Publications (59)183.18 Total impact
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Article: Short bouts of anaerobic exercise increase non-esterified fatty acids release in obesity.
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ABSTRACT: PURPOSE: It is demonstrated that aerobic exercise plays an important role in weight loss programs for obesity by increasing 24 h metabolic rate. While aerobic exercise can result in health and fitness benefits in obese subjects, also independently of weight loss, not completely clear are the effects of bouts of hard exercise on metabolic outcomes. The aim of this study was to test the hypothesis that short-term aerobic activity with anaerobic bouts might result in a greater improvement in the management of obesity than aerobic activity alone. METHODS: We studied 16 obese subjects (eight men) during a progressive cycloergometric test up to exhaustion, before and after 4 weeks of two different training schedules (6 days/week). Insulin and glycaemia, non-esterified fatty acids (NEFA) and lactic acid were sampled. Group A (eight subjects, four men) performed an aerobic cycle workout; Group B (eight subjects, four men) performed a 25 min aerobic workout followed by 5 min of anaerobic workout. All the subjects maintained their individual eating habits. RESULTS: The post-training test showed a decrease in AUCs NEFA in Group A (p < 0.05) and an increase in Group B (p < 0.05), together with an increase in lactic acid in Group A and a decrease in Group B (p < 0.01). β-cell function (HOMA2-B) revealed a reduction only in Group A (p < 0.05). Group B achieved a greatest reduction in body fat mass than Group A (p < 0.05). CONCLUSIONS: Aerobic plus anaerobic training seem to produce a greater response in lipid metabolism and not significant modifications in glucose indexes; then, in training prescription for obesity, we might suggest at starting weight loss program aerobic with short bouts of anaerobic training to reduce fat mass and subsequently a prolonged aerobic training alone to ameliorate the metabolic profile.European Journal of Nutrition 04/2013; · 2.75 Impact Factor -
Article: Cocaine Abuse and Sleep Apnea in Severe Obesity.
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ABSTRACT: Obesity is a cause of sleep breathing disorders that result in excessive daytime sleepiness. We describe the adaptive strategy used by an obese person who started to snort cocaine to remedy incoercible drowsiness affecting his working financial skills. Clinical workup documented severe sleep apnea, which was treated by noninvasive ventilation and resulted in withdrawing cocaine abuse. Undiagnosed sleep disorders may trigger surreptitious psychostimulant abuse in vulnerable individuals.Journal of Addiction Medicine 03/2013; · 1.95 Impact Factor -
Article: Deconvolution-based assessment of pituitary GH secretion stimulated with GHRH+arginine in Prader-Willi adults and obese controls.
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ABSTRACT: OBJECTIVE: The assessment of GH deficiency in adult patients with Prader-Willi syndrome (PWS) has been previously assessed through the evaluation of quantitative parameters, such as the peak value of GH response to exogenous stimuli. A comprehensive description of the pattern of secretory response obtainable by deconvolution analysis is still lacking. The aim of our study is to characterize the time evolution of responses of PWS subjects compared to obese controls. DESIGN AND SUBJECTS: GH responsiveness was measured following the combined administration of GHRH+arginine to 65 PWS adults (24 males, 41 females) aged 18-41.2 years, and 17 age-, gender- and body mass index-matched obese controls. PWS subjects were analyzed considering the stratification on different genotypes. MEASUREMENTS: GH response to GHRH+arginine was analysed in terms of peak values, standard area under the curves (AUCs), AUCs due to the stimulus, AUCs of the Instantaneous Secretion Rate signal and Secretion Response Analysis. RESULTS: Both in terms of peak values and AUC, GH responses were statistically different between PWS UPD15 and PWS DEL15 subjects as well as between PWS UPD15 and obese controls. PWS subjects showed a lower and a more delayed GH response compared to obese controls. Moreover, PWS UPD15 subjects had the most delayed GH response. CONCLUSIONS: Our findings demonstrate that impaired GH secretion in PWS subjects compared to obese controls not only regards amplitude parameters such as peak value and AUC, but also the shape of the secretory response, which is more delayed, especially for UPD15 subjects. © 2013 Blackwell Publishing Ltd.Clinical Endocrinology 01/2013; · 3.17 Impact Factor -
Article: Nuclear cardiology at the door of a new era: better to save mSv or to reduce imaging time?
