Adding attenuation corrected images in myocardial perfusion imaging reduces the need for a rest study.

The American Society of Nuclear Cardiology and the Society of Nuclear Medicine conclude that incorporation of attenuation corrected (AC) images in myocardial perfusion scintigraphy (MPS) will improve diagnostic accuracy. The aim was to investigate the value of adding AC stress-only images for the decision whether a rest study is necessary or not

Right ventricular metastasis of leiomyosarcoma

Metastatic presentation of leiomyosarcoma in the heart is very rare. We present transthoracic echocardiography and combined PET/CT images of a case with a large right ventricular metastasis of leiomyosarcoma. The patient was placed on cytostatic drugs for palliative purposes, but passed away one month later because of an untreatable ventricular tackycardia

Nuclear medicine technologists are able to accurately determine when a myocardial perfusion rest study is necessary.

ABSTRACT

Measurement of oxygen and carbon dioxide partial pressures in synovial fluid after tonometry

A commercially available gas analyser was used to measure tension of oxygen (PO2) and carbon dioxide (PCO2) in synovial fluid samples after tonometry. Measured values of PCO2 were close to the expected (median difference 0.2 kPa, range -0.4 to 0.4) within the analysed concentration range of 4-10 kPa. No consistent difference between measured and expected values of PO2 were found for oxygen in the range 3-11 kPa (median difference 0.1 kPa, range -0.3 to 1.2). For oxygen tensions below 3 kPa, however, the measured values invariably overestimated the actual PO2, the errors ranging from 0.3 to 1.9 kPa, median 1.1. The importance of proper handling of samples was investigated and storage for 1 h at 0 degrees C in plastic syringes resulted in elevation of the PO2 levels measured (range of elevation 0.2 to 3.6 kPa, median 1.15), whilst no significant differences were found when stored in glass syringes. Within the limits stated, commercially available gas analysers may thus be used to investigate these parameters related to local tissue metabolism in effusive joint conditions

Simultaneous quantification of myocardial perfusion, oxidative metabolism, cardiac efficiency and pump function at rest and during supine bicycle exercise using 1-11C-acetate PET - a pilot study

P>Background: PET using 1-11C-acetate (ACE-PET) applied at rest is used for measuring absolute myocardial blood flow (MBF) and oxidative metabolic rate (k(mono)). We evaluated the feasibility of quantitative ACE-PET during exercise. Methods: Five endurance athletes underwent dynamic PET scanning at rest and during supine bicycle stress. Exercise was maintained at a workload of 120 Watt for 17 min. The rate-pressure product (RPP) was recorded repeatedly. MBF, k(mono) in left (LV) and right (RV) ventricular wall, cardiac output (CO), cardiac efficiency and a lung uptake value reflecting left heart diastolic pressures were calculated from the PET data using previously validated models. Results: MBF increased from 0 center dot 71 +/- 0 center dot 17 to 2 center dot 48 +/- 0 center dot 25 ml min-1 per ml, LV-k(mono) from 0 center dot 050 +/- 0 center dot 005 to 0 center dot 146 +/- 0 center dot 021 min-1, RV-k(mono) from 0 center dot 023 + 0 center dot 006 to 0 center dot 087 + 0 center dot 014 min-1, RPP from 4 center dot 7 +/- 0 center dot 8 to 13 center dot 2 +/- 1 center dot 4 mmHg x min-1 x 103 and Cardiac Output from 5 center dot 2 +/- 1 center dot 1 to 12 center dot 3 +/- 1 center dot 2 l min -1 (all P < 0 center dot 001). Cardiac efficiency was unchanged (P = 0 center dot 99). Lung uptake decreased from 1 center dot 1 +/- 0 center dot 2 to 0 center dot 6 +/- 0 center dot 1 ml g-1 (P < 0 center dot 001). Discussion: A number of important parameters related to cardiac function can be quantified non-invasively and simultaneously with a short scanning protocol during steady state supine bicycling. This might open up new opportunities for studies of the integrated cardiac physiology in health and early asymptomatic disease

