• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.52-61
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• 1994

Background : The demand for refinement in noninvasive and quantitative assessment of left ventricular (LV) function is increasing. Purpose : To assess normal values of left ventricular functional parameters during both systole and diastole by scintigraphic method using computerized triple-head gamma camera and to evaluate correlations between these parameters. Methods : ECG gated blood pool scan with $^{99m}Tc$-Human serum albumin was performed in 94 normal Korean subjects. Ejection fraction (EF), systolic parameters [peak emptying rate (PER), average emptying rate (AER), time to peak emptying rate (TPER)], and diastolic parameters [peak filling rate (PFR), average filling rate (AFR), time to peak filling rate (TPFR)] were obtained by analysis of LV time-activity curve, the correlation of these parameters to the age and sex, and the correlation between these parameters were evaluated. Results : 1) Mean value of ejection fraction in study subjects was $59.6{\pm}5.25%$ and showed no significant correlation to age (r=-0.08) and sex but showed most pronounced correlation to PFR (r=0.46, p<0.001), PER (r=0.41, p<0.001), AFR (r=0.34, p<0.001) and AER (r=0.28, p<0.01). 2) Mean values of systolic parameters were as follows: $PER=3.22{\pm}0.50$ end-diastolic volume/sec, $AER=2.22{\pm}0.45$ end-diastolic volume/sec, $TPER=103.5{\pm}29.30$ msec. They showed no significant correlation to age and sex. 3) Mean values of diastolic parameters were as follows: $PFR=2.71{\pm}0.51$ end-diastolic volume/sec, $AFR=1.83{\pm}0.44$ end-diastolic volume/sec, $TPFR=132.1{\pm}33.45$ msec. They showed strong correlation to age (r=0.70, -0.64, 0.37, p<0.001). Conclusions : Left ventricular functional parameters in normal Korean subjects were obtained reliably by computerized scintigraphic method and may be applied to the evaluation of cardiac function in diseased patients.

• 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.

• Journal of Cardiovascular Imaging
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• v.30 no.3
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• pp.202-211
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• 2022

BACKGROUND: This study aims to investigate normal changes throughout aging of the heart in cardiac magnetic resonance (CMR) imaging in healthy volunteers. While type 2 diabetes mellitus is a frequent finding in the elderly population, also the influence of this circumstance in otherwise healthy persons is part of our study. METHODS: In this prospective single-center trial, 75 healthy subjects in distinct age groups and 10 otherwise healthy diabetics were enrolled. All subjects underwent functional, flow sensitive, native T2- and T1-mapping in a 1.5T CMR scanner. RESULTS: No differences in right and left ventricular ejection fractions were observed between aging healthy groups. Bi-ventricular volumes lowered significantly (p<0.001) between the age groups. There was also a significant decrease in myocardial T1 values, aortic distensibility, and left ventricular peak diastolic strain rates. There were no differences in T2 mapping and the other deformation parameters. Patients with type 2 diabetes mellitus had lower end-diastolic volume indexes; all the other measurements were comparable. CONCLUSIONS: Aging processes in the healthy heart involve a decrease in ventricular volumes, with ejection fractions remaining normal. Stiffening of the myocardium and aorta and a decrease in T1 values are potential indications of age-related remodeling. Type 2 diabetes mellitus seems to have no major influence on aging processes of the heart.

• YAKHAK HOEJI
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• v.41 no.6
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• pp.829-836
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• 1997

Studies on the effect of quinones on cardiac function has been conducted with normal hearts. But not with injured hearts, I.e. ischemia/reperfusion-injured heart. Quinone compounds are known to produce oxygen free radicals during metabolism, and for this reason, quinones are implicated in the aggravation of ischemia/reperfusion injury or cardioprotection, as in the case of ischemic preconditioning depending on the experimental conditions. The present study was carried out to examine the effect of 2-chloro-3-(4-cyanophenylamino)-1.4-naphthoquinone (NQ-Y15) on cardiac function of ischemic/reperfused and normal rat hearts. In isolated perfused hearts, various functional parameters such as left ventricular developed pressure (LVDP), left ventricular end-diastolic pressure (EDP) and maximum positive and negative dP/dt ($[\pm}dP/dt_{max}$), time to contracture, heart rate (HR) and coronary flow rate (CFR) were measured before and 30 min after dosing and following 25 min ischemia/30min reperfusion. NQ-Y15 increased LVDP, +dP/$d_{max}$and -dP/$dt_{min}$ by 18%. 30%, and 40%, respectively. There were no significant changes in other haemodynamic parameters. After ischemia/reperfusion injury, pretreatment with NQ-Y15 induced a significant decrease in LVDP and $[\pm}dP/dt_{max}$, but an increase in EDP. LDH-release was not significantly increased. These results suggested that NQ-Y15 may augment the ventricular contractility but it makes hearts more vulnerable to ischemia/reperfusion injury.