European Journal of Nuclear Medicine 09/2012; · 4.53 Impact Factor -
Article: Evaluation of ischaemia in obese patients: feasibility and accuracy of a low-dose protocol with a cadmium-zinc telluride camera.
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ABSTRACT: Obesity is a significant and independent risk factor for cardiovascular disease, and assessing ischaemia in obese patients is clinically important but sometimes difficult because of imaging artefacts. The aim of this study was to evaluate the feasibility and diagnostic accuracy of stress/rest imaging with a cadmium-zinc telluride (CZT) camera using a low-dose protocol in a series of consecutive obese patients referred for the evaluation of coronary artery disease. We considered 148 consecutive obese patients (mean BMI 39 ± 7 kg/m(2)) with known or suspected coronary artery disease referred to our laboratory for stress/rest myocardial perfusion imaging. A subgroup of 103 of the 148 patients underwent invasive coronary angiography for clinical reasons. All patients underwent a single-day stress/rest low-dose ultrafast protocol. Patients were injected with (99m)Tc-tetrofosmin at a dose in the range 185-222 MBq during bicycle exercise or dipyridamole stress, and underwent the first scan with an acquisition time of 7 min starting 15 min after the end of the stress. The rest scan with an acquisition time of 6 min was started from 30 to 45 min after (99m)Tc-tetrofosmin injection at a dose in the range 370-444 MBq. Images were visually inspected, and the summed stress score (SSS) and summed rest score (SRS) were obtained. Image quality was graded very good or excellent in all patients. Of the 103 patients who underwent coronary angiography, 12 (12 %), 26 (25 %) and 56 (54 %) showed one-, two- and three-vessel disease, and 9 showed normal coronary vessels. In the 103 patients submitted to coronary angiography, the mean SSS and SRS were 7 ± 6 and 2 ± 3, respectively. Semiquantitative regional and global SSS was a good discriminant of coronary artery disease and the area under the overall ROC curve was 0.848 (95 % CI 0.723-0.975). In obese patients, a single-day stress/rest low-dose ultrafast protocol with a CZT camera is clinically feasible and provides high image quality.European Journal of Nuclear Medicine 06/2012; 39(8):1254-61. · 4.53 Impact Factor -
Article: Impact of attenuation correction and gated acquisition in SPECT myocardial perfusion imaging: results of the multicentre SPAG (SPECT Attenuation Correction vs Gated) study
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ABSTRACT: PurposeIn clinical myocardial single photon emission computed tomography (SPECT), attenuation artefacts may cause a loss of specificity in the identification of diseased vessels that can be corrected by means of gated SPECT (GSPECT) acquisition or CT attenuation correction (AC). The purpose of this multicentre study was to assess the impact of GSPECT and AC on the diagnostic performance of myocardial scintigraphy, according to patient’s sex, body mass index (BMI) and site of coronary artery disease (CAD). MethodsWe studied a group of 104 patients who underwent coronary angiography within 1month before or after the SPECT study. Patients with a BMI > 27 were considered “overweight”. Attenuation-corrected and standard GSPECT early images were randomly interpreted by three readers blinded to the clinical data. ResultsIn the whole group, GSPECT and AC showed a diagnostic accuracy of 86.5% (sensitivity 82%, specificity 93%) and 77% (sensitivity 75.4%, specificity 81.4%), respectively (p < 0.05). In women, when anterior ischaemia was matched with CAD, AC failed to show any increase in specificity (AC 63.6% vs GSPECT 63.6%) with evident loss of sensitivity (AC 72.7% vs GSPECT 90.9%). AC significantly improved SPECT specificity in the identification of right CAD in overweight men (AC 100% vs GSPECT 66.7%, p <0.05). ConclusionAC improved specificity in the evaluation of right CAD in overweight men. In the other evaluable subgroups specificity was not significantly affected while sensitivity was frequently reduced. KeywordsCardiac perfusion imaging–Gated SPECT–Attenuation correctionEuropean journal of nuclear medicine and molecular imaging 04/2012; 38(10):1890-1898. · 4.99 Impact Factor -
Article: Clinical utility of estimated glomerular filtration rate in patients undergoing gated SPECT
