The use of technetium-99m hexamethylpropylene amine oxime labelled white blood cells to detect subclinical inflammation of the heart after cardiopulmonary bypass in children with congenital heart disease.
Ten children (6 boys and 4 girls, aged 1-9 years old) underwent operations with a cardiopulmonary bypass, and the technetium-99m hexamethylpropylene amine oxine (99mTc-HMPAO) labelled white blood cell (WBC) heart scans were used to detect postoperative leukocyte infiltration in the hearts. The results showed that 80% (8/10) of the cases had subclinical inflammation in the hearts (grading of WBC scans > or = score 2), and a positive correlation (R = 0.77) was noted between the severity of the inflammation (grading of the WBC scans) and the duration of the cardiopulmonary bypass in the operations. Another control group (9 boys and 2 girls, aged 2-13 years old) underwent operations without a cardiopulmonary bypass, and subclinical inflammation of hearts was demonstrated in only 1 case (9%) by the 99mTc-HMPAO labelled WBC scans (grading of WBC scans < score 2) after the operations. There was a significant difference (P < 0.001, by a Wilcoxon rank sum test) based upon the severity of the ischaemic heart damage in the two groups. In our preliminary conclusions, the 99mTc-HMPAO labelled WBC heart scans may provide non-invasive and directly discernible evidence of subclinical inflammation in the heart due to a transient ischaemic state during a cardiopulmonary bypass, even if the clinical symptoms and signs of carditis are not apparent.
Kao
C H
CH
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China.
Hsieh
K S
KS
Wang
Y L
YL
Wang
S J
SJ
D002315:Cardiopulmonary Bypass; D002648:Child; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007962:Leukocytes; D008297:Male; D015428:Myocardial Reperfusion Injury / Q000000981:diagnostic imaging*; D009205:Myocarditis / Q000000981:diagnostic imaging*; D015609:Organotechnetium Compounds; D010091:Oximes; D011877:Radionuclide Imaging; D019690:Technetium Tc 99m Exametazime
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime