Bax, J.

El-Said, G.M.

Elhendy, A.

Ibrahim, M.M.

NieropJeroen, P.R.

Roslandt, J.R.T.C.

Valkema, R.

van Domburg, R.T.

Elsevier - Publisher Connector 

176A ABSTRACTS - Oral .IACC Fehm:lry 19911 
myocardial peduslon trudging agent thal show redistribution phenomenon 
similar to that of TI. 
9:30 
~ Safety and Fesalblllty of Dobutsmlne-Atmplne 
Simms Myo~8~Illl P~rfuzlon Solntlgrsphy, 
Correlation With Perfuslon Abnormalities In 10/'6 
Patients Wltlt Known or Suspected Coronary Artery 
Ol laUe 
A, Elhendy, R, Vnlkem., R,T, van Oomburg, RR, NlomNerosn, J. Bax, 
G,M, EI.eal¢l, M,M, Ibmhlm, J,R,T,C, Roelen~, Themxc~n~r, Ro~r~m, 
The Nefhert~t'~ 
~our¢ / :  Oobulsmlne stress Is=ling la Increasingly used for lhe diagnosis 
end functional evaluation of coronary ertery dlseue, However, the relation 
belween myoaerdlal peduelon abnormalities end compile=lions of the teat 
hal not bean mludled, 
MefhOd~: We studied Ihe hemodynamlo protlle, eatery and feMkbkllty at 
debulemlna (up to 40 .g/kg/mln). atropine (up to 1 rag) alines myocardial 
pedu=lon aelnllgrephy (with 801 TI, 89m t~6"hnotium M$~I or fetrotosml'~ 
SPEOT) In a geneses(lye aeries at '1070, patS=sis (ag~ ~ ~9 4~ It Veers, 60% 
with provtous mycoardlal Infarction) re{erred for ewlluNIon O! myocardial 
I=oheml~. 
Re~t~; No Inf~rollon or death occurred during the lest, The loll was con. 
sldered teeelbie (a~hlovement o 85% oi the target heart rate Or e,n is~hem~e 
endpolnt) In 1005 patients (94%), Hypatenslon (systolic blood pressure drop 
~40 mm Hg) o~uned In 37 patients (3,4%). In~pen~t  p'~dlotors were 
higher b~nlln~ eyt~tollo bleed pressure (p ,~ 0,0001), n~mt~er l Isehemlo 
segment= (p < 0,05) end older age (p -~ 0.05), Supravantd~ular ohyarrttyth. 
mlu occurred in 48 patient= (4,4%), Independenl predlclor~ were higher 
Inl~mtto~ (ttx~:l pedu=en dele¢t~ score (p < 0.005) and older ego (p < 0,05), 
VentrlCuler tachycardl¢l o~urmd In 41 portents (3,8%), Independent prodle- 
tom were higher Infarction scare (p < 0,01) and mate gender (p < 0,05), All 
errhvthmlea lermlnaled spontaneously or after mefoprolol edmlnstrellon, 
Cort~u.t/on: Oobul~mlne-elroplne myocardial peduslon sclnllgrephy Is e 
aMO end feasible method for evalustlon of coronary =dOry disease, Patients 
with morn severe fixed pads=ion eboormalllles ere el e higher risk ol devel- 
oping te¢:hyerrhythmlas during the test. 
9"45 
~ Additive Diagnostic Valuss of Gating and 
Attenuation.Correction to Usual ResVetreas 
PeMualon SPECT In CoronsW Al le W Otnsse? 
D.S. Lee, Y, So, K.M Ktm, K.J. Chun, J,.K, Chung, M,C. Lea. Seoul Nation 
Unlversily,, Seoul, Korea 
l~ckgrouna: Etther gated portu8ton SPECT or attanualion corrected SPECT 
¢8n be used to Improve specificity In the diagnosis of coronary artery dlgease 
(CAD). We questioned If ed01ng either modallty Improved legnogtlc pedor. 
mence of mat.stress peffualon SPECT In paflenta having Intermediate risk In 
clinical tem~a. 
Mel#Kx/s: We parformad rest Tt-2Ollstreas gated attenuation-corrected 
Tc.99m.Mle) SPECT using AOAC vertex camera In 62 patients (M:32, F:30, 
60 ~ 10 y, coronary artery sfanosts >70%, 1 vessel: 12, 2 vegsel: 14, 3 
vaasel: 13. normal: 32). Three nuclear physicians graded the likelihood ol 
CAD using 5 scales (1: normal to 5: diseased) for each artary territory and 
per pallant. Sensitivity and specificity and area under ROC cuwes were 
compared between methods A) attenuation on-corrected SPECT, Et) gated 
SPECT added to A), and C) attenuation corrected SPECT added to e), par 
observer. 
Results: We found no difference in sensitivity (62%, 49%, 46%) and 
specLtlc|ty (87%, 96%, 91%) between three me(beds for each obsewer. 
Areas under ROC cunms (AUC) for diagnosis of CAD as well as for artery 
tern(Dries did not reveal any differences for each sodality (p > 0.05 for each 
comparison). 
AUC A B C 
obsl 0.752 0,689 0.739 
obs2 0.797 0.722 0,750 
obs3 0258 0,713 0,754 
Conclusion: In patients with intermediate risk of CAD, viewing gated 
SPECT and attenuation-corrected SPECT did not improve diagnostic pealer- 
manse. 
Admnerglc Receptors and Cardiac Funotlon 
Tuesday, March 31, 1998, 8:30 a.m.-10:00 a,m. 