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ABSTRACT: BackgroundChronic kidney disease is a major risk factor for coronary artery disease (CAD). The aim of the study was to examine the association between estimated glomerular filtration rate (GFR), presence of CAD, and prognosis in patients with reversible perfusion defects at gated single-photon emission computed tomography (g-SPECT). MethodsSix hundred fifty-eight subjects who had undergone stress/rest g-SPECT for evaluation of myocardial ischemia were divided into two groups according to the presence of CAD, defined by a 70% diameter stenosis in at least one major vessel or principal side branch at coronary angiography. ResultsGFR was lower in patients with CAD and after adjusting for several clinical characteristics through multivariate logistic regression analysis, reduced (<60mL/min/1.73m2) GFR remained a significant predictor of CAD (HR 1.80, 95% CI 1.04 to 3.12, P=.036). In addition, reduced GFR was associated with a greater extent of myocardial ischemia, assessed through the summed difference score, as well as with an increase in both total and cardiac mortality. ConclusionsIn patients with a positive g-SPECT scan, GFR is an accurate marker of CAD and is directly correlated to the extent of myocardial ischemia. Furthermore, reduced GFR had an adverse impact on survival in this particular population.Journal of Nuclear Cardiology 04/2012; 16(3):384-390. · 2.67 Impact Factor -
Article: Myocardial imaging with 99mTc-Tetrofosmin: Influence of post-stress acquisition time, regional radiotracer uptake, and wall motion abnormalities on the clinical result
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ABSTRACT: BackgroundWe previously demonstrated that early (15′, T1) post-stress myocardial imaging with Tetrofosmin could be more accurate than standard acquisitions (45′, T2) in identifying coronary artery disease. Methods and ResultsTo clarify this phenomenon, 120 subjects (age 61±10years) with both T1 and T2 scans were divided into Group 1 (53/120 pts) with more ischemia at T1 vs T2 imaging (T1-T2SDS≥3); Group 2 (67/120 pts) with similar results (T1-T2SDS≤2). Myocardial areas were categorized as control nonischemic, ischemic, and scarred on the basis of perfusion/contraction properties and coronary anatomy. In each area, regional myocardial count statistic and semiquantitative wall motion/thickening values were obtained. Analysis of T1 and T2 post-stress myocardial counts demonstrated a significant Tetrofosmin wash-out rate that was higher in Group 1 control nonischemic regions (15±8% vs 13.6±9.6%, P<.02), significantly lower in Group 1 ischemic regions (7±10% vs 12.2±9.5%, P<.0001), and comparable between scarred areas of the two groups (P=NS). Δ post-stress wall thickening (T1-T2) was lower in Group 1 ischemic regions (−4.5±9.15% vs −1.90±7.0%, P<.001) and comparable in both control nonischemic and scarred areas of the two groups (P=NS). ConclusionThe clinical result of Tetrofosmin gated-SPECT can be influenced by the post-stress acquisition time because of ischemic-induced regional wall thickening abnormalities and the existence of a differential radiotracer myocardial wash-out. KeywordsMyocardial perfusion imaging: SPECT-partial volume effect-Tetrofosmin-gated SPECTJournal of Nuclear Cardiology 04/2012; 17(2):276-285. · 2.67 Impact Factor -
Article: Hypopituitarism following brain injury: when does it occur and how best to test?
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ABSTRACT: Aim of this review is to highlight how and when Traumatic Brain Injury (TBI) as well as Subarachnoid Haemorrhage (SAH) and primary Brain Tumours (pBT) of the Central Nervous System (CNS) can induce hypopituitarism, an under-diagnosed clinical problem. Moreover, this review aims to clarify, on the basis of the recent evidences, how these patients have to be tested for pituitary-function. Both retrospective and prospective studies recommended that patients with more severe form of Brain Injuries (BI) and in particular, those with fractures of the base of the skull or early diabetes insipidus, have to be closely monitored for signs and symptoms of endocrine dysfunction. Further studies will be crucial to raise awareness and remind physicians on the prevalence of hypopituitarism in patients with BI and to elucidate any incremental benefits these patients may receive from hormone replacement.Pituitary 03/2012; 15(1):20-4. · 1.83 Impact Factor -
Article: [Imaging the innervation of the failing heart].
