PMID: 9443728Jan 27, 1998Paper

Arteriovenous shunting in patients with multiple myeloma and high-output failure

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
S InanirM Unlü

Abstract

High-output cardiac failure is one of the cardiovascular problems associated with multiple myeloma and frequently seen in patients with extensive bone lesions. The purpose of this study was to search arteriovenous shunting in patients with multiple myeloma and cardiac failure. After the exclusion of other causes of congestive heart failure, 11 patients whose cardiac indices were higher than or equal to 4 liter/min/m2 were selected for the study (7 women, 4 men; mean age 59.64 +/- 8.92 yr). All patients had Stage II-III disease and femoral involvement in radiological examination. Arteriovenous shunting was determined by means of intra-arterial injection technique of 99mTc-macroaggregated albumin (MAA) particles. A quantitative analysis of all scans was performed, and the results were correlated with cardiac index. Mean cardiac index was 4.33 +/- 0.36 liter/min/m2 in the study group. In all cases, arteriovenous shunting was detected (18.70% +/- 17.29%), and inhomogenous, increased radioactivity accumulation was revealed in the femoral region (lesion-to-background ratio 2.71 +/- 2.08). This zone corresponded to the area of infiltration in a radiograph. A significant correlation was found between shunting values and cardiac indices...Continue Reading

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