PubMed Health⌕ Search

Biomedical subjects

Jerome F Breen

Publications and source records attributed to Jerome F Breen.

18 recordsLinked to original sources
PubMed2006

Aortic valve calcification: determinants and progression in the population.

BACKGROUND: Aortic valve calcification (AVC) is considered degenerative. Recent data suggested links to atherosclerosis or coronary disease (CAD). METHODS AND RESULTS: AVC and coronary artery calcifications (CAC) were prospectively assessed by Electron-Beam-Computed-Tomography in 262 population-based research participants > or = 60 years. AVC was frequent (27%) with aging (P<0.01) and in men (P<0.05). AVC was associated with diabetes, hypertension, higher body-mass-index, and serum glucose (all P<0.05). AVC was a marker of higher prevalence (P<0.01) and severity of CAD (CAC score: 441+/-802 versus 265+/-566, P<0.05) independently of age. After follow-up of 3.8+/-0.9 years, AVC score increased (94+/-271 versus 54+/-173, P<0.01, +11+/-32 U/year), faster with higher baseline AVC score (P<0.01). Compared with participants remaining free of AVC, de novo acquisition of AVC was associated with higher LDL-cholesterol (141+/-31 versus 121+/-27 mg/dL, P<0.05) and faster CAC progression (+78+/-87 versus +28+/-47 U/year, P<0.05). In multivariate analysis, LDL-cholesterol independently determined AVC acquisition while higher baseline AVC scores determined faster progression of existing AVC. CONCLUSION: In the population, AVC is frequent with aging and atherosclerotic risk factors. AVC is a marker of subclinical CAD. AVC is progressive, appearing de novo with progressive atherosclerosis whereas established AVC progresses independently of atherosclerotic risk factors and faster with increasing initial AVC loads.

Age Distribution↗
PubMed2006

Relationship between coronary artery calcification detected by electron-beam computed tomography and abnormal stress echocardiography: association and prognostic implications.

OBJECTIVES: The purpose of this study was to compare the results and prognostic value of electron-beam computed tomography (EBCT) and exercise echocardiography. BACKGROUND: Although patients with elevated coronary artery calcium scores (CACS) might be referred for exercise echocardiography, the association of EBCT CACS with wall motion score index (WMSI) is not known. METHODS: Patients without known coronary artery disease who underwent both clinically indicated EBCT and exercise echocardiography within a 3-month period were identified. Exercise WMSI was based on a 16-segment model (normal = 1; abnormal >1). The EBCT CACS was derived with the Agatston scoring system. Follow-up was obtained for the combined end point of death and myocardial infarction. RESULTS: The study population included 556 patients (age 54 +/- 10 years; 65% male). Correlation between EBCT CACS and exercise WMSI was limited (r = 0.17, p < 0.0001) but statistically significant. The proportion of patients with abnormal exercise WMSI increased with increasing CACS severity (chi-square = 19.1, p < 0.001). However, even in those with CACS >400, 66% had normal exercise WMSI. Age, CACS, and chest pain were independently associated with abnormal exercise WMSI. Events occurred in 12 (2%) patients. Wall motion score index (risk ratio [RR] 3.7, p = 0.023) and age (RR 1.9, p = 0.019) were associated with events. CONCLUSIONS: Electron-beam computed tomography CACS was predictive of abnormal exercise WMSI, but the majority of patients with elevated CACS had normal WMSI. Wall motion score index and age were the best predictors of events. Prospective studies are indicated to establish the relative roles of these tests in risk stratification.

Aged↗
PubMed2006

Short-term hypoxic exposure at rest and during exercise reduces lung water in healthy humans.

