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Left ventricular function changes during pharmacological and physiological interventions and routine activities monitored in healthy volunteers by a portable radionuclide probe (VEST)
Authors:Luc Mortelmans   Estela Z. Cabrera   Nicole Dorny   John Thoeng   Magda Wauters   Frans van de Werf   Johan VanHaecke   Michel de Roo  Hilaire de Geest
Affiliation:(1) Cardiology, University Hospital, U.Z. Gasthuisberg, Leuven, Belgium;(2) Center of Statistics, Catholic University of Leuven, Leuven, Belgium;(3) Dept. of Nuclear Medicine, U.Z. Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
Abstract:A miniaturized radionuclide cardiac probe incorporated in a semi-rigid plastic chest garment has made ambulatory left ventricular (LV) function evaluation possible, with gated nuclear data being stored on tape together with electrocardiographic data, for subsequent off-line processing.After red blood cell labelling with 555 MBq (15 mCi)99mTc and standard gated blood pool imaging in 45° LAO, we performed a continuous monitoring of LV function in 20 healthy male volunteers (age range: 22–25 years), in resting control conditions as well as during activities (standing, walking, climbing stairs) and after interventions (isosorbide dinitrate intake, Trendelenburg position, inflation of cuffs around the thighs).VEST-monitoring proved to be a reliable method that gave reproducible results: changes of ejection (EF) in basal conditions were lower than 5% in 95% of the patients. Changes in LV function caused by daily activities were easily demonstrated. While standing effected no significant EF changes, walking and climbing increased EF by 6.9% (p<0.05) and 21.2% (p<0.05) respectively.Changes in LV volumes caused by alterations in venous return were also demonstrated. Compared with baseline, Trendelenburg increased end-diastolic volume (EDV) by 2.9% while isosorbide dinitrate and inflation of cuffs decreased it by 5.7% and 2.2% respectively.
Keywords:ejection fraction  interventions  left ventricular function  left ventricular volumes  radionuclide probe
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