Yasuaki Kawamura

Evaluation of viral myocarditis in children by radionuclide method.

Evaluation of viral myocarditis is essential for the clinician to assess the prognosis. In this study, Tl-201 myocardial scintigraphy and Tc-99m gated cardiac blood pool scan were performed in 16 patients with myocarditis diagnosed by clinical symptoms and laboratory findings and these nuclear medicine techniques were followed up for 5 years.Exercise Tl-201 scintigraphy using a bicycle ergometer was performed in 8 patients by SPECT imaging. There were mild to severe persistent defects found in all cases (100%), but pressure rate products showed normal response. The Tl-201 defect ratio improved gradually, but did not change significantly. In the resting Tl-201 image one of 16 patients showed severe multifocal defects.LVEF increased significantly from 1 year to 5 years after onset, while RVEF measured by gated blood pool scans showed slight increases 3 years to 5 years after diagnosis. It was concluded that myocardial perfusion improved only incompletely. Cardiac function (LVEF and RVEF) improved gradually, and pressure rate products were normal. Myocarditis should therefore be followed up in order to assess the prognosis; moreover, the relationship of myocarditis to dilated cardiomyopathy needs to be further studied.

Effect of hemodialysis on left and right ventricular function - Evaluation using electrocardiogram gated radionuclide ventriculography.

Eighteen outpatients with chronic renal failure undergoing hemodialysis (HD) were studied. Immediately before and after HD, the left and right ventricular function measured by electrocardiogram gated radionuclide ventriculography (RNV). By HD, body weight changed 58.6 +/- 7.50 kg to 57.2 +/- 6.80 kg and BUN level changed 67.9 +/- 29.00 mg/dl to 37.1 +/- 18.96 mg/dl and creatinine level changed 11.3 +/- 3.90 mg/dl to 6.8 +/- 2.48 mg/dl. Before HD, cardiac output was 8.08 +/- 1.50 l/min and cardiac index was 5.00 +/- 0.87 l/(min m2). Left ventricular function improved (LVEF changed 60.4 +/- 6.85% to 64.2 +/- 8.7%, LVEF/LVET changed 0.237 +/- 0.048%/ms to 0.254 +/- 0.021%/ms) between before and after HD, but there was not significant difference. Right ventricular function improved (RVEF changed 41.2 +/- 8.00% to 50.0 +/- 11.96, RVEF/RVET changed 0.167 +/- 0.028%/ms to 0.209 +/- 0.059%/ms) between before and after HD, and there was significant difference (p less than 0.05).

Evaluation of the visualized left atrium by 201Tl myocardial scintigraphy

201Tl myocardial scintigraphy was evaluated in patients with 18 mitral stenosis cases. Left atrium was to be seen in ANT (16.7%), LAO (16.7%), MLAO (16.7%) and L-LAT (11.1%), respectively. Furthermore, 201Tl uptake ratio of left atrium, right ventricle, pulmonary area tended significantly to increase in visible group compared with invisible group. PCW pressure was correlated with left atrial Tl uptake (r = 0.51, p less than 0.005), and it indicated some correlation between left atrial pressure and 201Tl uptake.