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001-es BibID:BIBFORM039496
Első szerző:Adams, J. N.
Cím:The persistence of hibernating myocardium after acute myocardial infarction / J. N. Adams, R. J. Trent, M. Norton, P. Mikecz, S. Walton, N. Evans
Dátum:1998
ISSN:0195-668X
Megjegyzések:Objective To establish the persistence of hibernating myocardium initially detected after myocardial infarction treated with thrombolysis. Methods and results Fourteen patients underwent gated positron emission tomography with 18-fluoro-deoxyglucose and N13-ammonia at a median of 8 days after first myocardial infarction. Repeat scans were performed at a median of 13 weeks post-infarction. A total of 148 (30·9%) myocardial segments showed reduced N13-ammonia uptake at the time of the first scan compared with 154·5 (32·2%) segments at the time of repeat imaging. The median change in the number of segments with reduced perfusion was -1·0. Initially 13 subjects had hibernating myocardium, seven patients had large areas and six had smaller regions. Six (46·2%) subjects had repeat scans showing unchanged areas of hibernating tissue and seven had second scans demonstrating changes in the size of the region of hibernating myocardium. One patient had no hibernating myocardium on either scan. Conclusions Positron emission tomography performed several months after myocardial infarction demonstrates significant changes in myocardial perfusion. However, a reduction in the number of segments with reduced perfusion does not always result in an improvement in myocardial metabolism and contraction. Whilst most regions of hibernating myocardium were still present several months after infarction, in only approximately half was the size of the mismatched region unchanged. Therefore it is not possible to predict the fate of hibernating myocardium which is present after infarction.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Heart Journal. - 19 : 2 (1998), p. 255-262. -
További szerzők:Trent, R. J. Norton, M. Mikecz Pál (1956-) (vegyész) Walton, S. Evans, Noel T. S.
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001-es BibID:BIBFORM046726
035-os BibID:PMID:8665333
Első szerző:Adams, J. N.
Cím:Incidence of hibernating myocardium after acute myocardial infarction treated with thrombolysis / J. N. Adams, M. Norton, R. J. Trent, P. Mikecz, S. Walton, N. Evans
Dátum:1996
ISSN:1355-6037
Megjegyzések:OBJECTIVE: To establish the incidence of hibernating myocardium after myocardial infarction treated with thrombolysis and to observe differences in the clinical outcome between patients with and without hibernating tissue. METHODS: 41 patients underwent gated positron emission tomography with 18-fluorodeoxyglucose and 13N-ammonia at a median of eight days after first myocardial infarction. RESULTS: All 41 subjects had a matched perfusion-metabolism deficit in the region of myocardium indicated as the site of infarction by an electrocardiograph; 32 patients (78%) had scans which also showed at least one area of reduced blood flow and contraction with a concomitant increase in glucose uptake, representing hibernating myocardium. Patients were followed up at a median of six months: all 41 were alive and none had sustained a further infarct or cardiac arrhythmia; 17 subjects with hibernating tissue (53.1%) and two without (25%) reported chest pain after myocardial infarction. CONCLUSIONS: Hibernating myocardium is relatively common shortly after myocardial infarction treated with thrombolysis. It does not influence mortality or the incidence of postinfarction chest pain.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Heart. - 75 : 5 (1996), p. 442-446. -
További szerzők:Norton, M. Trent, R. J. Walton, S. Evans, Noel T. S. Mikecz Pál (1956-) (vegyész)
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3.

001-es BibID:BIBFORM039549
Első szerző:Al-Mohammad, A.
Cím:Prevalence of hibernating myocardium in patients with severely impaired ischaemic left ventricles / A. Al-Mohammad, I. R. Mahy, M. Y. Norton, G. Hillis, J. C. Patel, P. Mikecz, S. Walton
Dátum:1998
ISSN:1355-6037
Megjegyzések:Objective-Severe impairment of left ventricular (LV) contraction is associated with an adverse prognosis in patients with ischaemic heart disease. Revascularisation may improve the impaired LV contraction if hibernating myocardium is present. The proportion of patients likely to benefit from this intervention is unknown. Therefore, the prevalence of hibernating myocardium in patients with ischaemic heart disease and severe impairment of LV contraction was assessed. Design-From a consecutive series of patients undergoing coronary angiography for the investigation of chest pain or LV impairment, all patients with ischaemic heart disease and an LV ejection fraction (LVEF) [less-than-or-eq, slant] 30% were identified. These patients underwent positron emission tomography (PET) to detect hibernating myocardium, identified by perfusion metabolism mismatch. Setting-A teaching hospital directly serving 500 000 people. Results-Of a total of 301 patients, 36 had ischaemic heart disease and an LVEF [less-than-or-eq, slant] 30%. Twenty-seven patients had PET images, while nine patients were not imaged because of emergency revascularisation (three), loss to follow up (one), inability to give consent (four), and age < 50 years (one, ethics committee guidelines). Imaged and non-imaged groups were similar in LV impairment, demographic characteristics, and risk factor profile. Fourteen patients (52% of the imaged or 39% of all patients with ischaemic heart disease and LVEF [less-than-or-eq, slant] 30%) had significant areas of hibernating myocardium on PET. Conclusion-It is possible that up to 50% of patients with ischaemic heart disease and severely impaired left ventricles have hibernating myocardium.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Heart. - 80 : 6 (1998), p. 559-564. -
További szerzők:Mahy, I. R. Norton, M. Hillis, G. Patel, J. Mikecz Pál (1956-) (vegyész) Walton, S.
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4.

001-es BibID:BIBFORM031844
035-os BibID:PMID:10573488
Első szerző:Al-Mohammad, A.
Cím:Can the surface electrocardiogram be used to predict myocardial viability? / A. Al-Mohammad, M. Y. Norton, I. R. Mahy, J. C. Patel, A. E. Welch, P. Mikecz, S. Walton
Dátum:1999
ISSN:1355-6037
Megjegyzések:OBJECTIVE: To investigate whether QRS morphology on the surface ECG can be used to predict myocardial viability. DESIGN: ECGs of 58 patients with left ventricular impairment undergoing positron emission tomography (PET) were studied. (13)N-Ammonia (NH(3)) and (18)F-fluorodeoxyglucose (FDG) were the perfusion and the metabolic markers, respectively. The myocardium is scarred when the uptake of both markers is reduced (matched defect). Reduced NH(3) uptake with persistent FDG uptake (mismatched defect) represents hibernating myocardium. First, the relation between pathological Q waves and myocardial scarring was investigated. Second, the significance of QR and QS complexes in predicting hibernating myocardium was determined. RESULTS: As a marker of matched PET defects, Q waves were specific (79%) but not sensitive (41%), with a 77% positive predictive accuracy and a poor (43%) negative predictive accuracy. The mean size of the matched PET defect associated with Q waves was 20% of the left ventricle. This was not significantly different from the size of the matched PET defects associated with no Q waves (18%). Among the regions associated with Q waves on the ECG, there were 16 regions with QR pattern (group A) and 23 regions with QS pattern (group B). The incidence of mismatched PET defects was 19% of group A and 30% of group B (NS). CONCLUSIONS: Q waves are specific but not sensitive markers of matched defects representing scarred myocardium. Q waves followed by R waves are not more likely to be associated with hibernating myocardium than QS complexes.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
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Megjelenés:Heart. - 82 : 6 (1999), p. 663-667. -
További szerzők:Norton, M. Mahy, I. R. Patel, J. Welch, A. E. Walton, S. Mikecz Pál (1956-) (vegyész)
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