• The Korean Journal of Nuclear Medicine
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• v.20 no.2
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• pp.39-45
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• 1986

Resting gated blood pool scan was used to derive left ventricular functional changes in normals (N=13, mean age=43) and in patients with coronary artery disease (N=50, mean age=53). Peak filling rates, average filling rates, and ejection fractions were significantly depressed in coronary artery disease. (p<0.0005, each other). And in coronary artery disease with normal ejection fraction (N=21), peak filling rates and average filling rates were depressed also, and peak filling rates of coronary artery disease with normal ejection fraction were abnormal in 61.2% and average fillin rates were abnormal in 71.4%. It appears that (1) resting peak filling rates and average filling rates were sensitive and easily obtainable parameters of the diastolic dysfunction assosiated with coronary artery disease, (2) a significant proportion of coronary artery disease patients without any evidence of abnormal systolic function have depressed resting peak filling rates and average filling rates of the left ventricle.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.339-345
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• 2009

Purpose : This study aimed to determine the variation in parameters according to cardiac cycle length (CL; time interval between the QRS peaks on ECG) in children by using the conventional pulsed Doppler and tissue Doppler imaging echocardiography. Methods : Eighteen children with an anatomically normal heart were enrolled for the study. All children were examined by conventional and pulsed Doppler echocardiography at Gangneung Asan hospital between July 2006 and June 2007. We measured the CLs, mitral inflow velocities (E,A) and tissue Doppler imaging (TDI) parameters (s', e', a') from apical 4-chamber view. The TDI parameters were measured at the lateral (Lat) and septal (Sep) part of the mitral valve. All parameters were measured at 6 to 18 consecutive beats from each child. We then evaluated the linear correlation between CL and each parameter. Results : The mean age was $3.6{\pm}0.5$ years (M:F=8:10). There were significantly negative linear correlations between CL and A, Lat s', Lat a', Sep s', Sep e', Sep a' (P<0.01). There were significantly positive linear correlations between CL and E/A, Lat e'/a', Sep e'/a' (P<0.01). However, the E and Lat e' were not correlated with CL (P=0.229 and 0.221, respectively). Conclusion : This study showed that the values of the left ventricular functional parameters were changed according to CL. From our results, it is imperative to carefully examine beat-to-beat variations in children.

• Clinical and Experimental Pediatrics
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• v.59 no.4
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• pp.190-195
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• 2016

Purpose: Severe aplastic anemia (SAA), a fatal disease, requires multiple transfusion, immunosuppressive therapy, and finally, hematopoietic stem cell transplantation (HSCT) as the definitive treatment. We hypothesized that iron overloading associated with multiple transfusions and HSCT-related complications may adversely affect cardiac function. Left ventricular (LV) function was assessed in children after HSCT for SAA. Methods: Forty-six consecutive patients with a median age of 9.8 years (range, 1.5-18 years), who received HSCT for SAA and who underwent comprehensive echocardiography before and after HSCT, were included in this study. The data of LV functional parameters obtained using conventional echocardiography, tissue Doppler imaging (TDI), and speckle-tracking echocardiography (STE) were collected from pre- and post-HSCT echocardiography. These data were compared to those of 40 age-matched normal controls. Results: In patients, the LV ejection fraction, shortening fraction, end-diastolic dimension, mitral early diastolic E velocity, TDI mitral septal E' velocity, and STE LV longitudinal systolic strain rate (SSR) decreased significantly after HSCT. Compared to normal controls, patients had significantly lower post-HSCT early diastolic E velocity and E/A ratio. On STE, patients had significantly decreased LV deformational parameters including LV longitudinal systolic strain (SS), SSR, and diastolic SR (DSR), and circumferential SS and DSR. Serum ferritin levels showed weak but significant correlations (P<0.05) with LV longitudinal SS and SSR and circumferential SS and DSR. Conclusion: Subclinical LV dysfunction is evident in patients after HSCT for SAA, and was associated with increased iron load. Serial monitoring of cardiac function is mandatory in this population.

