Heart failure is a dynamic condition with high morbidity and mortality and its prognosis should be reassessed frequently, particularly in patients for whom critical treatment decisions may depend on the results of pro...Heart failure is a dynamic condition with high morbidity and mortality and its prognosis should be reassessed frequently, particularly in patients for whom critical treatment decisions may depend on the results of prognostication. In patients with heart failure, nuclear cardiology techniques are useful to establish the etiol-ogy and the severity of the disease, while fewer studies have explored the potential capability of nuclear cardi-ology to guide cardiac resynchronization therapy （CRT） and to select patients for implantable cardioverter defbrillators （ICD）. Left ventricular synchrony may be assessed by radionuclide angiography or gated single-photon emission computed tomography myocardial perfusion scintigraphy. These modalities have shown promise as predictors of CRT outcome using phase analysis. Combined assessment of myocardial viability and left ventricular dyssynchrony is feasible using posi-tron emission tomography and could improve conven-tional response prediction criteria for CRT. Preliminary data also exists on integrated positron emission tomog-raphy/computed tomography approach for assessing myocardial viability, identifying the location of biven-tricular pacemaker leads, and obtaining left ventricular functional data, including contractile phase analysis. Fi-nally, cardiac imaging with autonomic radiotracers may be useful in predicting CRT response and for identifying patients at risk for sudden cardiac death, therefore po-tentially offering a way to select patients for both CRT and ICD therapy. Prospective trials where imaging is combined with image-test driven therapy are needed to better defne the role of nuclear cardiology for guiding device therapy in patients with heart failure.展开更多
Background Midgastric transverse band （MTB） was first observed over 100 years ago, after that many researchers worked on the subject postulated its physiologic role and the role in gastrointestinal diseases, but its...Background Midgastric transverse band （MTB） was first observed over 100 years ago, after that many researchers worked on the subject postulated its physiologic role and the role in gastrointestinal diseases, but its function remains unclear. With progress of imaging methods, the nature of MTB is unveiling. In this study we investigated the effect of MTB on the gastric empting delay in functional dyspepsia （FD） and explored the mechanism. Methods A total of 60 patients with FD and 65 age- and sex-matched healthy people who served as controls were studied. With ^99mTc-DTPA labeled semi-solid fat-parched flour served as test meal, gastric empting was examined in all subjects by using single photon emission computed tomography. Test meal was designated as general （60 g fat-parched flour） or large （80 g fat-parched flour） meal. Stomach was divided into proximal and distal parts by MTB. Half gastric empting time, areas of different gastric parts, intragastric food distribution and MTB width were tested with in given times. Results Patients with FD showed a delayed gastric empting and increased intragastric residue. Global and regional gastric erupting velocity was decreased. The areas of distal stomach and MTB were significantly greater in the FD patients than in the controls. Throughout the whole test period a distal stomach-dominated food distribution was shown. Those who took a large meal had longer half gastric empting time and greater MTB area than those who took a general meal. Conclusions Gastric empting delay is related to enlarged MTB area. Some dyspeptic symptoms may be induced by abnormal distribution and increased retention of food in distal stomach. MTB, being like atriaventricular valve that controls blood flow in heart, regulates transport, distribution, and empting of food in the stomach.展开更多
文摘Heart failure is a dynamic condition with high morbidity and mortality and its prognosis should be reassessed frequently, particularly in patients for whom critical treatment decisions may depend on the results of prognostication. In patients with heart failure, nuclear cardiology techniques are useful to establish the etiol-ogy and the severity of the disease, while fewer studies have explored the potential capability of nuclear cardi-ology to guide cardiac resynchronization therapy （CRT） and to select patients for implantable cardioverter defbrillators （ICD）. Left ventricular synchrony may be assessed by radionuclide angiography or gated single-photon emission computed tomography myocardial perfusion scintigraphy. These modalities have shown promise as predictors of CRT outcome using phase analysis. Combined assessment of myocardial viability and left ventricular dyssynchrony is feasible using posi-tron emission tomography and could improve conven-tional response prediction criteria for CRT. Preliminary data also exists on integrated positron emission tomog-raphy/computed tomography approach for assessing myocardial viability, identifying the location of biven-tricular pacemaker leads, and obtaining left ventricular functional data, including contractile phase analysis. Fi-nally, cardiac imaging with autonomic radiotracers may be useful in predicting CRT response and for identifying patients at risk for sudden cardiac death, therefore po-tentially offering a way to select patients for both CRT and ICD therapy. Prospective trials where imaging is combined with image-test driven therapy are needed to better defne the role of nuclear cardiology for guiding device therapy in patients with heart failure.
文摘Background Midgastric transverse band （MTB） was first observed over 100 years ago, after that many researchers worked on the subject postulated its physiologic role and the role in gastrointestinal diseases, but its function remains unclear. With progress of imaging methods, the nature of MTB is unveiling. In this study we investigated the effect of MTB on the gastric empting delay in functional dyspepsia （FD） and explored the mechanism. Methods A total of 60 patients with FD and 65 age- and sex-matched healthy people who served as controls were studied. With ^99mTc-DTPA labeled semi-solid fat-parched flour served as test meal, gastric empting was examined in all subjects by using single photon emission computed tomography. Test meal was designated as general （60 g fat-parched flour） or large （80 g fat-parched flour） meal. Stomach was divided into proximal and distal parts by MTB. Half gastric empting time, areas of different gastric parts, intragastric food distribution and MTB width were tested with in given times. Results Patients with FD showed a delayed gastric empting and increased intragastric residue. Global and regional gastric erupting velocity was decreased. The areas of distal stomach and MTB were significantly greater in the FD patients than in the controls. Throughout the whole test period a distal stomach-dominated food distribution was shown. Those who took a large meal had longer half gastric empting time and greater MTB area than those who took a general meal. Conclusions Gastric empting delay is related to enlarged MTB area. Some dyspeptic symptoms may be induced by abnormal distribution and increased retention of food in distal stomach. MTB, being like atriaventricular valve that controls blood flow in heart, regulates transport, distribution, and empting of food in the stomach.