Hypoxia and hypoxic exercise increase pulmonary arterial pressure, cause pulmonary capillary recruitment, and may influence the ability of the lungs to regulate fluid. To examine the influence of hypoxia, alone and combined with exercise, on lung fluid balance, we studied 25 healthy subjects after 17-h exposure to 12.5% inspired oxygen (barometric pressure = 732 mmHg) and sequentially after exercise to exhaustion on a cycle ergometer with 12.5% inspired oxygen. We also studied subjects after a rapid saline infusion (30 ml/kg over 15 min) to demonstrate the sensitivity of our techniques to detect changes in lung water. Pulmonary capillary blood volume (Vc) and alveolar-capillary conductance (D(M)) were determined by measuring the diffusing capacity of the lungs for carbon monoxide and nitric oxide. Lung tissue volume and density were assessed using computed tomography. Lung water was estimated by subtracting measures of Vc from computed tomography lung tissue volume. Pulmonary function [forced vital capacity (FVC), forced expiratory volume after 1 s (FEV(1)), and forced expiratory flow at 50% of vital capacity (FEF(50))] was also assessed. Saline infusion caused an increase in Vc (42%), tissue volume (9%), and lung water (11%), and a decrease in D(M) (11%) and pulmonary function (FVC = -12 +/- 9%, FEV(1) = -17 +/- 10%, FEF(50) = -20 +/- 13%). Hypoxia and hypoxic exercise resulted in increases in Vc (43 +/- 19 and 51 +/- 16%), D(M) (7 +/- 4 and 19 +/- 6%), and pulmonary function (FVC = 9 +/- 6 and 4 +/- 3%, FEV(1) = 5 +/- 2 and 4 +/- 3%, FEF(50) = 4 +/- 2 and 12 +/- 5%) and decreases in lung density and lung water (-84 +/- 24 and -103 +/- 20 ml vs. baseline). These data suggest that 17 h of hypoxic exposure at rest or with exercise resulted in a decrease in lung water in healthy humans.

Adult↗
PubMed2006

Computed tomographic angiography of the coronary arteries: techniques and applications.

Computed tomographic coronary angiography (CT-CA) is a direct but minimally invasive method of visualizing coronary arteries. Multidetector-row computed tomography (MDCT) is currently the CT modality most commonly used for coronary artery imaging. MDCT has been successfully used to detect stenoses in coronary arteries and coronary artery bypass grafts and to assess congenital coronary anomalies. Patients should not undergo CT-CA with MDCT if they have an irregular heart rhythm, a heart rate greater than 70 beats/min, and contraindications to pharmacologic agents for heart rate control, or if they have severe coronary artery disease or are likely to require revascularization.

Coronary Angiography↗
PubMed2005

Progression of subclinical coronary atherosclerosis: does obesity make a difference?

BACKGROUND: Obesity is associated with coronary artery calcification (CAC), a marker of the presence and extent of subclinical coronary atherosclerosis. Obesity adds incremental information in identifying those at higher risk of coronary heart disease to traditional risk factor assessment. The present study examined associations between obesity measures and progression of CAC in those at higher (> or =10%) and lower (<10%) 10-year coronary heart disease risk according to the Framingham risk equation. METHODS AND RESULTS: In this study, 443 asymptomatic white individuals >30 years of age (243 men) had baseline and follow-up CAC measurements an average of 8.9 years apart. Multivariable linear regression models were fit to determine associations of obesity measures at baseline with progression of CAC defined as log(e) of the difference between follow-up and baseline CAC area plus 1 divided by time (in years) between examinations, adjusting for baseline CAC quantity, age, sex, baseline hypertension status, and baseline cholesterol level. Among 329 participants (74.3%) in the lower-risk group, waist circumference (P=0.024), waist-to-hip ratio (P<0.001), body mass index (P=0.036), and being overweight compared with being underweight or of normal weight (P=0.008) were each significantly positively associated with progression of CAC. Among those at higher coronary heart disease risk, no baseline obesity measures were associated with CAC progression. CONCLUSIONS: Various measures of obesity were associated with increased progression of CAC in those at lower risk of coronary heart disease. Future studies examining the effectiveness of weight reduction strategies in reducing CAC progression among those with an otherwise favorable risk factor profile may be warranted.

Adult↗
PubMed2005

Clinical presentation, investigation, and management of pulmonary vein stenosis complicating ablation for atrial fibrillation.

