electric stimulation of the heart in 18 patients with acute myocardial infarction complicated by complete atrioventricular block. It is shown that block promotes the development of circulatory insufficiency in patients with myocardial infarction. The marked character of hemodynamic disorders and the changes induced in it by electric stimulation are determined in many respects by the functional condition of the left ventricle.