Giornale italiano di cardiologia (2006) 02/2012; 13(2):98-101. -
Chapter: Physiologic Risk Assessment in Stable Ischemic Heart Disease � Functional Evaluation Versus Coronary Anatomy
09/2011; , ISBN: 978-953-307-675-1 -
Article: High diagnostic accuracy of low-dose gated-SPECT with solid-state ultrafast detectors: preliminary clinical results.
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ABSTRACT: Appropriate use of SPECT imaging is regulated by evidence-based guidelines and appropriateness criteria in an effort to limit the burden of radiation administered to patients. We aimed at establishing whether the use of a low dose for stress-rest single-day nuclear myocardial perfusion imaging on an ultrafast (UF) cardiac gamma camera using cadmium-zinc-telluride solid-state detectors could be used routinely with the same accuracy obtained with standard doses and conventional cameras. To this purpose, 137 consecutive patients (mean age 61 ± 8 years) with known or suspected coronary artery disease (CAD) were enrolled. They underwent single-day low-dose stress-rest myocardial perfusion imaging using UF SPECT and invasive coronary angiography. Patients underwent the first scan with a 7-min acquisition time 10 min after the end of the stress protocol (dose range 185 to 222 MBq of (99m)Tc-tetrofosmin). The rest scan (dose range 370 to 444 MBq of (99m)Tc-tetrofosmin) was acquired with a 6-min acquisition time. The mean summed stress scores (SSS) and mean summed rest scores (SRS) were obtained semiquantitatively. Coronary angiograms showed significant epicardial CAD in 83% of patients. Mean SSS and SRS were 10 ± 5 and 3 ± 3, respectively. Overall the area under the ROC curve for the SSS values was 0.904, while the areas under the ROC curves for each vascular territory were 0.982 for the left anterior descending artery, 0.931 for the left circumflex artery and 0.889 for the right coronary artery. This pilot study demonstrated the feasibility of a low-dose single-day stress-rest fasting protocol performed using UF SPECT, with good sensitivity and specificity in detecting CAD at low patient exposure, opening new perspectives in the use of myocardial perfusion in ischaemic patients.European Journal of Nuclear Medicine 09/2011; 39(1):83-90. · 4.53 Impact Factor -
Article: Impact of attenuation correction and gated acquisition in SPECT myocardial perfusion imaging: results of the multicentre SPAG (SPECT Attenuation Correction vs Gated) study.
[show abstract] [hide abstract]
ABSTRACT: In clinical myocardial single photon emission computed tomography (SPECT), attenuation artefacts may cause a loss of specificity in the identification of diseased vessels that can be corrected by means of gated SPECT (GSPECT) acquisition or CT attenuation correction (AC). The purpose of this multicentre study was to assess the impact of GSPECT and AC on the diagnostic performance of myocardial scintigraphy, according to patient's sex, body mass index (BMI) and site of coronary artery disease (CAD). We studied a group of 104 patients who underwent coronary angiography within 1 month before or after the SPECT study. Patients with a BMI>27 were considered "overweight". Attenuation-corrected and standard GSPECT early images were randomly interpreted by three readers blinded to the clinical data. In the whole group, GSPECT and AC showed a diagnostic accuracy of 86.5% (sensitivity 82%, specificity 93%) and 77% (sensitivity 75.4%, specificity 81.4%), respectively (p<0.05). In women, when anterior ischaemia was matched with CAD, AC failed to show any increase in specificity (AC 63.6% vs GSPECT 63.6%) with evident loss of sensitivity (AC 72.7% vs GSPECT 90.9%). AC significantly improved SPECT specificity in the identification of right CAD in overweight men (AC 100% vs GSPECT 66.7%, p<0.05). AC improved specificity in the evaluation of right CAD in overweight men. In the other evaluable subgroups specificity was not significantly affected while sensitivity was frequently reduced.European Journal of Nuclear Medicine 06/2011; 38(10):1890-8. · 4.53 Impact Factor -
Article: Comparison between ultrafast and standard single-photon emission CT in patients with coronary artery disease: a pilot study.