BACKGROUND: Although segmental or circumferential ablation is effective in eliminating pulmonary vein (PV)-mediated atrial fibrillation (AF), this procedure may be complicated by the occurrence of PV stenosis. METHODS AND RESULTS: To establish the clinical presentation, diagnostic manifestations, and interventional management of PV stenosis, 23 patients with stenosis of 34 veins complicating ablation of AF were evaluated. Each patient became symptomatic 103+/-100 days after undergoing ablation. In 8 veins, the ablation producing the PV stenosis was a repeated procedure for continued AF. Nineteen patients presented with dyspnea on exertion, 7 with dyspnea at rest, 9 with cough, and 6 with chest pain. On multirow spiral computed tomography examination, the narrowest lumen of the affected PVs measured 3+/-2 mm compared with 13+/-3 mm at baseline (P< or =0.001). The relative perfusion of affected lung segments on isotope scans was reduced to 4+/-3% of total perfusion compared with 22+/-10% in unaffected segments. At percutaneous intervention, these veins showed 80+/-13% stenosis, with a mean gradient of 12+/-5 mm Hg. This was significantly reduced to a residual stenosis of 9+/-8% (P< or =0.001) and a residual gradient of 3+/-4 mm Hg (P< or =0.001). Twenty veins were treated with balloon dilatation alone, whereas 14 veins were stented with standard 10-mm-diameter bare-metal stents. Although the symptomatic response was nearly immediate and impressive, 14 patients developed in-stent or in-segment restenosis, requiring repeated interventions in 13. CONCLUSIONS: Percutaneous intervention produces rapid and dramatic symptom relief in patients with highly symptomatic PV stenosis after radiofrequency ablation for AF. Nevertheless, alternative treatment methods will be required to decrease recurrent in-stent or in-segment restenosis.

Adult↗
PubMed2005

CT evaluation of left atrial pulmonary venous anatomy.

Multidetector CT (MDCT) visualization of the left atrial pulmonary venous anatomy is becoming increasingly requested prior to radiofrequencey catheter ablation (RFCA) procedures for refractory cardiac arrhythmias. MDCT imaging can define left atrial anatomy including atrial size and venous attachments as well identify complications such as stenoses, dissections or perforations. Proper understanding enables the cardiac imager to be knowledgeable so as to obtain the specific information needed for the interventional cardiologist. This paper reviews the left atrial venous anatomy, the clinical aspects of refractory atrial fibrillation, MDCT imaging protocols, procedural aspects of the ablation, and complications should they arise.

Arrhythmias, Cardiac↗
PubMed2005

Atypical presentation of eosinophilic endomyocardial disease.

Idiopathic hypereosinophllic syndrome is classically defined as prolonged, unexplained peripheral eosinophilia in a patient presenting with evidence of end-organ damage. The heart is frequently Involved, resulting In eosinophilic endomyocardial disease and eventually restrictive cardlomyopathy. The mortality rate is high because of progressive heart failure or ventricular arrhythmias. We describe a patient who presented with a left ventricular apical thrombus without notable peripheral eosinophilia. Findings from clinical evaluation and extensive diagnostic testing, including right ventricular biopsy, were Inconclusive. Resection of the thrombus and subjacent endomyocardium revealed eosinophilic Infiltration of the endomyocardium, which led to the diagnosis of eosinophilic endomyocardial disease. Clinicians should be aware of the variable presentation of patients with eosinophil-associated endomyocardial disease so that affected patients may benefit from early diagnosis and treatment.

Aged↗
PubMed2004

Evaluation and clinical implications of aortic valve calcification measured by electron-beam computed tomography.

BACKGROUND: Electron-beam computed tomography (EBCT) is used to measure coronary calcification but not for aortic valve calcification (AVC). Its accuracy, association with aortic stenosis (AS) severity, and diagnostic and prognostic value with respect to AVC are unknown. METHODS AND RESULTS: In 30 explanted aortic valves, the AVC score by EBCT (1125+/-1294 Agatston units [AU]) showed a strong linear correlation (r=0.96, P<0.0001) with valvular calcium weight (653+/-748 mg) by pathology that allowed estimation of calcium weight as AVC score/1.7, with a small standard error of the estimate (53 mg). In 100 consecutive clinical patients, we measured AVC by EBCT and AS severity by echocardiographic aortic valve area (AVA). The AVC score was 1316+/-1749 AU (range 0 to 7226 AU). Intraobserver and interobserver variabilities were excellent (4+/-4% and 4+/-10%, respectively). AVC and AVA were strongly associated (r=0.79, P<0.0001) but had a curvilinear relationship that suggested that AVC and AVA provide complementary information. AVC score > or =1100 AU provided 93% sensitivity and 82% specificity for diagnosis of severe AS (AVA <1 cm2), with a receiver operator characteristic curve area of 0.89. AVC assessment by echocardiography was often more severe than by EBCT (P<0.0001). During follow-up, 22 patients either died, developed heart failure, or required surgery. With adjustment for age, sex, symptoms, ejection fraction, and AVA, the AVC score was independently predictive of event-free survival (risk ratio 1.06 per 100-AU increment [1.02 to 1.10], P<0.001), even after adjustment for echocardiographic calcifications. CONCLUSIONS: AVC is accurately and reproducibly measured by EBCT and shows a strong association and diagnostic value for severe AS. The curvilinear relationship between AVC and AVA suggests these measures are complementary, and indeed, AVC provides independent outcome information. Thus, AVC is an important measurement in the evaluation of patients with AS.

