• The Korean Journal of Nuclear Medicine
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• v.32 no.1
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• pp.1-9
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• 1998

Gated myocardial SPECT and attenuation correction gave birth to new insights into the pathophysiology of ischemic myocardial perfusion and function in clinical routine practice. Gated myocardial Tc-99m-compound SPECT improved diagnostic accuracy of coronary artery disease and enabled us to observe motion and thickening of myocardial walls as well as myocardial perfusion at the same time. Quantitative and qualitative assessment of myocardial performance and perfusion let us to understand the myocardial physiology in ischemia and infarction. In every patient who underwent gated perfusion SPECT, we will find ejection fraction, left ventricular volumes and regional wall motion. There are hopes to use gated TI-201 SPECT for the same purpose and to use gated SPECT for evaluation of wall motion and thickening at stress or immediate post-stress. Attenuation correction could improve diagnostic accuracy mainly by increasing normalcy ratio or performance of non-expert physicians. Both gated methods and attenuation correction improved specificity of non-expert physicians in diagnosing patients with moderate pretest likelihood. New imaging techniques will fill the desire of cardiologists to examine function and perfusion, and possibly metabolism in their clinical routine practice.

• The Korean Journal of Nuclear Medicine
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• v.39 no.2
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• pp.75-81
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• 2005

Myocardial perfusion and function can be quantified using SPECT and PET. There was controversy over the usefulness of the correction techniques for physical artifacts, such as photon attenuation and scatter, in the quantification of myocardial perfusion using SPECT. However, the cumulated results of many investigations have leaded the consensus on the usefulness of the correction procedures to improve the accuracy and specificity of the myocardial SPECT in the assessment of coronary artery diseases. Although the clinical value of the myocardial perfusion PET has not been preyed yet, the absolute myocardial blood flow and perfusion reserve values quantified using myocardial PET are employed in many basic investigations. In this paper, the methods for the quantitative myocardial SPECT and PET will be reviewed.

• Journal of Trauma and Injury
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• v.34 no.2
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• pp.119-125
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• 2021

Purpose: The present study aimed to analyze the effect of trauma-related shock on myocardial function in the early stages of trauma through transthoracic echocardiography (TTE) findings. Methods: We performed a retrospective review and analysis of the medical records of patients aged ≥18 years who were evaluated by TTE within 2 days of admission for trauma-related shock (n=72). Patients were selected from a group of 739 patients admitted with trauma-related shock between January 2014 and December 2016. Results: The incidence rate of myocardial dysfunction in the left ventricle (LV) was 6.8% (5/72), with rates of 7.7% (4/52) in the thoracic injury group and 5.0% (1/20) in the non-thoracic injury group. In the diastolic function of LV, relaxation abnormality was present in 55.8% (29/52) of patients in the thoracic injury group and 50% (10/20) of patients in the non-thoracic injury group. Conclusions: This study may suggest that traumatic shock without thoracic injury may influence myocardial function in the early stages after trauma. Therefore, evaluation of myocardial function may be needed for patients experiencing shock after trauma, regardless of the presence of thoracic injury.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.999-1005
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• 2016

The purpose of this study was to investigate the effects of low-intensity cardiac rehabilitation exercise on the cardiac function and the degree of fibrosis in an older white rat model. This study used male Sprague-Dawley white rats that were 50 weeks old. After the acute myocardial infarction induction, Twenty of the rats were randomly allocated into an experimental group and a control group, and each of the groups consisted of 8 rats. In the experimental group, the exercise was conducted for six weeks, 30 minutes a day, five days a week, using a Rotarod treadmill for animals. The degree of myocardial fibrosis was significantly repressed in the experimental group($13.69{\pm}1.90%$) and in the control group($15.67{\pm}1.54%$)(p<0.05). However, fractional shortening and ejection fraction did not show a significant difference. The results of this study suggest that cardiac rehabilitation with low intensity treadmill exercise repress the myocardial fibrosis.

• The Korean Journal of Nuclear Medicine
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• v.37 no.4
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• pp.207-218
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• 2003

Myocardial perfusion imaging has been increasingly used to provide prognostic data and guidance on the choice of appropriate management of patients with known or suspected coronary artery disease. The electrocardiogram gated myocardial SPECT program is corning into wide use with an advent of $^{99m}Tc-labeled$ tracers and an improvement of SPECT machines. The gated technique permits measurement of important cardiac prognostic indicators without any further discomforts or radiation burden in patients underwent standard myocardial perfusion SPECT. In addition, gated study significantly improves diagnostic yield by reducing the number of borderline interpretations and could find myocardial stunning and viable myocardium. Gated single photon emission computed tomography (SPECT) imaging allows the automated calculation of end-diastolic volume, end-systolic volume, ejection fraction, myocardial mass and the assessment of regional wall motion and thickening, and it have dramatically improved assessment of coronary artery disease in routine nuclear practice. This allows the simultaneous assessment of both perfusion and function within the same acquisition, and serves as a cost-effective technique for providing more diagnostic data with fewer diagnostic tests. Because the diagnostic and prognostic power derived from knowledge of left ventricular function can be added to that provided by assessing myocardial perfusion, gated SPECT imaging has rapidly gained widespread acceptance and is now used on a routine clinical basis in a growing number of laboratories, including South Korea. The gated SPECT technique for measurement of left ventricular parameters has been validated against a variety of well established techniques. In this work, overview of gated myocardial perfusion SPECT focus on functional parameters is presented.