Georgia World Congress  Center, Room 255W 
8:30 
~ Admnoql lo  Stimulation the Remodeled Rat In fest  of 
Heart: Dlfferen©es Between Isolated I.kmrt and 
MyO(=yte Fun=Ion 
A,J,C, Prahatlh, R, John, D, LI,, t,S, Anen¢l, VA Mad/eel Cornier, 
Minneapolis, MN, USA 
Vantdoular emodeling is a key event tn the evolution ot ¢ongQslivo hmrt 
leilura lelfowSn9 a m#ailllll tnleltlol~ (MI), Wl  l~ve l~t ly  ~ ttult 
allheugh remodeled heenl are dyslun~llonel el the glol~ll level, oardiomy. 
oWlee laolefad from their remote, non.lnfemted, hypo¢onlmcltle N l~n ls  
show no cenlm¢lile ebnormatllln ~th In the I~sel elate and during inolmpic 
etlmul~lloa with (¢a~'lo, To Investigate the Qffe¢le of #.edm~rgio stimuli. 
lion, we studied Isol~ted heart fgn¢lfon In 6 tMamtod he~ (6 ~ Post.MI) 
and e~.matohed lorelei hearts (n .  6), MI hearts demonetrated,signifi. 
oenlly mdu~d contractile h#netlon (~ mM (Ce~*]o, S,S I~; Lat~lendedl LV 
developed pm.ura 31 Vs 54 mmHg, LVdP/dt 033 Ve 1636 mmh'~s, p .~ 
0,05) and e depressed Frank.Sliding mlstlonahlp (p .~ O,0~, =nova), From a 
similar group of remodeled MI bead~ (n ~ 8) we Isolated royce/tea (n .  37) 
and ~omp~red their ¢Onhe~tile funclton (video edge detection) end [Ce~']i 
klnellcs (Fura.~) with 33 myo~/te= from sham operandi bea~h~ (n = 4), Isopm. 
terenol ©~used e dose.dependent Ir~mase (p < 0,001, ~ted  muaum~ 
anDre) In both oentreottle (myocyto %ehodenlng, velocity of shortening) 
(Ca =* ~ pemmet~ra (Fum.2 Ratto ^ ~t l tu~,  Veto=ty of rise m Fure-2 Ra i l .  
The Increase In Ihese perametem was 81gnilieanlly more In MI t~  in Sham 
myocytea (p < 0.05 enova) 
.. • • 
Cll~i~d~l ~Oal 108 I0,? 3110-? elll~,l 11111~9 3llO,9 11108 
• omo~m~ol (M) ~ (M) 
These data suggest a dissociation in the p.adrenerglc response between 
the Isolated heart and isolated cardiac myocytes in this model. The de.n- 
regulation of this response in the global function cannot be explained by 
altered F-adrererglc response in the myocytes isolated from the remodeled 
myocardtum. 
8:45 
~ Chrenlc Pressure Overload Is Associated With 
Cardlooyte Apoptoale, but Does Not Increase 
Vulne¢abllky to  ~D.Admnargl¢ Medlste¢l Cardlo¢~e 
Apoptosls  
¥. Shizukuda, E,H, Sonnanblick, D.L. GOshen. A.C. Borr...zuk, R.N. Kitslso 
P.M. Bultflck, Albert Einstein College or Medic/re, Bronx, NY, USA 
Background: The transition from left ventricular hypertrophy to heart failure 
may be partially mediated by apoptoti¢ cell loss. To explore this hypothe- 
sis, we asked whether hearts hypertrophied secondary to abdominal aortic 
bending manifest cardiocyte aboptosls (APe) and it they are additionally 
susceptible to damage by tl-adrenergic stimulation. 
Methods: The suprarenal abdominal aorta of rats was partially ligated. 
Altar two weeks, rats were treated with either vehicle (B-C) or Isoproterenol 
(Iso, 400 /= g/kg/hr, B-I by Alzet minlpump) for 24 hrs. Age and weight 
matched rats ware treated either with vehicle (C) or Iso (C-I) for 24 hr~ 
served as controls. 5/=re sections from paraffin embedded hearts at the 
mid-ventricle vel were analyzed by TUNEL method to assess the extent of 
Ape. 
Results: 
C (3-I •-C B-I 
N/B (rag/g) 2.55±0.10 2.86 ± 0.11 3.12+0.09" 4.31 ±0.17 TM 
Ape tPer area) 1.1 ~ 0.5 8.5 ~ 1,5" 7.9 ± 1.5" 7.5, ~ 1.3" 
Ape (per cells) 0.14 i 0.07 1.43 ~ 0,28' 1,08 • 0.23" 1.24 ± 0.28" 
Number of rats 5 5 5' 6 
(Data ~ro moan J_ SEM. H/B; heart: body weight ratio, per area; per em ~. per cells: per 
10,000 cardiocytes. "p ~ 0.05 vs. C; mp ~. 0.05 vs. B-C). 
Conclusion: Both cardiac hypertrophy secondary to abdominal aorta 
banding and/~-adrenergic stimulation induce Apo, no synergistic affect was 
seen when these stimuli were superimposed. 


Safety feasibility dobutamine-atropine stress myocardial perfusion scintigraphy, correlation with perfusion abnormalities in 1076 patients with known or suspected coronary artery disease 

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Safety feasibility dobutamine-atropine stress myocardial perfusion scintigraphy, correlation with perfusion abnormalities in 1076 patients with known or suspected coronary artery disease

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