Does radiofrequency catheter ablation induce a deterioration in sympathetic innervation? A positron emission tomography study

Detecting changes in serial myocardial perfusion SPECT: a simulation study

BACKGROUND

New algorithms were evaluated for their efficacy in detecting and quantifying serial changes in myocardial perfusion from single photon emission computed tomography (SPECT).

METHODS AND RESULTS

We generated 72 simulations with various left ventricular positions, sizes, count rates, and perfusion defect severities using the nonuniform rational B-splines (NURBs)-based CArdiac Torso (NCAT) phantom. Images were automatically aligned by use of both full linear and rigid transformations and quantified for perfusion by use of the CEqual program. Changes within a given perfusion defect were compared by use of a Student t test before and after registration. Registration approaches were compared by use of receiver operating characteristic analysis. Changes of 5% were not detected well in single patients with or without alignment. Changes of 10% and 15% could be detected with false-positive rates of 15% and 10%, respectively, in single studies if alignment was performed before perfusion analysis. Alignment also reduced the number of studies necessary to demonstrate a significant perfusion change (P < .05) in groups of patients by about half.

CONCLUSION

Comparison of mean uptake by t values in SPECT perfusion defects can be used to detect 10% and greater differences in serial perfusion studies of single patients. Image alignment is necessary to optimize automatic detection of perfusion changes in both single patients and groups of patients.

Effects of Bay Y5959 on Ca2+ currents and intracellular Ca2+ in cells that have survived in the epicardial border of the infarcted canine heart

We determined and compared the effects of the dihydropyridine agonist, Bay Y5959, on the amplitude of L-type Ca2+ currents and intracellular Ca2+ transients in epicardial cells from noninfarcted hearts (NZs) and surviving cells from the epicardial border zone of 5-day infarcted canine hearts (IZs). We determined the effects of Bay Y5959 on the L-type Ca2+ current by using single cells and a whole-cell voltage-clamp approach. To elucidate the effects of Bay Y5959 on the amplitude and time course of the spatially averaged intracellular Ca2+ transient (Ca(i)T), myocytes from the two cell groups were loaded and studied by using the Ca2+-sensitive indicator fura-2/AM. Bay Y5959 increased the amplitude of the L-type Ca2+ current in both cell groups, but peak amplitude in NZs was always greater than that in IZs. Bay Y5959 also increased Ca(i)T amplitude in both NZs and IZs and significantly accelerated the Ca(i)T time course in IZs, particularly at the faster pacing-cycle length. We suggest that the Bay Y5959 effect to restore L-type Ca2+ currents in IZs contributes to its observed antiarrhythmic effects during the reentrant ventricular tachycardias that are known to occur in the epicardial border zone of the infarcted heart.