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ABSTRACT: A novel technology has been developed for ultrafast (UF) single-photon emission CT (SPECT) myocardial perfusion imaging by using a pinhole collimation design and multiple cadmium zinc telluride crystal arrays. The purpose of this study was to compare myocardial perfusion imaging obtained by UF-SPECT with standard (S) SPECT in patients with known or suspected coronary artery disease. A total of 34 patients underwent single-day (99m)Tc-tetrofosmin stress/rest myocardial perfusion imaging. UF-SPECT was performed 10 minutes before S-SPECT. Images were qualitatively analyzed, and the summed stress score and summed rest score were calculated. The segmental tracer uptake value (percentage of maximum myocardial uptake) also was quantified for both UF- and S-SPECT. When only 29 of 34 patients with significant coronary lesions were analyzed, the summed stress score was 10.1±4.4 versus 6.4±2.9, respectively, for UF- and S-SPECT (P=0.002). Qualitative and quantitative per-patient analysis showed similar results in detection of coronary artery disease for UF- and S-SPECT. In contrast, per-vessel analysis demonstrated higher regional sensitivity of UF- versus S-SPECT. UF-SPECT showed higher sensitivity in detecting multivessel disease (P=0.003) versus S-SPECT. This pilot study confirms that UF-SPECT provides high-quality fast myocardial perfusion imaging and suggests that it may allow a more-accurate evaluation of both extent and severity of myocardial ischemia in patients with coronary artery disease.Circulation Cardiovascular Imaging 11/2010; 4(1):51-8. · 5.94 Impact Factor -
Article: Dynamics of GH secretion during incremental exercise in obesity, before and after a short period of training at different work-loads.
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ABSTRACT: Growth hormone (GH) secretion is normally sensitive to physical exercise. Intensity and duration of exercise, fitness and age can all influence the GH response to exercise. In obesity, GH secretion is decreased both in basal conditions and in response to exercise. To analyse the dynamics of GH response to a progressive cycloergometric test, conducted up to exhaustion, in adult normal subjects and obese patients, after a reconditioning program at different workloads. We studied eight lean subjects (four men, mean age 34.3 years, range 26-47 years, mean body mass index (BMI) 22.1 kg/m(2)). GH was sampled at baseline and during the last 30 s of each power output increase. Anaerobic threshold (AT) was detected by the V-slope method. The same test was carried out in 16 obese subjects (seven men, mean age 39.1 years, range 20-59 years, mean BMI 35.8 kg/m(2)) and repeated after a 4-week reconditioning program consisting of aerobic workout (Group A, eight subjects, three men, mean age 40.5 years, range 22-59 years, mean BMI 33.6 kg/m(2)), and aerobic plus anaerobic work (group B, eight subjects, four men, mean age 37.6 years, range 20-56 years, mean BMI 38.0 kg/m(2)) for 6 days/week, with no dietary restrictions. Mean exercise peak occurred at higher intensity in controls (140 vs 110 W, P < 0.05), and AT exceeded at higher work outputs than in obese subjects (102 vs 74 W, P < 0.05). In controls, GH response to exercise was prompt and further sustained after AT; in obese subjects, GH increased slowly and insignificantly before AT, thereafter it increased to lower levels than in controls (P < 0.001). Following the reconditioning period, both Group A and Group B of obese subjects failed to improve exercise performance as well as GH response to exercise before AT; beyond AT, a greater GH response to exercise occurred in Group B than Group A (7.59 ± 0.32 μg/l at peak of exercise) with significantly different Delta AUCs (Area Under the Curves) following AT: 30.5 ± 12 μg.min/l in Group A vs 124.2 ± 38 μg.min/l in Group B, P < 0.05. Our results confirm the blunted GH response to exercise in obese adults when compared to lean counterparts. With obesity, aerobic training poorly increases the GH response beyond AT, while supplemental anaerobic workload appears to increase GH response beyond AT. These observations may have implications for the prescription of physical exercise, which is one of the recommendations in the management of obesity.Clinical Endocrinology 10/2010; 73(4):491-6. · 3.17 Impact Factor -
Article: Investigations of thyroid hormones and antibodies in obesity: leptin levels are associated with thyroid autoimmunity independent of bioanthropometric, hormonal, and weight-related determinants.
