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M Fraile

Publications and source records attributed to M Fraile.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Diagnosis of coronary disease by means of stress gamma-tomography with 99m-technetium-isonitriles].

BACKGROUND: To assess the yield of exercise myocardial stress tomogammagraphy (SPET) with methoxy-isobutyl-isonitrile-technetium-99m (99mTc-MIBI) in the diagnosis of coronary artery disease. METHODS: Seventy-two consecutive patients, without previous myocardial infarction and with coronary angiography, were investigated. All underwent a symptom-limited exercise test with intravenous infection of 15 mCi of 99mTc-MIBI 30-60 seconds before the end of exercise. Detection of tomographic images was performed after one hour. Rest images were detected 24 hours later. Images with exercise perfusion defects which became normal at rest were considered as positive. RESULTS: Sensitivity (84%), specificity (93%), global value (87%), positive predictive value (95%), and negative predictive value (79%) of 99mTc-MIBI were significantly higher than those of conventional exercise electrocardiogram (46%, 69%, 55%, 69% and 46%, respectively). These values were lower when exercise test was insufficient (peak heart rate below 80% in the absence of angina). The sensitivity values were similar for the diagnosis of one (81%), two (76%), and three (93%) vessel disease. The application of Bayes' theorem disclosed that the highest yield of MIBI was achieved with prevalences ranging between 30% and 70%. CONCLUSION: The efficacy of 99mTc-MIBI SPET for the diagnosis of coronary artery disease was satisfactory, particularly when exercise was sufficient and with a prevalence of coronary artery disease ranging between 30% and 70%.

Coronary Disease↗
PubMed1995

[Myocardial contractility and viability. A radionuclide tomography study using technetium-99m labeled isonitriles].

BACKGROUND: There are comparatively few studies evaluating the patterns of myocardial viability and its relation with contractility in patients with coronary artery disease. The aim of the present study was to quantify the viable and nonviable myocardium, using 99m-technetium isonitriles SPET, as related with left ventricular regional wall motion abnormalities. METHOD: 61 consecutive patients with coronary artery disease were investigated. The severity and extension of the defects were evaluated using a qualitative and quantitative analysis of the 99mTc-isonitriles SPET and compared with ventricular wall motion in contrast ventriculography. An uptake level of 40% of peak uptake or higher was considered as indicating viable myocardium. RESULTS: Of the 244 evaluated regions (4 per patient), 72 (29%) had normal perfusion, 100 (41%) were ischemic, 25 (10%) had a mild irreversible defect and 47 (19%) had a severe irreversible defect. Wall motion was normal in 176 regions (72%), 29 (12%) were hypokinetic, and 39 (16%) were akinetic of dyskinetic. The amount of viable myocardium in akinetic and dyskinetic regions (64.8%) was significantly different (p < 0.05) from that in hypokinetic (86.1%) and normokinetic (98.8%) regions. Visual assessment of uptake underestimated myocardial viability, as quantitative analysis disclosed that in 61% of akinetic and dyskinetic regions with severe irreversible defects there was more than 50% of viable myocardium. CONCLUSIONS: In 61% of akinetic and dyskinetic regions with a severe irreversible defect in perfusion scintigraphy positive viability criteria were found. Therefore, visual assessment of the myocardial perfusion studies using 99mTc-MIBI SPET underestimates viable myocardium. Tomographic studies with quantification of the uptake and defect extension are required for a proper evaluation of viable myocardium.

Adult↗
PubMed1994

[Isotopic renogram after captopril administration: clinical experience in the assessment of the hypertensive patient].

BACKGROUND: Isotopic renogram allows renal function to be estimated in both kidneys independently. The glomerular filtrate in ischemic kidneys is largely dependent on the tone of the efferent glomerular arteriolae and therefore on the concentration of circulating angiotensin II. METHODS: In 42 patients with severe high blood pressure in whom renal angiographic study was carried out for suspicion of vasculo-renal hypertension, an isotopic renogram using 99m Tc-DTPA as a tracer was performed in basal conditions and following the administration of 50 mg of oral captopril. RESULTS: In 21 patients both the angiographic examination and the post-captopril renogram were normal. In 16 patients in whom uni or bilateral stenosis higher than 50% of the lumen of renal artery was observed on angiographic examination, the post-captopril renogram showed changes. In 5 patients the angiography was normal while the renogram showed evaluable changes. No false negatives were observed in the post-captopril renogram, however the basal renogram was not demonstrative in 6 patients with stenosis of the renal artery. Sensitivity of the test was thus 100% and specificity 80%. The positive predictive value was 76% and the negative predictive value 100%. CONCLUSIONS: The post-captopril renogram may be a useful test in the functional study of renal behaviour in patients with vasculo-renal hypertension.