Aortic Valve↗
PubMed2004

Comparison of acute and chronic antioxidant interventions in experimental renovascular disease.

Reactive oxygen species (ROS) can modulate renal hemodynamics and function both directly, by leading to vasoconstriction, and indirectly, by inducing renal inflammation and tissue growth. The involvement of oxidative stress in the pathogenesis of renovascular disease (RVD) is increasingly recognized, but the relative contribution of long-term tissue injury to renal dysfunction remains unclear. We hypothesized that functional and structural alterations elicited by oxidative stress in RVD would be more effectively modulated by chronic than by acute antioxidant intervention. Renal hemodynamics and function were quantified in vivo in pigs using electron-beam computed tomography at baseline and after vasoactive challenge (ACh and sodium nitroprusside); after 12 wk of RVD (simulated by concurrent hypercholesterolemia and renal artery stenosis, n = 7); RVD acutely infused with the SOD-mimetic tempol (RVD+tempol, n = 7); RVD chronically supplemented with antioxidant vitamins C (1 g) and E (100 IU/kg; RVD+vitamins, n = 7); or control (normal, n = 7). Renal tissue was studied ex vivo using immunoblotting and immunohistochemistry. Basal renal blood flow (RBF) and glomerular filtration rate were similarly decreased in all RVD groups. ACh-stimulated RBF remained unchanged in RVD, increased in RVD+tempol, but further increased (similarly to normal) in RVD+vitamins (P < 0.05 vs. RVD). Furthermore, RVD+vitamins also showed a decreased presence of superoxide anion, decreased NAD(P)H-oxidase and nitrotyrosine expression, increased endothelial nitric oxide synthase expression, and attenuated renal fibrosis. Chronic antioxidant intervention in early RVD improved renal hemodynamic responses more effectively than acute intervention, likely due to increased nitric oxide bioavailability and decreased structural injury. These suggest that chronic tissue changes play an important role in renal compromise mediated by oxidative stress in RVD.

Acetylcholine↗
PubMed2004

Long-term antioxidant intervention improves myocardial microvascular function in experimental hypertension.

Hypertension increases oxidative stress, which can impair myocardial microvascular function and integrity. However, it is yet unclear whether long-term antioxidant intervention in early hypertension would preserve myocardial perfusion and vascular permeability responses to challenge. Pigs were studied after 12 weeks of renovascular hypertension without (n=8) or with daily supplementation of antioxidants (100 IU/kg vitamin E and 1 g vitamin C, n=6), and compared with normal controls (n=7). Myocardial perfusion and microvascular permeability were measured in vivo by electron beam computed tomography before and after 2 cardiac challenges (intravenous adenosine and dobutamine). Basal left ventricular muscle mass was also obtained. Mean arterial pressure was significantly increased in both groups of hypertensive animals (without and with antioxidants, 123+/-9 and 126+/-4 mm Hg, respectively, versus normal, 101+/-4 mm Hg; both P<0.05), but muscle mass was not different among the groups. The impaired myocardial perfusion response to adenosine observed in hypertensives (normal, +51+/-14%; P<0.05 versus baseline; hypertension, +14+/-15%; P=0.3 versus baseline) was preserved in hypertensive pigs that received antioxidants (+44+/-15%; P=0.01 compared with baseline). Long-term antioxidant intervention also preserved subendocardial microvascular permeability responses in hypertension. On the other hand, antioxidant intervention had little effect on the hypertension-induced myocardial vascular dysfunction observed in response to dobutamine. This study demonstrates that the impaired myocardial perfusion and permeability responses to increased cardiac demand in early hypertension are significantly improved by long-term antioxidant intervention. These results support the involvement of oxidative stress in myocardial vascular dysfunction in hypertension and suggest a role for antioxidant strategies to preserve the myocardial microvasculature.

Animals↗
PubMed2004

Statistical assessment of regional time-density measurement of myocardial perfusion.

