Clinical Application and Results of the Assessment of Coronary Blood Flow by the Regional Precordial Xenon Residue Detection Technique

Methodological and technical aspects as well as application and results of the precordial Xenon-residue-detection technique are critically reviewed. The results concern mainly normal flow in various regions of the heart esp. in the free wall of the right and left ventricle, poststenotic flow in patients with coronary artery disease in relation to the degree of proximal nar-rowings as well as wall motion of the corresponding LV segment, bypassgraft flow and flow after drug interventions esp. nitrates, betablockers, the calcium-antagonist Nifedipine and the coronary dilator Dipyridamole. In spite of its serious limitations (high affinity of Xenon for fatty tissue, geometrical problems in the assessment of flow and its relation to anatomy, gas exchange in situations of high flow etc.), the technique is found to be a usefull investigatory tool. Due to its technical display and the related high costs routine application is, however, prohibitive.

Die Methodologie, praktische Durchführung sowie die Resultate der präkordialen Xenon Clearance Technik werden kritisch beschrieben und bewertet. Die Resultate betreffen vor allem den Fluß in den verschiedenen normalen Gebieten des Herzens, in der freien Wand des rechten und linken Ventrikels, den Fluß in den poststenotischen Gebieten bei Patienten mit koronarer Herzkrankheit in Relation zum Stenosegrad und der Reduktion der LV Wandbewegung im betreffenden Areal, den Fluß im aorto-koronaren Bypass-Graft sowie nach Medikation, insbesondere nach Verabreichung von Nitraten, Betablockern, dem Calciumantagonisten Nifedipine, und dem Koronardilatatoren Dipyridamol. Trotz der erheblichen theoretischen und praktischen Einschränkungen der Technik (hohe Affinität des Xenons zum Fettgewebe, geometrische Probleme in Relation zur Anatomie, Gasaustausch bei hohen Flußwerten etc.) hat sich die Technik in der klinischen Forschung der koronaren Herzkrankheit bewährt. Ihr relativ großer technischer Aufwand und die damit verbundenen Kosten lassen sie aber nicht zur Routinemethode werden.

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