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Nuclear cardiac stress test

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https://www.readbyqxmd.com/read/28695407/nuclear-cardiology-in-china-2017
#1
Gongshun Tang
This paper provides the current state of nuclear cardiology in China and contrasts it with the state of nuclear cardiology in the United States (US). The West China Hospital and New York-Presbyterian Hospital (NYPH) were used as representative hospitals to contrast nuclear cardiology in China and the US, respectively. In 2015, there were 101 medical cyclotrons, 774 SPECT or SPECT/CT, 240 PET/CT, and 6 PET/MR cameras in China. Most (~90%) of the nuclear cardiology studies are gated SPECT myocardial perfusion imaging (MPI), and ~10% are other types of studies including MUGA, PET/CT MPI, and viability studies...
July 10, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28626854/spatial-indices-of-repolarization-correlate-with-non-st-elevation-myocardial-ischemia-in-patients-with-chest-pain
#2
Salah Al-Zaiti, Ervin Sejdić, Jan Nemec, Clifton Callaway, Prem Soman, Robert Lux
Mild-to-moderate ischemia does not result in ST segment elevation on the electrocardiogram (ECG), but rather non-specific changes in the T wave, which are frequently labeled as non-diagnostic for ischemia. Robust methods to quantify such T wave heterogeneity can have immediate clinical applications. We sought to evaluate the effects of spontaneous ischemia on the evolution of spatial T wave changes, based on the eigenvalues of the spatial correlation matrix of the ECG, in patients undergoing nuclear cardiac imaging for evaluating intermittent chest pain...
June 19, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28526976/how-to-achieve-patient-centered-testing-role-of-the-protocol-nurse
#3
Patricia N Salimi, Joelyn B Niggel, Friederike K Keating
INTRODUCTION: Patient-centered cardiac testing is predicated on choosing the right test for the right patient. We studied the effects of changing from script-driven scheduling to nurse-driven protocoling of stress tests. METHODS AND RESULTS: A protocol nurse reviewed records before scheduling and communicated with patients and ordering providers if needed. We found that instituting nurse protocolling of all non-imaging (ETT) and nuclear (MPI) stress tests (N = 3071) resulted in protocol changes in 37% of our patients, and reduced the proportion of tests that could not be performed as scheduled by 56% and cancelations by 71% (P < 0...
May 19, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28515848/coronary-artery-disease-detection-limitations-of-stress-testing-in-left-ventricular-dysfunction
#4
REVIEW
Ritin Bomb, Senthil Kumar, Anand Chockalingam
Incidental diagnosis of left ventricular systolic dysfunction (LVD) is common in clinical practice. The prevalence of asymptomatic LVD (Ejection Fraction, EF < 50%) is 6.0% in men and 0.8% in women and is twice as common as symptomatic LVD. The timely and definitive exclusion of an ischemic etiology is central to optimizing care and reducing mortality in LVD. Advances in cardiovascular imaging provide many options for imaging of patients with left ventricular dysfunction. Clinician experience, patient endurance, imaging modality characteristics, cost and safety determine the choice of testing...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28473305/quality-of-social-media-and-web-based-information-regarding-inappropriate-nuclear-cardiac-stress-testing-and-the-choosing-wisely-campaign-a-cross-sectional-study
#5
David E Winchester, Diana Baxter, Merry J Markham, Rebecca J Beyth
BACKGROUND: The World Wide Web and social media provide the public with access to medical information unlike any other time in human history. However, the quality of content related to cardiac stress testing is not well understood. OBJECTIVE: The aim of our study was to evaluate the quality of content on the Internet relating to the use of cardiac nuclear stress testing and the Choosing Wisely campaign. METHODS: We searched the World Wide Web, Google Video (including YouTube), and Twitter for information relating to these two topics...