• Korean Journal of Adult Nursing
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• v.21 no.2
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• pp.212-224
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• 2009

Purpose: The purpose of this study was to examine the effects of the cardiac rehabilitation program(Phase III) on cardiovascular and cardiorespiratory function in the elderly (age, ${\geq}$ 60) who experienced acute myocardial infarction. Methods: The design of research was nonequivalent control group pretest-posttest design. Subjects were 10 people in the experimental group and 10 in the control group. The intervention program was the cardiac rehabilitation program(Phase III), and was performed for 50 ~ 60 minutes, twice a week for 8 weeks. The dependent variables were the cardiovascular and cardiorespiratory function. Results: Significant differences were shown in RHR, RSBP, SRPP, SBS, BMI, PT of the experimental group after the intervention. As for the differences in the amount of changes, there were differences among groups in RHR, RSBP, SRPP, SBS, PMET, and PT of the experimental group. Conclusion: The cardiac rehabilitation program(Phase III) may be effective in improving cardiovascular function and enhancing cardiorespiratory function in elderly patients with acute myocardial infarction.

• Journal of Biomedical Engineering Research
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• v.16 no.2
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• pp.223-230
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• 1995

This study investigates a combined mathematical model for the quantitative estimation of regional myocardial blood flow in experimental canine coronary artery occlusion and in patients with ischemic myocardial diseases using Rb-82 dynamic myocardial positron emission tomography. The coronary thrombosis was induced using the new catheter technique by narrowing the lumen of coronary vessel gradually, which finally led to partial obstruction of coronary artery. Thirty four Rb-82 dynamic myocardial PET scans were performed sequentially for each experiment using our 5, 10 and 20 second acquisition protocol, respectively, and six to seven regions of interest were drawn on each transaxial slices, one on left ventricular chamber for input function and the others on normal and decreased perfusion myocardial segments for the flow estimation in those regions. Two compartment model and graphical analysis method have been applied to the measured sets of regional PET data, and the rate constants of influx to myocardial tissue were calculated for regional myocardial flow estimates with the two parameter fits of raw data by the Levenberg-Marquardt method. The results showed that, (I) two compartment model suggested by Kety-Schmidt, with proper modification of the measured data and volume of distribution, could be used for the simple estimation of regional myocardial blood flow, (2) the calculated regional myocardial blood flow estimates were dependent on the selection of input function, which reflected partial volume effect and left ventricular wall motion in previously used graphical analysis, and (3) mathematically fitted input and tissue time activity curves were more suitable than the direct application of the measured data in terms of convergence.

• Investigative Magnetic Resonance Imaging
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• v.11 no.1
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• pp.1-9
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• 2007

The obstacles for cardiac imaging are motion artifacts due to cardiac motion, respiration, and blood flow, and low signal due to small tissue volume of heart. To overcome these obstacles, fast imaging technique with ECG gating is utilized. Cardiac exam using MRI comprises of morphology, ventricular function, myocardial perfusion, metabolism, and coronary artery morphology. During cardiac morphology evaluation, double and triple inversion recovery techniques are used to depict myocardial fluidity and soft tissue structure such as fat tissue, respectively. By checking the first-pass enhancement of myocardium using contrast-enhanced fast gradient echo technique, myocardial blood flow can be evaluated. In addition, delayed imaging in 10 - 15 minutes can inform myocardial destruction such as chronic myocardial infarction. Ventricular function including regional and global wall motion can be checked by fast gradient echo cine imaging in quantitative way. MRI is acknowledged to be practical for integrated cardiac evaluation technique except coronary angiography. Especially delay imaging is the greatest merit of MRI in myocardial viability evaluation.

• Journal of Cardiovascular Imaging
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• v.31 no.4
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• pp.191-199
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• 2023

BACKGROUND: Assessment of left ventricular (LV) function plays a pivotal role in the management of patients with valvular heart disease, including those caused by rheumatic heart disease. Noninvasive LV pressure-strain loop analysis is emerging as a new echocardiographic method to evaluate global LV systolic function, integrating longitudinal strain by speckle-tracking analysis and noninvasively measured blood pressure to estimate myocardial work. The aim of this study was to characterize global LV myocardial work efficiency in patients with severe rheumatic mitral stenosis (MS) with preserved ejection fraction (EF). METHODS: We retrospectively included adult patients with severe rheumatic MS with preserved EF (> 50%) and sinus rhythm. Healthy individuals without structural heart disease were included as a control group. Global LV myocardial work efficiency was estimated with a proprietary algorithm from speckle-tracking strain analyses, as well as noninvasive blood pressure measurements. RESULTS: A total of 45 individuals with isolated severe rheumatic MS with sinus rhythm and 45 healthy individuals were included. In healthy individuals without structural heart disease, the mean global LV myocardial work efficiency was 96% (standard deviation [SD], 2), Compared with healthy individuals, median global LV myocardial work efficiency was significantly worse in MS patients (89%; SD, 4; p < 0.001) although the LVEF was similar. CONCLUSIONS: Individuals with isolated severe rheumatic MS and preserved EF, had global LV myocardial work efficiencies lower than normal controls.

• Korean Journal of Radiology
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• v.20 no.5
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• pp.709-718
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• 2019

Objective: To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). Materials and Methods: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. Results: The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = -0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = -0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001). Conclusion: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.