Abstract Background: Gamma cameras with cadmium-zinc telluride (CZT) detectors allowed the quantification of myocardial flow reserve (MBF), which can increase the accuracy of myocardial perfusion scintigraphy (MPS) to detect the cause of chest discomfort. Objective: To assess the clinical impact of MBF to detect the cause of chest discomfort. Methods: 171 patients with chest discomfort who underwent coronary angiography or coronary CT angiography also underwent MPS and MBF in a time interval of <30 days. The acquisitions of dynamic imaging of rest and stress were initiated simultaneously with the 99mTc injection sestamibi (10 and 30mCi, respectively), both lasting eleven minutes, followed by immediately acquiring perfusion images for 5 minutes. The stress was performed with dipyridamole. A global or per coronary territory MBF <2.0 was classified as abnormal. Results: The average age was 65.9±10 years (60% female). The anatomical evaluation showed that 115 (67.3%) patients had coronary obstruction significant, with 69 having abnormal MPs and 91 having abnormal MBF (60.0% vs 79.1%, p<0.01). Among patients without obstruction (56 – 32.7%), 7 had abnormal MPS, and 23 had reduced global MBF. Performing MBF identified the etiology of the chest discomfort in 114 patients while MPS identified it in 76 (66.7% vs 44.4%, p<0.001). Conclusion: MBF is a quantifiable physiological measure that increases the clinical impact of MPS in detecting the cause of chest discomfort through greater accuracy for detecting obstructive CAD, and it also makes it possible to identify the presence of the microvascular disease. Background cadmiumzinc cadmium zinc CZT (CZT MBF, , (MBF) (MPS Objective Methods 17 30 <3 days mTc 10 (1 30mCi mCi respectively, respectively respectively) minutes dipyridamole 20 2 0 <2. Results 65910 65 9 65.9±1 60% 60 (60 female. female . female) 11 67.3% 673 67 3 (67.3% significant 6 60.0% 600 (60.0 791 79 1 79.1% p<0.01. p001 p p<0.01 01 p<0.01) 56 (5 32.7%, 327 32.7% 32 32.7%) 66.7% 667 66 (66.7 444 44 4 44.4% p<0.001. p0001 p<0.001 001 p<0.001) Conclusion CAD disease (MBF < ( <2 6591 65.9± (6 67.3 (67.3 60.0 (60. 79.1 p00 p<0.0 32.7 66.7 (66. 44.4 p000 p<0.00 00 659 65.9 67. (67. 60. 79. p0 p<0. 32. 66. (66 44. 65. (67 p<0 p<

Resumo Fundamento: Gama-câmaras com detectores de telureto-cádmio-zinco (CZT) permitiram a quantificação da reserva de fluxo miocárdico (RFM), podendo aumentar a acurácia da cintilografia miocárdica de perfusão (CMP) para detectar a causa do desconforto torácico. Objetivo: Avaliar o impacto clínico da RFM para detectar a causa do desconforto torácico. Métodos: 171 pacientes com desconforto torácico que foram submetidos a coronariografia ou angiotomografia de coronárias também realizaram CMP e RFM num intervalo de tempo <30 dias. As aquisições das imagens dinâmicas de repouso e estresse foram iniciadas simultaneamente à injeção de 99mTc sestamibi (10 e 30mCi, respectivamente), ambas com duração de onze minutos, seguidas imediatamente pela aquisição das imagens de perfusão durante 5 minutos. O estresse foi realizado com dipiridamol. Uma RFM global ou por território coronariano <2,0 foi classificada como anormal. Resultados: A idade média foi de 65,9±10 anos (60% do sexo feminino). A avaliação anatômica mostrou que 115 (67,3%) pacientes apresentavam obstrução coronariana significativa, sendo que, 69 apresentavam CMP anormal e 91 apresentavam RFM anormal (60,0% vs. 79,1%, p<0,01). Dentre os pacientes sem obstrução (56 – 32,7%), 7 tinham CMP anormais e 23 tinham RFM global reduzida. A realização da RFM identificou a etiologia do desconforto torácico em 114 pacientes enquanto a CMP identificou em 76 (66,7% vs. 44,4%, p<0,001). Conclusão: A RFM é uma medida fisiológica quantificável que aumenta o impacto clínico da CMP na detecção da causa do desconforto torácico através de uma maior acurácia para detecção de DAC obstrutiva e ainda possibilita identificar a presença de doença microvascular. Fundamento Gamacâmaras Gama câmaras teluretocádmiozinco telureto cádmio zinco CZT (CZT RFM, , (RFM) (CMP Objetivo Métodos 17 30 <3 dias mTc 10 (1 30mCi mCi respectivamente, respectivamente respectivamente) minutos dipiridamol 20 2 0 <2, Resultados 65910 65 9 65,9±1 60% 60 (60 feminino. feminino . feminino) 11 67,3% 673 67 3 (67,3% significativa 6 60,0% 600 (60,0 vs 791 79 1 79,1% p<0,01. p001 p p<0,01 01 p<0,01) 56 (5 32,7%, 327 32,7% 32 32,7%) reduzida 66,7% 667 66 (66,7 444 44 4 44,4% p<0,001. p0001 p<0,001 001 p<0,001) Conclusão microvascular (RFM < ( <2 6591 65,9± (6 67,3 (67,3 60,0 (60, 79,1 p00 p<0,0 32,7 66,7 (66, 44,4 p000 p<0,00 00 659 65,9 67, (67, 60, 79, p0 p<0, 32, 66, (66 44, 65, (67 p<0 p<

