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Myocardial perfusion imaging

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https://www.readbyqxmd.com/read/28549119/systematic-review-of-cost-effectiveness-of-myocardial-perfusion-scintigraphy-in-patients-with-ischaemic-heart-disease-a-report-from-the-cardiovascular-committee-of-the-european-association-of-nuclear-medicine-endorsed-by-the-european-association-of-cardiovascular
#1
Elin Trägårdh, Siok Swan Tan, Jan Bucerius, Alessia Gimelli, Oliver Gaemperli, Oliver Lindner, Denis Agostini, Christopher Übleis, Roberto Sciagrà, Riemer H Slart, S Richard Underwood, Fabien Hyafil, Marcus Hacker, Hein J Verberne
Coronary artery disease (CAD) is a major cause of death and disability. Several diagnostic tests, such as myocardial perfusion scintigraphy (MPS), are accurate for the detection of CAD, as well as having prognostic value for the prediction of cardiovascular events. Nevertheless, the diagnostic and prognostic value of these tests should be cost-effective and should lead to improved clinical outcome. We have reviewed the literature on the cost-effectiveness of MPS in different circumstances: (i) the diagnosis and management of CAD; (ii) comparison with exercise electrocardiography (ECG) and other imaging tests; (iii) as gatekeeper to invasive coronary angiography (ICA), (iv) the impact of appropriate use criteria; (v) acute chest pain, and (vi) screening of asymptomatic patients with type-2 diabetes...
May 26, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28547671/is-coronary-calcium-scoring-too-late-total-body-arterial-calcium-burden-in-patients-without-known-cad-and-normal-mpi
#2
Adel H A Allam, Randall C Thompson, Michael A Eskander, Mohamed A Mandour Ali, Ayman Sadek, Chris J Rowan, M Linda Sutherland, James D Sutherland, Bruno Frohlich, David E Michalik, Caleb E Finch, Jagat Narula, Gregory S Thomas, L Samuel Wann
BACKGROUND: Patients with normal myocardial perfusion imaging (MPI) have a good prognosis. However, pre-clinical coronary and extracoronary atherosclerosis may exist in the absence of myocardial ischemia. METHODS: 154 Egyptian patients (mean age 53 years) underwent whole-body non-contrast CT following normal MPI. RESULTS: Atherosclerosis in the form of calcification was observed in ≥1 vascular bed in 115 of 154 (75%) patients. This included the iliofemoral (62%), abdominal aorta (53%), thoracic aorta (47%), coronary (47%), and carotid (25%) vascular beds...
May 25, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28547175/influence-of-body-mass-index-and-type-of-low-level-exercise-on-the-side-effect-profile-of-regadenoson
#3
Carlos Salgado-Garcia, Amelia Jimenez-Heffernan, Juana Lopez-Martin, Manuela Molina-Mora, Tarik Aroui, Elena Sanchez de Mora, Carlos Ramos-Font, Francisco Rivera de Los Santos, Carlos Ruiz-Frutos
PURPOSE: Regadenoson, an A2A adenosine receptor pharmacologic stress agent for radionuclide myocardial perfusion imaging (MPI), is administered as a single, fixed dose. We studied the side effect profile of regadenoson combined with two types of low-level exercise, according to body mass index (BMI). METHODS: Three hundred and fifty-six patients (46.1% men, mean age 67.7±10.7 years, range 31-90 years) underwent regadenoson stress testing combined with low-level exercise...
May 25, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28546762/cardiovascular-magnetic-resonance-imaging-clinical-implications-in-the-evaluation-of-connective-tissue-diseases
#4
REVIEW
Sophie Mavrogeni, George Markousis-Mavrogenis, Loukia Koutsogeorgopoulou, Genovefa Kolovou
Cardiovascular magnetic resonance imaging is a recently developed noninvasive, nonradiating, operator-independent technique that has been successfully used for the evaluation of congenital heart disease, valvular and pericardial diseases, iron overload, cardiomyopathies, great and coronary vessel diseases, cardiac inflammation, stress-rest myocardial perfusion, and fibrosis. Rheumatoid arthritis and other spondyloarthropathies, systemic lupus erythematosus, inflammatory myopathies, mixed connective tissue diseases (CTDs), systemic sclerosis, vasculitis, and sarcoidosis are among CTDs with serious cardiovascular involvement; this is due to multiple causative factors such as myopericarditis, micro/macrovascular disease, coronary artery disease, myocardial fibrosis, pulmonary hypertension, and finally heart failure...