May 4, 2017: Interactive Journal of Medical Research
https://www.readbyqxmd.com/read/28385304/functional-testing-or-coronary-computed-tomography-angiography-in-patients-with-stable%C3%A2-coronary-artery-disease
#6
Mads E Jørgensen, Charlotte Andersson, Bjarne L Nørgaard, Jawdat Abdulla, Jacqueline B Shreibati, Christian Torp-Pedersen, Gunnar H Gislason, Richard E Shaw, Mark A Hlatky
BACKGROUND: The choice of either anatomical or functional noninvasive testing to evaluate suspected coronary artery disease might affect subsequent clinical management and outcomes. OBJECTIVES: This study analyzed the association of initial noninvasive cardiac testing in outpatients with stable symptoms, with subsequent use of medications, invasive procedures, and clinical outcomes. METHODS: We studied patients enrolled in a Danish nationwide register who underwent initial noninvasive cardiac testing with either coronary computed tomography angiography (CTA) or functional testing (exercise electrocardiography or nuclear stress testing) from 2009 to 2015...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28215415/diagnostic-and-prognostic-value-of-lead-avr-during-exercise-testing-in-patients-suspected-of-having-myocardial-ischemia
#7
Max Wagener, Roger Abächerli, Ursina Honegger, Nicolas Schaerli, Gil Prêtre, Raphael Twerenbold, Christian Puelacher, Germaine Sunier, Philipp Reddiess, Maria Rubini Gimenez, Karin Wildi, Jasper Boeddinghaus, Thomas Nestelberger, Patrick Badertscher, Zaid Sabti, Ramun Schmid, Remo Leber, Dayana Flores Widmer, Samyut Shrestha, Ivo Strebel, Damian Wild, Stefan Osswald, Michael Zellweger, Christian Mueller, Tobias Reichlin
We aimed to assess the diagnostic and prognostic value of ST-segment deviation in aVR, a lead often ignored in clinical practice, during exercise testing and to compare it to the most widely used criterion of ST-segment depression in V5. We enrolled 1,596 patients with suspected myocardial ischemia referred for nuclear perfusion imaging undergoing bicycle stress testing. ST-segment amplitudes in leads aVR and V5 were automatically measured. The presence of inducible myocardial ischemia was the diagnostic end point and adjudicated based on nuclear perfusion imaging and coronary angiography...
April 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28194437/mitochondrial-quality-control-dysregulation-in-conditional-ho-1-mice
#8
Hagir B Suliman, Jeffrey E Keenan, Claude A Piantadosi
The heme oxygenase-1 (Hmox1; HO-1) pathway was tested for defense of mitochondrial quality control in cardiomyocyte-specific Hmox1 KO mice (HO-1[CM](-/-)) exposed to oxidative stress (100% O2). After 48 hours of exposure, these mice showed persistent cardiac inflammation and oxidative tissue damage that caused sarcomeric disruption, cardiomyocyte death, left ventricular dysfunction, and cardiomyopathy, while control hearts showed minimal damage. After hyperoxia, HO-1(CM)(-/-) hearts showed suppression of the Pgc-1α/nuclear respiratory factor-1 (NRF-1) axis, swelling, low electron density mitochondria by electron microscopy (EM), increased cell death, and extensive collagen deposition...
February 9, 2017: JCI Insight
https://www.readbyqxmd.com/read/28006775/fgf-2-transcriptionally-down-regulates-the-expression-of-bnip3l-via-pi3k-akt-foxo3a-signaling-and-inhibits-necrosis-and-mitochondrial-dysfunction-induced-by-high-concentrations-of-hydrogen-peroxide-in-h9c2-cells
#9
Qian Chen, Xiaosong Chen, Conghui Han, Ying Wang, Tao Huang, Yingdong Du, Zhen Dong
BACKGROUND/AIMS: Cardiovascular disease is a growing major global public health problem. Necrosis is one of the main forms of cardiomyocyte death in heart disease. Oxidative stress is regarded as one of the key regulators of cardiac necrosis, which eventually leads to cardiovascular disease. Many pharmacological and in vitro studies have suggested that FGF-2 can act directly on cardiomyocytes to maintain the integrity and function of the myocardium and prevent damage during oxidative stress...