Adolescent↗
PubMed1994

Pericardial and myocardial localization of antimyosin in a case of acute myocarditis.

A 60-yr-old immunodepressed woman presented with acute perimyocarditis and cardiac tamponade complicating meningococcic infection. We had the opportunity to study her cardiac condition by injecting antimyosin during the acute phase. Images at 48 hr showed unexpected findings, with obvious localization of the tracer in the pericardial fluid, as well as myocardial uptake. Possible mechanisms for pericardial activity are discussed.

Antibodies, Monoclonal↗
PubMed1994

[An evolutionary study at 5 years of left ventricular systolic function in patients with an uncomplicated infarct].

INTRODUCTION AND OBJECTIVES: The aim of the present study was to compare the left ventricular ejection fraction in a first uncomplicated acute myocardial infarction before hospital discharge (initial ejection fraction) and 5 years later (late ejection fraction) and to evaluate the factors that may influence their possible changes. PATIENTS AND METHODS: Eighty-three patients (mean age: 52.2 +/- 7.5, range: 35-65 years) who had a first uncomplicated infarction were evaluated. Between 10 and 15 days after the acute episode, thallium perfusion scintigraphy, radionuclide ventriculography and coronary arteriography were carried out. The ventricular function was reevaluated after 5 years with radionuclide ventriculography. The population was classified according to the localization of infarction (anterior or inferior) and to the initial ejection fraction (< 30%, 30-50% and > 50%). The factors derived from predischarge exercise test, perfusion scintigraphy, radionuclide ventriculography and coronary arteriography that might have had an influence on ejection fraction changes were evaluated with bivariate and multivariate analysis. RESULTS: 1) left ventricular ejection fraction of anterior infarctions was lower than in inferior infarctions, both during the subacute phase (35.1 +/- 12.9 vs 48.1 +/- 12.1; p < 0.001) and after 5 years (41.3 +/- 15.1 vs 47.6 +/- 12.8; p = 0.006); 2) a significant increase in ejection fraction after 5 years was found in patients with anterior infarction (35.1 +/- 12.9 vs 41.3 +/- 15.1; p < 0.001), particularly in those with initial ejection fraction between 30-50% (38.8 +/- 5.9 vs 44.8 +/- 11.2; p < 0.001), and 3) no variable, either clinical or derived from exercise test, perfusion scintigraphy, radionuclide ventriculography or coronary arteriography, discriminated between the patients in whom ejection fraction decreased by more than 5% during follow-up nor those with anterior infarction and initial ejection fraction between 30-50% in whom ventricular function was improved after 5 years. CONCLUSIONS: Left ventricular ejection fraction of anterior infarctions shows a significant improvement after 5 years, particularly in the subgroups with initial ejection fraction between 30-50%. Predictive factors of such improvement have not been identified.

Adult↗
PubMed1992

Simultaneous multiple intracranial and spinal meningiomas.

We report on the case of a 50-year old woman with two intracranial meningiomas and two spinal ones. All were diagnosed at the same time and there were no signs of neurofibromatosis. Multiple meningiomas in different neural spaces are extremely rare, and even rarer is the simultaneous diagnosis of separate coincident lesions. The literature in this regard is reviewed.

Brain Neoplasms↗
PubMed1989

Transplant renography: 99m-Tc-DTPA versus 99m-Tc-MAG3. A preliminary note.

99mTc-MAG3 has been proposed as a replacement for both 131I-hippuran and 99mTc-DTPA on clinical grounds. We undertook a prospective preliminary study to ascertain whether 99mTc-MAG3 works better than 99mTc-DTPA in the follow up of renal transplant recipients. Seventeen patients (21 renograms each MAG3 and DTPA) were studied, together, with a reference group of 10 patients in whom MAG3 and Hippuran clearance rates were determined simultaneously. As expected, 99mTc-MAG3 analog images were excellent and 99mTcMAG3 clearance correlated very well with 131I-hippuran clearance (r = 0.978). MAG3 values were 60% of hippuran values. However, when the corresponding renographic and perfusion findings were faced with different diagnostic challenges, such as post transplant renal failure and rejection, 99mTc MAG3 did not differ from 99mTc-DTPA in a significant way. 99mTc-DTPA was superior to 99mtc-MAG3 in one case of rejection.

Adult↗