2017: Journal of Inflammation Research
https://www.readbyqxmd.com/read/28545628/comparison-of-the-appropriateness-of-myocardial-perfusion-imaging-in-men-versus-women
#5
Ali Alsamarah, Asha Bansari, Hesham Nasser, Wajiha Raza, Issa Alsamarah, Anastasiya Bagrova, David E Winchester
After a decade of appropriate use criteria publication, the degree and predictors of inappropriate use in women compared with men are not known. We conducted a retrospective cohort investigation comparing appropriateness categories (appropriate, maybe appropriate, and rarely appropriate) and cardiovascular outcomes in patients undergoing nuclear myocardial perfusion imaging (MPI) between June 2011 and September 2014 in predominantly inpatient setting. Of 1,475 cases reviewed, 747 (50.6%) were women, and they were more likely to have rarely appropriate use 118 (15...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28540215/myocardial-flow-reserve-mfr-with-positron-emission-tomography-pet-computed-tomography-ct-clinical-impact-in-diagnosis-and-prognosis
#6
REVIEW
Maria Cecilia Ziadi
In recent years, radionuclide myocardial perfusion imaging (MPI) using positron emission tomography/computed tomography (PET/CT) has emerged as a robust tool for the diagnosis, risk stratification and management of patients with known or established coronary artery disease (CAD). Cardiac PET/CT imaging affords key advantages compared to single photon emission computed tomography (SPECT) that encompass: (I) improved diagnostic accuracy; (II) decreased radiation exposure due to the utilization of short-lived radiopharmaceuticals, and importantly; (III) the ability to quantify noninvasively myocardial blood flow (MBF) in absolute terms, that is in ml per minute per gram of tissue...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540212/infarct-characterization-using-ct
#7
REVIEW
Ludovico La Grutta, Patrizia Toia, Erica Maffei, Filippo Cademartiri, Roberto Lagalla, Massimo Midiri
Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540211/delayed-enhancement-cardiac-computed-tomography-for-the-assessment-of-myocardial-infarction-from-bench-to-bedside
#8
REVIEW
Gaston A Rodriguez-Granillo
A large number of studies support the increasingly relevant prognostic value of the presence and extent of delayed enhancement (DE), a surrogate marker of fibrosis, in diverse etiologies. Gadolinium and iodinated based contrast agents share similar kinetics, thus leading to comparable myocardial characterization with cardiac magnetic resonance (CMR) and cardiac computed tomography (CT) at both first-pass perfusion and DE imaging. We review the available evidence of DE imaging for the assessment of myocardial infarction (MI) using cardiac CT (CTDE), from animal to clinical studies, and from 16-slice CT to dual-energy CT systems (DECT)...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540209/myocardial-blood-flow-quantification-for-evaluation-of-coronary-artery-disease-by-computed-tomography
#9
REVIEW
Filippo Cademartiri, Sara Seitun, Alberto Clemente, Ludovico La Grutta, Patrizia Toia, Giuseppe Runza, Massimo Midiri, Erica Maffei
During the last decade coronary computed tomography angiography (CTA) has become the preeminent non-invasive imaging modality to detect coronary artery disease (CAD) with high accuracy. However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540208/myocardial-ct-perfusion-imaging-for-ischemia-detection
#10
REVIEW
Patricia Carrascosa, Carlos Capunay
Coronary computed tomography angiography (CCTA) plays an important role in many specific scenarios such as in symptomatic patients with intermediate pretest of coronary artery disease (CAD), as well as in the triage of patients with acute chest pain with TIMI risk ≤2. However, it cannot detect the presence of associated ischemia, which is critical for clinical decision making among patients with moderate to severe stenosis. Although functional information can be obtained with different non-invasive tools, cardiac CT is the unique modality that can perform a comprehensive evaluation of coronary anatomy plus the functional significance of lesions...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28537039/investigation-of-dose-reduction-in-cardiac-perfusion-spect-via-optimization-and-choice-of-the-image-reconstruction-strategy
#11
Albert Juan Ramon, Yongyi Yang, P Hendrik Pretorius, Piotr J Slomka, Karen L Johnson, Michael A King, Miles N Wernick
BACKGROUND: We investigated the extent to which the administered dose (activity) level can be reduced without sacrificing diagnostic accuracy for three reconstruction strategies for SPECT-myocardial perfusion imaging (MPI). METHODS: We optimized the parameters of the three reconstruction strategies for perfusion-defect detection over a range of simulated administered dose levels using a set of hybrid studies (derived from 190 subjects) consisting of clinical SPECT-MPI data modified to contain realistic simulated lesions...