ABSTRACT Objective This study aimed to evaluate the occurrence and clinical predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM. Subjects and methods The study included 45 women with type 1 diabetes mellitus (DM) (aged 36 ± 9 years) who underwent carotid Doppler ultrasound evaluation to determine the carotid artery intima-media thickness (CIMT) and to assess the occurrence of carotid artery plaques. Insulin sensitivity was assessed by estimated glucose disposal rate (eGDR), and metabolic syndrome (MS) was defined by the World Health Organization criteria. Results The cohort had a mean age of 36 ± 9 years, diabetes duration of 18.1 ± 9.5 years, and body mass index (BMI) of 24.6 ± 2.4 kg/m2. MS was present in 44.4% of the participants. The CIMT was 0.25 ± 0.28 mm, and the prevalence of carotid artery plaques was 13%. CIMT correlated positively with hypertension (p = 0.04) and waist-to-hip ratio (r = 0.37, p = 0.012). The presence of carotid artery plaques correlated positively with age (p = 0.018) and hypertension (p = 0.017). eGDR correlated negatively with CIMT (r = -0.39, p = 0.009) and carotid plaques (p = 0.04). Albuminuria showed a correlation trend with CIMT (p = 0.06). Patients with carotid artery plaques were older, had a higher prevalence of hypertension, and lower eGDR. No correlation was found between CIMT and carotid plaques with diabetes duration, MS, BMI, cholesterol profile, glycated hemoglobin, high-sensitivity C-reactive protein, or fibrinogen. Conclusion Insulin resistance, central obesity, hypertension, and older age were predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM.

Four untrained standardbred horses performed a standardized exercise test on the treadmill and an automated blood collection system programmed to obtain blood samples every 15 s was used for blood collection in order to evaluate the kinetics of adrenaline and noradrenaline. The highest average values obtained for adrenaline and noradrenaline were 15.0 ± 3.0 and 15.8 ± 2.8 nmol/l respectively, with exponential accumulation of adrenaline (r = 0.977) and noradrenaline (r = 0.976) during the test. Analysis of the correlation between noradrenaline and adrenaline for each phase of the test shows that correlation coefficient decreases as the intensity of exercise increases (from r = 0.909 to r = 0.788). This suggests that during submaximal exercise, the process for release, distribution and clearance of adrenaline into blood circulation differs from that of noradrenaline.

Nel presente lavoro quattro cavalli trottatori non allenati hanno effettuato un test di esercizio standardizzato sul treadmill, durante il quale sono stati eseguiti prelievi di sangue ogni 15 secondi mediante un sistema automatizzato. Lo scopo è stato valutare la cinetica di adrenalina e noradrenalina. I valori massimali di adrenalina e noradrenalina sono risultati essere rispettivamente 15,0 ± 3.0 e 15,8 ± 2,8 nmol/l con un accumulo plasmatico di tipo esponenziale per l'adrenalina (r = 0,977) e la noradrenalina (r = 0,976). L'analisi della correlazione fra adrenalina e noradrenalina mostra come il coefficiente di correlazione diminuisce con l'aumentare dell'intensità dell'esercizio (da r = 0,909 a r = 0,788) e questo suggerisce ci sia una differenza nel processo di rilascio, distribuzione e clearance fra adrenalina e noradrenalina nei cavalli durante l'esercizio fisico submassimale.