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ABSTRACT: Obesity can alter the thyroid hormone status as a result of a dysregulated endocrine loop between the hypothalamo-pituitary unit and adipose tissue. The adipocytokine leptin has been shown to promote autoimmunity; hence, we aimed to clarify whether leptin excess of obesity could increase the susceptibility to develop autoimmune thyroid disease (AITD). This cross-sectional study was performed in a tertiary care center. Free thyroid hormones, TSH, thyroglobulin, and antithyroid antibodies levels were tested in 165 obese and 118 lean subjects. Results were plotted against variables related to body composition, leptin levels, glucose homeostasis, energy expenditure, and pattern of weight accrual. Compared with controls, obese patients had lower free T3 levels and free T4 levels (P<0.01), greater prevalence of hypothyroidism (P<0.05), and higher commonness of antithyroid antibodies (P<0.05). As a marker of AITD, thyroid peroxidase antibodies were more frequent in the obese group (P<0.01). Correlation analysis showed that leptin levels were associated with AITD (P<0.01) independent of bioanthropometric variables. Multiple logistic regression analysis in pooled groups identified female sex and leptin as significant predictors of AITD. Obesity increases the susceptibility to harbor AITD with an emerging role for leptin as a peripheral determinant, which needs to be confirmed in future investigations.The Journal of clinical endocrinology and metabolism 08/2010; 95(8):3965-72. · 6.50 Impact Factor -
Article: CRT in Patients with Heart Failure: Time Course of Perfusion and Wall Motion Changes.
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ABSTRACT: In patients treated with CRT no data relative to the relationship between regional wall motion and perfusion and reverse remodelling of the left ventricle at short and medium term followup were available. To this aim, 36 heart failure patients were studied by G-SPECT before (T0), within 2 months (T1) and 6 months (T2) after CRT. A clinical followup was completed for 36 months. In 30/36 patients there was an improvement of NYHA Class at T1 that persisted at T2. G-SPECT showed significant improvement of perfusion at T1 in 92% of patients without further changes at T2. A reduction of LV volumes, an increase of EF and an improvement of regional wall motion and thickening were observed at T1 versus baseline, with only minor changes at T2. Moreover, baseline extension of perfusion defects was scarcely correlated with improvement after CRT. Finally, end diastolic volume, perfusion defect and diabetes mellitus were independent predictors of survival. The main effects of CRT on regional myocardial perfusion and wall motion are obtained within 2 months. Volume overload modulates recovery of ventricular function independently of reperfusion and, with extension of perfusion abnormalities and diabetes were independent predictors of survival during followup.Cardiology research and practice. 01/2010; 2010:981064. -
Article: Myocardial imaging with 99mTc-Tetrofosmin: Influence of post-stress acquisition time, regional radiotracer uptake, and wall motion abnormalities on the clinical result.
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ABSTRACT: We previously demonstrated that early (15', T1) post-stress myocardial imaging with Tetrofosmin could be more accurate than standard acquisitions (45', T2) in identifying coronary artery disease. To clarify this phenomenon, 120 subjects (age 61 +/- 10 years) with both T1 and T2 scans were divided into Group 1 (53/120 pts) with more ischemia at T1 vs T2 imaging (T1-T2SDS > or = 3); Group 2 (67/120 pts) with similar results (T1-T2SDS < or = 2). Myocardial areas were categorized as control nonischemic, ischemic, and scarred on the basis of perfusion/contraction properties and coronary anatomy. In each area, regional myocardial count statistic and semiquantitative wall motion/thickening values were obtained. Analysis of T1 and T2 post-stress myocardial counts demonstrated a significant Tetrofosmin wash-out rate that was higher in Group 1 control nonischemic regions (15 +/- 8% vs 13.6 +/- 9.6%, P < .02), significantly lower in Group 1 ischemic regions (7 +/- 10% vs 12.2 +/- 9.5%, P < .0001), and comparable between scarred areas of the two groups (P = NS). Delta post-stress wall thickening (T1-T2) was lower in Group 1 ischemic regions (-4.5 +/- 9.15% vs -1.90 +/- 7.0%, P < .001) and comparable in both control nonischemic and scarred areas of the two groups (P = NS). The clinical result of Tetrofosmin gated-SPECT can be influenced by the post-stress acquisition time because of ischemic-induced regional wall thickening abnormalities and the existence of a differential radiotracer myocardial wash-out.Journal of Nuclear Cardiology 12/2009; 17(2):276-85. · 2.67 Impact Factor -
Article: Single-shot cardiorenal scintigraphy with 99mTc-tetrofosmin: a dynamic characterization at rest and during adenosine infusion.