2016: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/27846640/cardiac-stress-test-trends-among-us-patients-younger-than-65-years-2005-2012
#10
Vinay Kini, Fenton H McCarthy, Elias Dayoub, Steven M Bradley, Frederick A Masoudi, P Michael Ho, Peter W Groeneveld
Importance: After a period of rapid growth, use of cardiac stress testing has recently decreased among Medicare beneficiaries and in a large integrated health system. However, it is not known whether declines in cardiac stress testing are universal or are confined to certain populations. Objective: To determine trends in rates of cardiac stress testing among a large and diverse cohort of commercially insured patients. Design, Setting, and Participants: A serial cross-sectional study with time trends was conducted using administrative claims from all members aged 25 to 64 years belonging to a large, national managed care company from January 1, 2005, to December 31, 2012...
December 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27793103/the-sphinx-s-riddle-cardiovascular-involvement-in-autoimmune-rheumatic-disease
#11
REVIEW
Sophie Mavrogeni, George Markousis-Mavrogenis, Genovefa Kolovou
Factors leading to Cardiovascular Disease (CVD) in Autoimmune Rheumatic Diseases (ARD) include: a) atherosclerosis and macro-microvascular coronary artery disease b) pericardial, myocardial and vascular inflammation c) heart valve disease d) heart failure and e) pulmonary hypertension.Cardiology utilizes various non-invasive imaging modalities, such as rest/stress Electrocardiogram (ECG), echocardiography, nuclear imaging and more recently Cardiovascular Magnetic Resonance (CMR) to detect ischemic or inflammatory disease in ARD...
October 28, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27783337/the-new-frontier-of-cardiac-computed-tomography-angiography-fractional-flow-reserve-and-stress-myocardial-perfusion
#12
REVIEW
Gianluca Pontone, Giuseppe Muscogiuri, Daniele Andreini, Andrea I Guaricci, Marco Guglielmo, Saima Mushtaq, Andrea Baggiano, Edoardo Conte, Virginia Beltrama, Andrea Annoni, Alberto Formenti, Elisabetta Mancini, Mark G Rabbat, Mauro Pepi
The increased number of patients with coronary artery disease (CAD) in developed countries is of great clinical relevance and involves a large burden of the healthcare system. The management of these patients is focused on relieving symptoms and improving clinical outcomes. Therefore the ideal test would provide the correct diagnosis and actionable information. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography (ICA), but their diagnostic yield remains low with limited accuracy when compared to obstructive CAD at the time of ICA or invasive fractional flow reserve (FFR)...
December 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27543308/diagnostic-performance-of-treadmill-exercise-cardiac-magnetic-resonance-the-prospective-multicenter-exercise-cmr-s-accuracy-for-cardiovascular-stress-testing-exact-trial
#13
Subha V Raman, Jennifer A Dickerson, Wojciech Mazur, Timothy C Wong, Erik B Schelbert, James K Min, Debbie Scandling, Cheryl Bartone, Jason T Craft, Paaladinesh Thavendiranathan, Ernest L Mazzaferri, John W Arnold, Robert Gilkeson, Orlando P Simonetti
BACKGROUND: Stress cardiac magnetic resonance (CMR) has typically involved pharmacologic agents. Treadmill CMR has shown utility in single-center studies but has not undergone multicenter evaluation. METHODS AND RESULTS: Patients referred for treadmill stress nuclear imaging (SPECT) were prospectively enrolled across 4 centers. After rest (99m)Tc SPECT, patients underwent resting cine CMR. In-room stress was then performed using an MR-compatible treadmill with continuous 12-lead electrocardiogram monitoring...