RATIONALE AND OBJECTIVES: The measurement of time-density relationships of the myocardium in studies of magnetic resonance perfusion images is a clinical technique used in assessing myocardial perfusion. This article presents a new technique, allowing regional time-density measurement and display of myocardial perfusion with improved accuracy compared with traditional manual trace techniques. Moreover, a method using statistical methods to discriminate relative decreased perfusion regions that differ significantly from the normally perfused myocardial tissue is introduced. MATERIALS AND METHODS: Human datasets were obtained using a 1.5 T Signa Echospeed system (GE Medical Systems, Milwaukee, WI). The perfusion sequence was a 2D cardiac-gated fast gradient echo sequence with echo train readout, generating an in-plane pixel size of 1.46 mm2. Seven 10-mm-thick contiguous short axis tomographic slice images were obtained during a prolonged single breathhold. Data was collected at 30 time phases per slice image level during passage of 20 cc gadolinium contrast injected at a rate of 4-5 cc/sec into an antecubital vein. RESULTS: Dilution properties can be determined and displayed as color-encoded regions superimposed on the myocardial slice according to the area of interest. Time-density curves throughout the perfusion study can be generated. Moreover, displays of normal and decreased perfusion areas can be used as statistically enhanced diagnosis guides. CONCLUSION: This measurement, display, and diagnosis technique adds diagnostically important information to previous measurement and visualization techniques, providing enhanced detection and quantitative evaluation of regional deficits in myocardial contractility and perfusion, providing improved reliability and reproducibility of clinical diagnoses from MR-perfusion data.

Analysis of Variance↗
PubMed2003

Clinical safety of magnetic resonance imaging early after coronary artery stent placement.

OBJECTIVES: Our aim was to examine the rate of adverse cardiac events in patients undergoing magnetic resonance imaging (MRI) <8 weeks after coronary stent placement. BACKGROUND: The risk of coronary stent thrombosis from dislodgement due to MRI early after stent placement is not well defined. Manufacturers recommend postponing MRI studies until eight weeks after coronary stent placement. METHODS: We analyzed the Mayo Clinic Rochester Percutaneous Coronary Intervention Database and examined records of 111 patients who underwent MRI <8 weeks after coronary stent placement treated with aspirin and a thienopyridine. Occurrence of death, myocardial infarction (MI), and repeat revascularization within 30 days of MRI were recorded. RESULTS: Magnetic resonance imaging (1.5 tesla) was performed within a median of 18 days (range, 0 to 54 days) after coronary stent placement. Four noncardiac deaths occurred, and three patients had repeat revascularization procedures. Stent thrombosis did not occur (95% confidence interval, 0% to 3.3%). CONCLUSIONS: Magnetic resonance imaging <8 weeks after coronary stent placement appears to be safe, and the risk of cardiac death or MI due to stent thrombosis is low. Postponing MRI does not appear to be necessary.

Aged↗
PubMed2003

Constrictive pericarditis in 26 patients with histologically normal pericardial thickness.

BACKGROUND: Traditionally, increased pericardial thickness has been considered an essential diagnostic feature of constrictive pericarditis. Although constriction with a normal-thickness pericardium has been demonstrated clinically by noninvasive imaging, the details of clinicopathological correlates have not been described. METHODS AND RESULTS: A total of 143 patients with proven constriction underwent pericardiectomy at Mayo Clinic between 1993 and 1999. Their baseline characteristics, operative data, and pathological specimens were reviewed retrospectively. The pericardium was of normal thickness (< or =2 mm) in 26 patients (18%; group 1) and was thickened (>2 mm) in 117 (82%; group 2). The most common causes of constriction in group 1 included previous cardiac surgery, chest irradiation, previous infarction, and idiopathic disease. There was little difference in symptoms and findings on physical examination between the 2 groups. Microscopically, no patient had an entirely normal pericardium. Histopathological abnormalities in group 1 were mild and focal, including fibrosis, inflammation, calcification, fibrin deposition, and focal noncaseating granulomas. Pericardiectomy was equally effective in relieving symptoms regardless of the presence or absence of increased thickness. CONCLUSIONS: Pericardial thickness was not increased in 18% of patients with surgically proven constrictive pericarditis, although the histopathological appearance was focally abnormal in all cases. When clinical, echocardiographic, or invasive hemodynamic features indicate constriction in patients with heart failure, pericardiectomy should not be denied on the basis of normal thickness as demonstrated by noninvasive imaging.

Adult↗
PubMed2003

Renal artery stent placement: complications at a single tertiary care center.

