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Study objective: The purpose of this study was to evaluate the effect of thermistor position with varying injectate temperatures on the reproducibility of thermodilution cardiac output determination. The key hypothesis [...]

Silent ischemia is an episode of decreased blood flow to the heart that is not accompanied by symptoms. These episodes are indicative of future risks for heart problems, including myocardial infarction (heart attack). The functioning of the left ventricle, which pumps blood from the heart to the body, can be monitored by using a radionuclide device known as the VEST. This device monitors radioactive materials in the blood as a means of measuring left ventricular (LV) ejection fraction, or the percent of the volume of blood that is pumped from the LV at the end of a contraction. The technique is thought to be a sensitive means for detecting silent ischemia and identifying individuals who are at high risk for more serious heart problems. Balloon angioplasty is a technique for increasing the diameter of narrowed or blocked artery. A balloon-tipped catheter is inserted into the constricted vessel and the balloon is inflated. When used on coronary arteries, this technique results in transient (brief) ischemia and LV dysfunction because the inflated balloon temporarily blocks the flow of blood in the diseased vessel. This study examined the effectiveness of the VEST in detecting silent ischemia in 12 patients undergoing balloon angioplasty. A total of 18 inflations were monitored. The VEST detected significant decreases in LV ejection fraction in 17 of 18 inflations. Symptoms occurred during 10 of the 18 balloon inflations. These results indicate that the VEST can continuously monitor LV function and may be useful in detecting silent ischemia. (Consumer Summary produced by Reliance Medical Information, Inc.)

This ambitious text attempts to review the current status and future directions of interventional cardiology. The field of interventional cardiology began slightly more than 10 years ago when Dr. Andreas [...]