Monitoring the effect of anticoagulants on left atrial thrombi in patients with rheumatic heart disease: assessment with 111In-oxine-labelled platelet heart scintigraphy and transoesophageal echocardiography.
111In-oxine-labelled platelet heart scintigraphy (In-plt) was used to evaluate the activity of left atrial thrombi detected by transoesophageal echocardiography (TEE) in 16 cases of rheumatic heart disease. The effect of anticoagulants on the therapeutic intervention of these patients was evaluated by In-plt and TEE. In-plt was performed in all patients in serial pre- and post-anticoagulant therapy studies with anterior, 45 degrees left anterior oblique and left lateral views taken daily from the second to sixth day after injection of labelled platelets. After discontinuing anticoagulants for at least 1 week, only nine cases of left atrial thrombi were detected among the 16 cases by initial In-plt. After anticoagulants were again used for at least 3 weeks, all nine positive cases became negative on repeat In-plt. These results suggest that the diagnostic sensitivity of In-plt is lower than that of TEE. However, In-plt is more suitable and useful for evaluating the activity of left atrial thrombi after antithrombotic agent therapy and for monitoring the effect of anticoagulant therapy on left atrial thrombi in patients with rheumatic heart disease.
Sun
S S
SS
Department of Nuclear Medicine, China Medical College Hospital, Taichung, Taiwan, Republic of China.
Hsieh
J F
JF
Tsai
S C
SC
Ho
Y J
YJ
Lee
J K
JK
Kao
C H
CH
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology*; D016279:Atrial Function, Left; D001792:Blood Platelets / Q000000981:diagnostic imaging; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D015125:Oxyquinoline / Q000031:analogs & derivatives*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging*
D000925:Anticoagulants; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C032950:indium oxine; D015125:Oxyquinoline