Gated Heart Shares The Imaging Of Coronary Heart Disease Diagnosis And Treatment To The Value Of Research And Ischemic Heart Shares The Molecular Etiology Discussed

Objective:1. To investigate mitochondrial DNA ( mtDNA ) mutations in samples of ischemic and nonischemic myocardium and skeletal muscle from patients with coronary artery disease(CAD), and the possible relation between mtDNA mutations and CAD.2. To study the diagnostic value in CAD of ECG-gated exercise stress 99mTc-Sestamibi SPECT myocardial perfusion imaging ( MPI) and compare with that of exercise stress electrocardiography(ETT) and non gated myocardial perfusion imaging.3. To study the diagnostic value in severe CAD of ECG-gated exercise stress 99mTc-Sestamibi SPECT MPI and compare with that of non ECG-gated MPI.4. To evaluate the LVEF measured from the incorporation of GS Quant soft ware and 99mTc-Sestamibi SPECT MPI with ECG gating.5. To investigate the possible value of LVEF and its deviation measured from the ECG-gated dipyridamole stress 99mTc-sestamibi SPECT MPI in the diagnosis of coronary artery disease and to compare the diagnostic accuracy of the two different stress protocols.6. To determine the possible severity of coronary artery stenosis with reversible regional wall motion abnormalities (RWMA) present on ECG-gated exercise stress 99mTc-sestamibi SPECT MPI .Methods:1. Nested PCR, PCR-RFLP and DNA auto-sequence analyses techniques were employed to detect and verify mutated mtDNAs in autopsy samples of skeletal muscles and myocardium from ischemic and nonischmic areas of 6 CAD patients.2. Two hundred and fifteen suspected CAD patients who had undergone coronary angiography and ECG-gated 99mTc-Sestamibi SEPCT myocardial perfusion imaging within one month in our hospital were enrolled and values of diagnostic sensitivity, specificity, positive predictive value, negative predictive value and total accuracy were gainedand compared among ETT, non ECG-gated 99mTc-Sestamibi SEPCT MPI and ECG-gated 99mTc-Sestamibi SEPCT MPI.3. The same two hundred and fifteen suspected CAD patients in last paper were enrolled and distributed into three vessel and non three vessel groups according to their coronary angiography result( > 70%); The diagnostic values of severe coronary artery disease with exercise stress ECG-gated and non ECG-gated 99ll1Tc-Sestamibi SEPCT MPI were obtained and compared with each other. Then to determine which one of the two protocols were superior in the identification of severe three vessel CAD.4. Twenty four patients with suspected CAD who had finished coronary angiography and ECG-gated 99mTc-Sestamibi SEPCT MPI within one month in our hospital were selected, the LVEF obtained from ECG-gated 99mTc-Sestamibi SPECT MPI, radionuclide angiography and two dimensional echocardiography were studied to verify the accuracy and reproducibility of the LVEF value of ECG-gated 99mTc-Sestamibi SEPCT MPI gained from Siemens E.CAM+ SPECT with GS Quant soft ware. Other 30 patients who had accomplished coronary angiography and dipyridamole stress ECG-gated 99mTc-Sestamibi SEPCT MPI within one month in our hospital were chosen and then distributed into one, two and three vessel CAD groups according to coronary angiographic results( > 50%). To study the possible value of LVEF got from dipyridamole stress and rest ECG-gated 99mTc-Sestamibi SEPCT MPI in identification of severe coronary artery disease, and compare the sensitivity and specificity of the two different stress SPECT MPI protocols in the diagnoses of coronary artery disease.5. Ninety seven patients undergoing coronary angiography and exercise stress ECG-gated 99mTc-sestamibi SPECT MPI within two weeks were recruited. Images had been acquired between 15min to 20min after stress. A five grades and twenty segments marking system was introduced to assess RWMA and thickening of left ventricles.Results:1. Two types of deleted mtDNAs had been identified in ischemicmyocardium of one CAD patient, while only one of the two deleted mtDNAs in his nonischemic myocardium and skeletal muscle. One type of deleted mtDNA and one type of...