Asymptomatic leg and carotid atherosclerosis in smokers is related to degree of ventilatory capacity: longitudinal and cross-sectional results from 'Men born in 1914', Sweden

Although smoking is associated with cardiovascular disease (CVD), many individuals remain healthy after many years of smoking. The population based cohort 'Men born in 1914' was used to investigate whether the occurrence of non-invasively detected atherosclerosis among smokers is associated with lung function [(i.e. height-adjusted forced expiratory volume during 1 s (FEV1.0) and vital capacity (VC)]. Two hundred and seven smokers without history of CVD were examined with spirometry and calf plethysmography at 55 years, and with spirometry, ankle-arm blood pressure recordings and ultrasound examinations of the carotid arteries at 68 years. Eighty-three men had atherosclerosis defined as carotid stenosis >30% or ankle-arm index <0.9. FEV1.0 and VC were both at 55 years (longitudinally) and at 68 years (cross-sectionally) lower among men with atherosclerosis at 68 years (55 years: FEV1.0, 3.2+/-0.6 vs. 3.4+/-0.5 l; P=0.02; VC, 4.2+/-0.5 vs. 4.4+/-0.5 l; P=0.02; 68 years: FEV1.0, 2.6+/-0.6 vs. 2.9+/-0.7 l; P=0.004; VC, 3.8+/-0.6 vs. 4.0+/-0.6; P=0.009, for men with and without atherosclerosis). The longitudinal and cross-sectional associations between FEV1.0, VC and atherosclerosis remained significant after adjustments for several potential confounders (tobacco consumption at 55 and 68 years, hypertension, diabetes, alcohol consumption at 68 years, and pulse wave amplitude as a measure of degree of atherosclerosis at 55 years). We conclude that the risk of developing atherosclerosis is associated with the degree of ventilatory capacity. The results suggest that in smokers, reduced lung function is a marker of susceptibility for atherosclerosis

Increased incidence of myocardial infarction and stroke in hypertensive men with reduced lung function

BACKGROUND AND OBJECTIVE: Although hypertension is associated with increased cardiovascular risk, many individuals remain free from disease. This study is aimed to investigate whether this variation in individual susceptibility is associated with lung function. DESIGN: Population-based prospective cohort study. PARTICIPANTS: 'Men born in 1914', Malmo, Sweden. Subjects (n = 639) were examined and considered free from prevalent cardiovascular disease at age 55 years. MAIN OUTCOME MEASURES: Mortality, fatal and non-fatal stroke and cardiac events (fatal or non-fatal myocardial infarction) during 28-years follow-up. RESULTS: Of the men, 467 had normal blood pressure and 172 (27%) had hypertension (> or = 160/95 mmHg or treatment for hypertension). Hypertensive men with height-adjusted forced expiratory volume during 1 s (FEV1.0) below median had significantly higher rates of stroke (13.4 versus 5.8/1,000 person-years), cardiac events (27.1 versus 12.8/1,000 person-years) and all cause mortality (52.5 versus 28.6/1,000 person-years) than hypertensive men with high FEV1.0. These differences remained statistically significant after adjustment for potential confounders. Men with normal blood pressure and FEV1.0 below median had higher rates of stroke (5.4 versus 4.2/1,000 person-years), cardiac events (13.3 versus 11.6/1,000 person-years) and all cause mortality (29.9 versus 21.2/1,000 person-years) than men with normal blood pressure and high FEV1.0. After adjustments for potential confounders, FEV1.0 was significantly associated with mortality among men with normal blood pressure, whereas the associations with stroke and cardiac events did not reach significance. CONCLUSION: The incidence of cardiovascular disease and death associated with hypertension is increased among men with reduced lung function. The synergistic interaction between hypertension and lung function was independent of smoking and other potential confounders

Primary lung tumour visualised by transthoracic echocardiography

We present images of a rare case where a primary lung tumour was visualised by transthoracic echocardiography. The patient was a 78-year-old male where Chest X-ray had revealed a tumour-suspected structure in the left lung. Both transthoracic echocardiography and combined PET/CT images showed a large tumour located close to the heart. Fine-needle biopsy showed non-small cell lung cancer