Shuji Nanjo

Comparative analysis of the therapeutic effects of long-acting and short-acting loop diuretics in the treatment of chronic heart failure using 123I-metaiodobenzylguanidine scintigraphy

Loop diuretics are essential for the treatment of chronic heart failure (CHF) but short‐acting diuretics are reported to induce sympathetic nervous system (SNS) activation. This study was performed to compare therapeutic effects of two loop diuretics, long‐acting azosemide and short‐acting furosemide, using 123I‐metaiodobenzylguanidine (123I‐MIBG) scintigraphy.

Scintigraphic studies on the etiology of Ampulla Cardiomyopathy

BACKGROUND Although there are many reports on Ampulla Cardiomyopathy, its etiologic mechanisms are not well known. AIM Etiology of Ampulla Cardiomyopathy was investigated by myocardial scintigraphy with various nuclear tracers. SUBJECTS AND METHODS In nine patients with Ampulla Cardiomyopathy, myocardial scintigraphy was performed at acute, subacute and chronic phases. Total defect score (TDS) of tallium-201 (Tl) or technetrium-99m sestamibi (MIBI) myocardial perfusion and iodine-123-beta-methyl-p-iodophenyl penta-decanoic acid (BMIPP) scintigraphies was calculated. Cardio-mediastinal ratio (H/M) and washout rate (WR) of early and delayed images of iodine-123-meta-iodobenzylguanidine (MIBG) scintigraphy were also calculated. The patients in whom TDS of myocardial perfusion scintigraphy at acute phase was 0, were classified into group N (n = 5) and those with TDS > or = 1 into group D (n = 4). RESULTS TDS of BMIPP at acute, subacute and chronic phases was higher in D than in N; 28.8 +/- 10.3 vs. 7.2 4.7 (p = 0.0039), 15.5 +/- 2.1 vs. 1.0 +/- 0.8 (p < 0.0001) and 2.7 +/- 1.2 vs. 0 (p = 0.05), respectively. WR of MIBG at acute phase was also higher in D (50.3 +/- 5.7% vs. 36.6 +/- 10.5%, p = 0.05). H/M (dH/M) on the delayed images and WR at chronic phase were not different between the two groups. H/M (eH/M) on the early images was lower in D. Blood noradrenaLine (ng/ml) at acute phase was higher in D than in N (1.21 +/- 0.55 vs. 0.45 +/- 0.33, p < 0.05). Left ventricular ejection fraction (LVEF) was decreased in both at acute phase but it was lower in D than in N (48.1 +/- 3.7% vs. 69.9 +/- 9.7%, p < 0.05) at subacute phase. CONCLUSION These findings suggest that the etiology of Ampulla Cardiomyopathy is neurologically stunned myocardium induced by coronary microcirculatory disorder. Due to the significant amount of time that was necessary for normalization of wall motion in the D group, myocardial scintigraphy is believed to be also useful in assessment of severity.

Efficacy of contrast-enhanced MR imaging in cardiomyopathy: an experimental study using Bio14.6 hamsters.

RATIONALE AND OBJECTIVES Myocardial fibrosis was evaluated with magnetic resonance (MR) imaging in Bio14.6 hamsters. MATERIALS AND METHODS Gated gradient-echo T1-weighted images and spin-echo images with gadopentetate dimeglumine enhancement (0.2 mmol/kg) were obtained. RESULTS Myocardial enhancement persisted for 13 minutes after administration of gadopentetate dimeglumine, and myocardial signal intensity peaked at 13 minutes on gradient-echo T1-weighted images. The enhanced areas were greater in Bio14.6 hamsters at 25-42 weeks than at 10 weeks. Pathologic data revealed enhancement with inflammation at 10 weeks and fibrosis with vessel proliferation at 25-42 weeks. Pathologic fibrotic change was greater at 32-42 weeks than at 10 weeks. The myocardium of 42-week-old Bio14.6 hamsters showed remarkable contrast enhancement, which continued for 13 minutes. There was no correlation between gadolinium enhancement and pathologic findings in the evaluation of myocardial degeneration and fibrosis. CONCLUSION Gadolinium-enhanced MR imaging was useful for estimating myocardial fibrotic changes with vessel proliferation and myocardial damage.

Primary idiopathic chylopericardium: Report of two cases

Primary chylopericardium is an extremely rare disease. This report presents two cases of this disease, in a 47-year-old man and 21-year-old woman. Both cases were given diagnosis of primary chylopericardium by chylous pericardial fluid examination and lymphangio-scintigraphy which demonstrated abnormal communication between the left thoracic duct and the pericardial cavity.