TY - JOUR
T1 - Hemodynamic determinants of thallium-201 lung uptake in patients during atrial pacing stress
AU - Brown, Kenneth A.
AU - McKay, Raymond
AU - Heller, Gary V.
AU - Royal, Henry D.
AU - Parker, J. Anthony
AU - Silverman, Kenneth J.
AU - Aroesty, Julian
N1 - Funding Information:
From the Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, the Departments of Medicine (Cardiovascular Division) and Radiology (Nuclear Medicine Division), Beth Israel Hospital and Harvard Medical School. Supported in part by grant HL 28939 from the National Heart, Lung, and Blood Institute, and by Research Training Grant HlO7374 from the United States Public Health Service. Dr. Parker is the recipient of a Research Career Development Award from the National Heart, Lung, and Blood Institute, NOS. 5KO4 and HLO0465.
PY - 1986/1
Y1 - 1986/1
N2 - The present investigation was undertaken to define the hemodynamic determinants of lung uptake of thallium-201 (Tl-201) in man during stress. Graded tachycardia was induced by atrial pacing with continuous hemodynamic monitoring in 21 patients (6 normal, 15 with coronary artery disease). At peak pacing, 80 MEq (2.2 mCi) of Tl-201 was injected intravenously and imaging commenced within 5 minutes. Lung activity was expressed as a percentage of peak myocardial activity on the anterior image (Lung Tl-201 Index). The influence of rest, peak and post pacing hemodynamic parameters including cardiac index, pulmonary capillary wedge pressure, left ventricular end-diastolic pressure, pulmonary artery pressure, and heart rate on Lung Tl-201 Index was examined using step-wise multiple regression. Change in cardiac index from rest to peak pacing was negatively correlated, while pulmonary capillary wedge pressure at peak pacing was positively correlated to Lung Tl-201 Index (combined r value of 0.75). No other parameter had a significant correlation. In summary, lung uptake of Tl-201 activity during atrial pacing stress appears to depend on: (1) changes in cardiac output which may determine tissue contact time and thus influence extraction efficiency, and (2) hydrostatic pressure in the pulmonary capillary bed.
AB - The present investigation was undertaken to define the hemodynamic determinants of lung uptake of thallium-201 (Tl-201) in man during stress. Graded tachycardia was induced by atrial pacing with continuous hemodynamic monitoring in 21 patients (6 normal, 15 with coronary artery disease). At peak pacing, 80 MEq (2.2 mCi) of Tl-201 was injected intravenously and imaging commenced within 5 minutes. Lung activity was expressed as a percentage of peak myocardial activity on the anterior image (Lung Tl-201 Index). The influence of rest, peak and post pacing hemodynamic parameters including cardiac index, pulmonary capillary wedge pressure, left ventricular end-diastolic pressure, pulmonary artery pressure, and heart rate on Lung Tl-201 Index was examined using step-wise multiple regression. Change in cardiac index from rest to peak pacing was negatively correlated, while pulmonary capillary wedge pressure at peak pacing was positively correlated to Lung Tl-201 Index (combined r value of 0.75). No other parameter had a significant correlation. In summary, lung uptake of Tl-201 activity during atrial pacing stress appears to depend on: (1) changes in cardiac output which may determine tissue contact time and thus influence extraction efficiency, and (2) hydrostatic pressure in the pulmonary capillary bed.
UR - http://www.scopus.com/inward/record.url?scp=0022622765&partnerID=8YFLogxK
U2 - 10.1016/0002-8703(86)90560-0
DO - 10.1016/0002-8703(86)90560-0
M3 - Article
C2 - 3946135
AN - SCOPUS:0022622765
SN - 0002-8703
VL - 111
SP - 103
EP - 107
JO - American Heart Journal
JF - American Heart Journal
IS - 1
ER -