Use of ^99mTc-HMPAO in Evaluating the Results of Cerebral Hypoperfusion Prevention in the Patients with Coronary Heart Disease after Coronary Artery Bypass Grafting

Abstract:

The purpose of this study is to research the use of the radiopharmaceutical ^99mTc-HMPAO in the evaluation of drug prevention of cerebral complications in patients with coronary heart disease after coronary artery bypass grafting (CABG) performed with cardiopulmonary bypass (CPB). The study included 30 patients, in whom surgical revascularization was performed with CPB. 11 patients in this group were prescribed instenon. All the patients underwent brain tomoscintigraphy with ^99mTc-HMPAO and neuropsychological testing before CABG and 10-15 days after it. The results showed that ^99mTc-HMPAO is useful radiopharmaceutical for evaluation of cerebral complications in patients after CABG. Thus, coronary artery bypass grafting using CPB can be complicated by the deterioration of cerebral perfusion and cognitive dysfunction, while preventive medication with instenon can prevent or significantly reduce the violations of cerebral hemodynamics and neuropsychological status of the patients.

• Periodical: Advanced Materials Research (Volume 1084)
• Pages: 506-510
• DOI: https://doi.org/10.4028/www.scientific.net/AMR.1084.506
• Online since: January 2015
• Authors: Nataliya Yu. Efimova*, Vladimir I. Chernov, Irina Yu. Efimova, Shamil Akhmedov, Yuri B. Lishmanov
• Keywords: ^99mTc-HMPAO, Cerebral Perfusion, Cognitive Dysfunction, Coronary Artery Bypass Grafting, Single Photon Emission Computed Tomography (SPECT)

References

[1] J.M. Murkin, J.S. Marizke, A.M. Buchan, C. Bentley, C.J. Wong, A randomised study of the influence of perfusion technique and pH management strategy in 316 patients undergoing coronary bypass surgery, J. Thorac Cardiovasc Surg. 110 (1995) 349-362.

DOI: 10.1016/s0022-5223(95)70230-x

[2] R.A. Hall, D.J. Fordyce, M.E. Lee, B. Eisenberg, R.F. Lee, J.H. 4th Holmes, W.G. Campbell, Brain SPECT imaging and neuropsychological testing in coronary artery bypass patients, J. Ann. Thorac. Surg. 68 (1999) 2082-(2088).

DOI: 10.1016/s0003-4975(99)01213-8

[3] N.A. Lassen, A.R. Andersen, L. Fribrg, O.B. Paulson, The Retention of [99m-Tc]-d, l, -HMPAO in the Human Brain after Intracarotid Bolus injection: A Kinetic Analysis, J. Cerebral Blood Flow & Metab. 8 (1988) 13-22.

DOI: 10.1038/jcbfm.1988.28

[4] Y. Yonekura, S. Nishizawa, T. Mukai, SPECT with 99m-Tc- d, l –hexamethyl propylene amine oxime (HM-PAO) compared with regional cerebral blood flow measured by PET. Effects of linearization, J. Cerebral Blood Flow & Metab. 8 (1988) 82-89.

DOI: 10.1038/jcbfm.1988.36

[5] A.R. Luriya, The higher cortical functions of a human being and their disorders in local brain injuries, Moscow State University Publ., Moscow, (1969).

[6] D. Wechsler, Wechsler Memory Scale-Revised. Manual. Psychological Corporation, New York, (1987).

[7] D. Barbut, F.S. Yao, O.N. Hager, P. Kavanaugh, R.R. Trifiletti, J.P. Gold, Comparison of transcranial Doppler ultrasonography and transesophageal echocardiography to monitor emboli during coronary artery bypass surgery, J. Stroke 27(1996) 87-90.

DOI: 10.1161/01.str.27.1.87

[8] T. Pederson, K. Hatteland, B.K. Semb, Bubble extraction by various arterial-filters measured in vitro with Doppler ultrasound techniques, J. Ultrasound Med Biol. 8 (1982) 77-81.

DOI: 10.1016/0301-5629(82)90070-9

[9] D.A. Stump, A.T. Roger, J.W. Hammon, S.P. Newman, Cerebral emboli and cognitive outcome after cardiac surgery, J Cardiovasc. Vasc. Anesth. 1 (1996) 113-119.

DOI: 10.1016/s1053-0770(96)80186-8

[10] W. Pugsley, Assessment of microembolic load during cardiopulmonary bypass by transcranial Doppler techniques. In: Smith P, Taylor K (Eds), Cardiac surgery and the brain. Edward Arnold, London, 1993, pp.159-164.

[11] W Harringer. Capture of particulate emboli during cardiac procedures in which aortic cross-clamp is used, J. Ann Thorac Surg. 70 (2000) 1119-1123.

DOI: 10.1016/s0003-4975(00)01760-4

[12] В. Saletu, J. Grunberger, Progr. Neuro-Psychopharmacol. 2 (1978) 543-551.