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ABSTRACT: Renal function is known to be a strong predictor of cardiovascular prognosis, and cardiorenal disease is increasingly investigated in medical research. In this study, we tested the hypothesis that a single combined cardiorenal scintigraphy examination with the perfusion tracer (99m)Tc-tetrofosmin is feasible and may allow the simultaneous investigation of cardiac and renal pathology in cardiovascular patients. Thirty patients scheduled for dual-day gated SPECT also gave their informed consent for a renal acquisition after a single injection of 370 MBq of (99m)Tc-tetrofosmin, at rest (30 patients) or with adenosine (21 patients), and to undergo an additional standard renal study with the glomerular tracer (99m)Tc-diethylenetriaminepentaacetic acid (DTPA) (74 MBq) after 1 wk (24 patients). Kidney images and renograms were obtained. Renal uptake index, expressed as the percentage ratio of kidney counts cumulated over the second minute after injection to the administered dose, was calculated as a functional renal parameter. Time to peak activity and separate kidney percentage uptake (as the percentage contribution of each kidney to total renal uptake) were also calculated. Compared with (99m)Tc-DTPA, (99m)Tc-tetrofosmin provided better-quality kidney images, with a higher uptake index (13.17% +/- 4.76% vs. 8.33% +/- 2.45%, P < 0.001) and with comparable separate kidney percentage uptake and times to peak activity. (99m)Tc-tetrofosmin uptake index was significantly lower in the patients who were more compromised according to renal and cardiovascular functional parameters, and correlated with (99m)Tc-DTPA uptake index (r = 0.77, P < 0.001), serum creatinine (r = 0.59, P < 0.005), log brain natriuretic peptide N-terminal levels (r = -0.65, P < 0.005), myocardial and carotid intima-media wall thickness (for both, r = -0.61, P < 0.005), and the Doppler index of renal vascular resistance (r = -0.60, P < 0.005). In the 21 patients who underwent the provocative test, adenosine induced a significant decrease in renal (99m)Tc-tetrofosmin uptake index (from 14.12% +/- 4.50% to 11.81% +/- 3.33%, P < 0.005) suggesting a decrement in renal perfusion or function. (99m)Tc-tetrofosmin cardiorenal scintigraphy is feasible at low cost as a single-shot study and may allow both the evaluation of renal morphology and renograms during a cardiac study and the calculation of renal functional parameters.Journal of Nuclear Medicine 09/2009; 50(8):1288-95. · 6.38 Impact Factor -
Article: Physiologic risk assessment in stable ischemic heart disease: still superior to the anatomic angiographic approach.
Journal of Nuclear Cardiology 08/2009; 16(5):697-700. · 2.67 Impact Factor
Top co-authors
Top Journals
Institutions
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2010–2013
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Università degli Studi del Piemonte Orientale "Amedeo Avogadro"
Alessandria, Piedmont, Italy
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2009–2012
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Fondazione Toscana Gabriele Monasterio
Pisa, Tuscany, Italy -
National Research Council - Italy
Roma, Latium, Italy
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1992–2012
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National Research Council
- Institute of Clinical Physiology IFC
Roma, Latium, Italy -
Istituto di Fisiologia Clinica del CNR
Pisa, Tuscany, Italy
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2008–2009
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I.R.C.C.S. Istituto Auxologico Italiano
Verbania, Piedmont, Italy
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2007
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University of Padua
Padova, Veneto, Italy
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2006
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Democritus University of Thrace
Xánthi, Anatoliki Makedonia kai Thraki, Greece
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2004
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Ospedale di San Raffaele Istituto di Ricovero e Cura a Carattere Scientifico
Milano, Lombardy, Italy
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