• Korean Journal of Radiology
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• v.24 no.12
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• pp.1221-1231
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• 2023

Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland-Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion: Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.

• The Korean Journal of Physiology and Pharmacology
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• v.3 no.3
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• pp.329-337
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• 1999

Thyroid hormone-induced cellular dysfunctions may be associated with changes in the intracellular $Ca^{2+}$ concentration. The ryanodine receptor, a $Ca^{2+}$ release channel of the SR, is responsible for the rapid release of $Ca^{2+}$ that activates cardiac muscle contraction. In the excitation-contaction coupling cascade, activation of ryanodine receptors is initiated by the activity of sarcolemmal $Ca^{2+}$ channels, the dihydropyridine receptors. In hyperthyroidism left ventricular contractility and relaxation velocity were increased, whereas these parameters were decreased in hypothyroidism. The mechanisms for these changes have been suggested to include alterations in the expression and/or activity levels of various proteins. In the present study, quantitative changes of ryanodine receptors and the dihydropyridine receptors, and the functional consequences of these changes in various thyroid states were investigated. In hyperthyroid hearts, $[^3H]ryanodine$ binding and ryanodine receptor mRNA levels were increased, but protein levels of ryanodine were not changed significantly. However, the above parameters were markedly decreased in hypothyroid hearts. In case of dihydropyridine receptor, there were a significant increase in the mRNA and protein levels, and [3H]nitrendipine binding, whereas no changes were observed in these parameters of hypothyroid hearts. Our findings indicate that hyperthyroidism is associated with increases in ryanodine receptor and dihydropyridine receptor expression levels, which is well correlated with the ryanodine and dihydropyridine binding. Whereas opposite changes occur in ryanodine receptor of the hypothyroid hearts.

• Journal of Cardiovascular Imaging
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• v.30 no.4
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• pp.263-275
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• 2022

BACKGROUND: Cardiac allograft vasculopathy (CAV) is a complication beyond the first-year post-heart transplantation (HTx). We aimed to test the utility of cardiac magnetic resonance (CMR) to detect functional/structural changes in HTx recipients with CAV. METHODS: Seventy-seven prospectively recruited HTx recipients beyond the first-year post-HTx and 18 healthy controls underwent CMR, including cine imaging of ventricular function and T1- and T2-mapping to assess myocardial tissue changes. Data analysis included quantification of global cardiac function and regional T2, T1 and extracellular volume based on the 16-segment model. International Society for Heart and Lung Transplantation criteria was used to adjudicate CAV grade (0-3) based on coronary angiography. RESULTS: The majority of HTx recipients (73%) presented with CAV (1: n = 42, 2/3: n = 14, 0: n = 21). Global and segmental T2 (49.5 ± 3.4 ms vs 50.6 ± 3.4 ms, p < 0.001;16/16 segments) were significantly elevated in CAV-0 compared to controls. When comparing CAV-2/3 to CAV-1, global and segmental T2 were significantly increased (53.6 ± 3.2 ms vs. 50.6 ± 2.9 ms, p < 0.001; 16/16 segments) and left ventricular ejection fraction was significantly decreased (54 ± 9% vs. 59 ± 9%, p < 0.05). No global, structural, or functional differences were seen between CAV-0 and CAV-1. CONCLUSIONS: Transplanted hearts display functional and structural alteration compared to native hearts, even in those without evidence of macrovasculopathy (CAV-0). In addition, CMR tissue parameters were sensitive to changes in CAV-1 vs. 2/3 (mild vs. moderate/severe). Further studies are warranted to evaluate the diagnostic value of CMR for the detection and classification of CAV.