N-terminal-proB natriuretic peptide in patients with stable coronary artery disease evaluated for ischemia with myocardial perfusion imaging

BACKGROUND: Natriuretic peptides have emerged in the last years as useful diagnostic and prognostic biomarkers in patients with stable CAD. Myocardial ischemia per se might increase NT-proBNP levels. OBJECTIVES: The aim of the present study was to determine whether NT-proBNP levels in patients with stable CAD and preserved left ventricular function are elevated and second, to compare NT-proBNP in patients with verified ischemia on myocardial perfusion imaging (MPI) to non-ischemic subjects with known CAD. METHODS: 117 patients were prospectively included, divided in two groups: group A (26 patients)--with normal MPI and without known CAD and group B (91 patients)--with abnormal MPI or known CAD. Patients from group B were further divided according to the presence of ischemia on MPI in non-ischemic (29 pts) and ischemic (62 pts) subgroup. RESULTS: Levels of NT-proBNP in group B were significantly higher compared to group A (median 53 vs 21 pg/ ml, p = 0.012). End diastolic and end systolic volumes were higher, and ejection fraction after stress and at rest was lower in group B (63% vs 71%, p = 0.0004 and 69% vs 75%, p = 0.008). No significant difference in NT-pro BNP levels (median 48 vs 62 pg/ml, p = 0.5) and functional parameters between the ischemic and nonischemic subjects was found. CONCLUSION: Our data show that patients with stable coronary artery disease and preserved left ventricular function have elevated levels of NT-proBNP. We could not demonstrate that the presence of myocardial ischemia per se was an additional factor leading to increase of the natriuretic propeptide (Tab. 4, Ref. 12)

2-[18F]fluoro-2-deoxy-D-glucose production: correlation between yield and eob activity

2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) production is a routine synthesis process, involving fully automated synthesizer with single-use disposable system - integrated fluidic processor (IFP cassette) and overall synthesis time of 30 minutes. The synthesis of [18F]FDG is a six-step process consisting of two chemical reactions, a nucleophilic 18F- fluorination followed by a base-catalyzed hydrolysis. 18F- is produced by irradiating enriched [18O]-water with protons with GE PETtrace 16.5 MeV cyclotron, at University Institute of Positron Emission Tomography, Skopje. The amount of starting radioactivity depends on the desired radioactivity of final product, so because of that, our objective was to determine whether amount of starting radioactivity affects the radiolabeling efficiency and the capacity of starting materials or the production yield. Forty batches of [18F]FDG were produced with same IFP cassette and the same reagent kit (different batch production but same producer). The mean decay corrected production yield for [18F]FDG produced by starting radioactivity of 18F- from 20-35 GBq, 55-75 GBq and 150-170 GBq were 71,44% ± 5,5%, 70,13% ± 5,5% and 67,11% ± 2.3%, respectively. The results confirm that the starting radioactivity of radioisotope does not affect the production yield and there is no significant difference between the results in these three groups of results, p>0.05 (0.069). [18F]FDG was successfully synthesized with a production yield above 60% in all batches, as result of the high-quality and the large capacity of starting materials for radioactivity to give efficient radiochemical synthesis

Unique PET Facility in Skopje - New Perspective for the Health Care of the Patients in the Balkan Region

Positron emission tomography has become one of the most promising methods in detecting oncological, cardiological, neurological diseases in the last decade and entered slowly in the other fields showing promising results. As is well confirmed, PET has the key advantage of enabling diagnosis of diseases in the early stages, determining the extent of the disease process and its pathological impact, as well as monitoring the effectiveness of chemotherapy and treatment planning