May 23, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28536897/validation-of-myocardial-perfusion-quantification-by-dynamic-ct-in-an-ex-vivo-porcine-heart-model
#12
Gert Jan Pelgrim, Marco Das, Sjoerd van Tuijl, Marly van Assen, Frits W Prinzen, Marco Stijnen, Matthijs Oudkerk, Joachim E Wildberger, Rozemarijn Vliegenthart
To test the accuracy of quantification of myocardial perfusion imaging (MPI) using computed tomography (CT) in ex-vivo porcine models. Five isolated porcine hearts were perfused according to Langendorff. Hearts were perfused using retrograde flow through the aorta and blood flow, blood pressure and heart rate were monitored throughout the experiment. An inflatable cuff was placed around the circumflex (Cx) artery to create stenosis grades which were monitored using a pressure wire, analysing perfusion at several fractional flow reserve values of 1...
May 23, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28528579/phosphodiesterase-type-5-inhibition-may-reduce-diastolic-function-in-women-with-ischemia-but-no-obstructive-coronary-artery-disease
#13
Michael D Nelson, Puja K Mehta, Janet Wei, Behzad Sharif, Louise E J Thomson, Daniel Berman, Debiao Li, C Noel Bairey Merz
BACKGROUND: Ischemia, in the absence of obstructive coronary artery disease, is prevalent in women, and associated with increased risk for major cardiovascular events. Coronary microvascular dysfunction is prevalent in these patients, and associated with impaired diastolic function. Despite our general understanding, however, optimal treatment of this cohort remains elusive. METHODS: To address this knowledge gap, we performed an open-label treatment trial to assess whether phosphodiesterase type 5 inhibition improves coronary microvascular perfusion and diastolic function in women with signs and symptoms of ischemia but no evidence of obstructive coronary artery disease...
May 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28528431/rapid-rest-stress-regadenoson-ungated-perfusion-cmr-for-detection-of-coronary-artery-disease-in-patients-with-atrial-fibrillation
#14
Erik T Bieging, I Haider, G Adluru, L Chang, P Suksaranjit, D Likhite, A Shaaban, L Jensen, B D Wilson, C J McGann, E DiBella
Cardiovascular magnetic resonance (CMR) perfusion has been established as a useful imaging modality for the detection of coronary artery disease (CAD). However, there are several limitations when applying standard, ECG-gated stress/rest perfusion CMR to patients with atrial fibrillation (AF). In this study we investigate an approach with no ECG gating and a rapid rest/stress perfusion protocol to determine its accuracy for detection of CAD in patients with AF. 26 patients with AF underwent a rapid rest/regadenoson stress CMR perfusion imaging protocol, and all patients had X-ray coronary angiography...
May 20, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28528146/prognostic-value-of-coronary-ct-angiography-with-selective-pet-perfusion-imaging-in-coronary-artery-disease
#15
Teemu Maaniitty, Iida Stenström, Jeroen J Bax, Valtteri Uusitalo, Heikki Ukkonen, Sami Kajander, Maija Mäki, Antti Saraste, Juhani Knuuti
OBJECTIVES: The purpose of this study was to evaluate the prognostic value of sequential hybrid imaging strategy in which positron emission tomography (PET) perfusion imaging is performed selectively in patients with suspected obstructive coronary artery disease (CAD) on coronary computed tomography angiography (CTA). BACKGROUND: Coronary CTA is an accurate diagnostic test for excluding obstructive CAD. However, the positive predictive value is suboptimal. METHODS: We investigated 864 consecutive symptomatic patients with intermediate probability of CAD who adhered to the sequential imaging approach...