PURPOSE: To describe complications after renal artery stent placement in patients with atherosclerotic renal artery stenosis (RAS) at a single tertiary care center and analyze the risk factors for these complications. MATERIALS AND METHODS: Medical records and angiograms of 171 patients who underwent a total of 179 consecutive percutaneous transluminal renal artery stent placement (PTRS) procedures for atherosclerotic RAS were retrospectively reviewed. Data on patient comorbidities, procedure indication, lesion location, serum creatinine level, and procedure-related complications were analyzed. The Wilcoxon rank-sum test was used to assess the association of continuous risk factors with complications, and the chi(2) test was used to assess the association of categoric risk factors with outcomes. RESULTS: The technical success rate for PTRS was 98%. Major complications included renal infarction in five patients (2.8%), permanently increased serum creatinine level in 10 patients (5.6%) that required hemodialysis in five (2.8%), blood transfusion in four patients (2.2%), surgical intervention for procedure-related complications in two patients (1.1%), and deep vein thrombosis in one patient (0.6%). Overall, major complications occurred in 15 procedures (8.4%). Death within 30 days after PTRS occurred in two patients (1.1%), but neither death was definitively caused by the procedure. No risk factors were found to be significantly (P <.05) associated with major complications. Patients with renal artery site or renal function complications tended to be older (P =.01) and have higher creatinine levels (P =.06). CONCLUSIONS: Renal artery stent placement allows treatment of advanced atheromatous RAS in patients with significant medical and surgical comorbidities. Complications are frequent but few have long-term significance.

Aged↗
PubMed2002

Incidental renal artery stenosis among a prospective cohort of hypertensive patients undergoing coronary angiography.

OBJECTIVE: To determine the feasibility, safety, and clinical yield of angiographic screening among hypertensive patients undergoing coronary angiography. PATIENTS AND METHODS: This study was a prospective cohort analysis of hypertensive patients who underwent cardiac catheterization at a tertiary care referral center from July 1998 to March 1999. Abdominal aortography was performed to screen for renal artery stenosis, the percentage of which was measured. RESULTS: The mean +/- SD age of the 297 study patients was 64.9+/-10.2 years; 58.6% were male, and 98.0% were white. Mean +/- SD systolic/diastolic blood pressure was 142.8+/-22.5/79.6+/-11.4 mm Hg. Aortography required a mean incremental dose of 62+/-9 mL of nonionic contrast agent. No complications were attributable to aortography. Of 680 renal arteries, 611 (90%) were visualized adequately. Also, 53% of patients had normal renal arteries, 28% had stenoses less than 50%, and 19.2% had stenoses of 50% or more. Renal artery stenosis was bilateral in 3.7% of patients and high grade (>70% stenosis) in 7%. Patients with renal artery stenosis were more likely to have had a previous coronary intervention. In multivariate analysis, systolic blood pressure (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.03-138; P=.02), history of stroke or transient ischemic attack (OR, 2.7; 95% CI, 1.27-5.78; P=.01), and cancer (OR, 2.0; 95% CI, 1.02-3.82; P=.04) independently correlated with renal artery stenosis of 50% or more. CONCLUSION: The prevalence of incidental renal artery stenosis among hypertensive patients undergoing coronary catheterization is significant. Therefore, screening abdominal aortography should be considered in these patients to better define their risk of cardiovascular complications.

Aortography↗
PubMedDate not supplied

Operator-interactive method for simultaneous measurement of left and right ventricular volumes and ejection fraction by tomographic electrocardiography-gated blood pool radionuclide ventriculography.

BACKGROUND: A method that uses single photon emission computed tomography (SPECT) equilibrium radionuclide angiocardiography (ERNA) to measure right ventricular (RV) and left ventricular (LV) volumes (in milliliters) and ejection fraction (EF) is described. METHODS AND RESULTS: We recorded 35 paired SPECT ERNA and electron beam computed tomography (EBCT) cardiac studies in 27 patients; for comparison with EBCT, a method for measurement of RV and LV volumes and EF with SPECT ERNA was developed in 18 paired studies and was validated and assessed for reproducibility in 17. Validation indicated that SPECT ERNA and EBCT were similar for measurement of RV volume (end-systolic and end-diastolic volumes in a combined analysis) and EF (180+/-74 mL vs 182+/-80 mL and 0.44+/-0.11 vs 0.43+/-0.11, respectively) and for measurement of LV volume and EF (88+/-36 mL vs 84+/-43 mL and 0.53+/-0.081 vs 0.59+/-0.07, respectively). The SPECT ERNA method was quite reproducible. CONCLUSIONS: RV and LV volumes and EF can be measured readily via SPECT ERNA.

Algorithms↗