May 15, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28526044/clinical-outcomes-meta-analysis-measuring-subendocardial-perfusion-and-efficacy-of-transmyocardial-laser-revascularization-with-nuclear-imaging
#16
REVIEW
Jessika Iwanski, Shannon M Knapp, Ryan Avery, Isabel Oliva, Raymond K Wong, Raymond B Runyan, Zain Khalpey
INTRODUCTION: Randomized and nonrandomized clinical trials have tried to assess whether or not TMR patients experience an increase in myocardial perfusion. However there have been inconsistencies reported in the literature due to the use of different nuclear imaging modalities to test this metric. The primary purpose of this meta-analysis was to determine whether SPECT, MUGA and PET scans demonstrate changes in myocardial perfusion between lased and non-lased subjects and whether laser type affects myocardial perfusion...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28522072/cardiovascular-magnetic-resonance-in-systemic-sclerosis-pearls-and-pitfalls
#17
REVIEW
Sophie I Mavrogeni, Juerg Schwitter, Luna Gargani, Alessia Pepe, Lorenzo Monti, Yannick Allanore, Marco Matucci-Cerinic
Systemic sclerosis (SSc) is an autoimmune disease characterized by vascular dysfunction and excessive fibrosis, involving internal organs including the heart. The estimated prevalence of cardiac involvement in SSc is high and remains subclinical until the late stages. It is either primary, related to myocardial inflammation and fibrosis, or secondary, due to pulmonary arterial hypertension (SSc-PAH) or systemic hypertension, in those patients with renal involvement. Cardiovascular magnetic resonance (CMR) is a useful tool for the early assessment of cardiac involvement in SSc...
March 31, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28512723/low-dose-dual-isotope-procedure-planed-for-myocardial-perfusion-czt-spect-and-assessed-through-a-head-to-head-comparison-with-a-conventional-single-isotope-protocol
#18
Laetitia Imbert, Véronique Roch, Charles Merlin, Wassila Djaballah, Florent Cachin, Mathieu Perrin, Marine Claudin, Antoine Verger, Henri Boutley, Gilles Karcher, Pierre-Yves Marie
PURPOSE OF THE REPORT: This study aimed at assessing an original low-dose dual-isotope procedure in which the abnormal stress Tc-99m Sestamibi SPECT is followed by rest Tl-201 SPECT, along with a head-to-head comparison with a single-isotope procedure. METHODS AND RESULTS: One hundred two patients, referred for a low-dose stress-SPECT with Sestamibi (123 ± 20 MBq) on a CZT camera and for whom a rest Sestamibi SPECT was warranted, had an additional Tl-201 rest-SPECT (52 ± 5 MBq) between stress and rest Sestamibi SPECT recordings...
May 16, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28512722/status-of-cardiovascular-pet-radiation-exposure-and-strategies-for-reduction-an-information-statement-from-the-cardiovascular-pet-task-force
#19
James A Case, Robert A deKemp, Piotr J Slomka, Mark F Smith, Gary V Heller, Manuel D Cerqueira
Cardiovascular positron emission tomography (PET) imaging provides high-quality visual and quantitative myocardial perfusion and function images. In addition, cardiovascular PET can assess myocardial viability, myocardial inflammatory disorders such as cardiac sarcoid, and infections of implanted devices including pacemakers, ventricular assist devices, and prosthetic heart valves. As with all nuclear cardiology procedures, the benefits need to be considered in relation to the risks of exposure to radiation...
May 16, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28511327/-determination-of-iodine-content-in-the-left-ventricular-myocardium-of-healthy-subjects-using-dual-source-dual-energy-ct-myocardial-first-perfusion-imaging-a-preliminary-study
#20
Z X Chen, G Wang, L Liang, X R Lu, Q H Guo, Y N Zhai, X N Shi
Objective: To analyze the normal value of the iodine content in the left ventricular myocardium of healthy subjects and to observe if there is a segmental differences on iodine distribution by using the second generation dual-source dual-energy computed tomography myocardial first perfusion imaging. Methods: In this retrospective study, 42 healthy subjects, who admitted to our department between January to June 2016, with normal second generation dual-source dual-energy computed tomography and coronary CT angioghphy (CTA), electrocardiogram (ECG) results, normal cardiac, hepatic, renal function, normal myocardial enzymes results were enrolled, data from 38 out of 42 subjects with satisfactory image quality were analyzed using Siemens Dual Energy-Heart PBV image processing software...
May 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
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