August 19, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27489064/silent-myocardial-infarction-secondary-to-cardiac-autonomic-neuropathy-in-a-patient-with-rheumatoid-arthritis
#14
Dileep Unnikrishnan, Aasems Jacob, Mark Anthony Diaz, Jeffrey Lederman
An 83-year-old female patient with rheumatoid arthritis and hypertension presented to the emergency department with fever and chills of 1 day duration. On examination, temperature was 100.9 F, heart rate 111/min and she had orthostatic hypotension. Laboratory tests showed elevated blood urea nitrogen and white cell count. The patient underwent treatment for symptomatic urinary tract infection and while her fever and leucocytosis resolved, tachycardia persisted. An EKG done showed T inversions in leads II, III, arteriovenous fistula, V2 and V3...
August 3, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27465770/the-clinical-utility-of-new-cardiac-imaging-modalities-in-australasian-clinical-practice
#15
Christian Hamilton-Craig, Jonathan Chan
Cardiac imaging is a rapidly evolving field, with improvements in the diagnostic capabilities of non-invasive cardiac assessment. We review the two main emerging technologies in cardiac imaging: computed tomography coronary angiography (CTCA) to evaluate chest symptoms and to exclude coronary artery disease; and cardiovascular magnetic resonance (CMR) for evaluating cardiac morphology, function and presence of scar. CTCA is an excellent "rule out" test, with a negative predictive value approaching 100%. Radiation exposure is no longer a concern for CTCA, with doses routinely < 5 mSv, and as low as < 1 mSv in selected patients...
August 1, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27438890/cardiac-stress-testing-and-the-radiotracer-supply-chain-nuclear-freeze
#16
Venkatesh L Murthy, Jessica Lehrich, Brahmajee K Nallamothu
No abstract text is available yet for this article.
August 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27412900/monosialoganglioside-containing-nanoliposomes-restore-endothelial-function-impaired-by-al-amyloidosis-light-chain-proteins
#17
Daniel A Franco, Seth Truran, Volkmar Weissig, Diana Guzman-Villanueva, Nina Karamanova, Subhadip Senapati, Camelia Burciu, Marina Ramirez-Alvarado, Luis M Blancas-Mejia, Stuart Lindsay, Parameswaran Hari, Raymond Q Migrino
BACKGROUND: Light chain amyloidosis (AL) is associated with high mortality, especially in patients with advanced cardiovascular involvement. It is caused by toxicity of misfolded light chain proteins (LC) in vascular, cardiac, and other tissues. There is no treatment to reverse LC tissue toxicity. We tested the hypothesis that nanoliposomes composed of monosialoganglioside, phosphatidylcholine, and cholesterol (GM1 ganglioside-containing nanoliposomes [NLGM1]) can protect against LC-induced human microvascular dysfunction and assess mechanisms behind the protective effect...
June 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27364992/plasma-macrophage-migration-inhibitor-factor-is-elevated-in-response-to-myocardial-ischemia
#18
Fenling Fan, Lu Fang, Xiao-Lei Moore, Xuegang Xie, Xiao-Jun Du, David A White, Jessica O'Brien, Helen Thomson, Jun Wang, Hans G Schneider, Andris Ellims, Thomas W Barber, Anthony M Dart
BACKGROUND: Macrophage migration inhibitory factor (MIF) is a key regulator of inflammatory responses, including in the heart. Plasma MIF is elevated early in the course of acute myocardial infarction. In this study, we hypothesized that plasma MIF may also be increased in acute myocardial ischemia. METHODS AND RESULTS: Patients undergoing cardiac stress test (stress nuclear myocardial perfusion scan or stress echocardiography) were recruited. Twenty-two patients had a stress test indicative of myocardial ischemia and were compared with 62 patients who had a negative stress test...
July 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27249552/stress-echocardiography-in-patients-with-morbid-obesity
#19
REVIEW
Benoy N Shah, Roxy Senior
The incidence of significant obesity is rising across the globe. These patients often have a clustering of cardiovascular risk factors and are frequently referred for noninvasive cardiac imaging tests. Stress echocardiography (SE) is widely used for assessment of patients with known or suspected coronary artery disease (CAD), but its clinical utility in morbidly obese patients (in whom image quality may suffer due to body habitus) has been largely unknown. The recently published Stress Ultrasonography in Morbid Obesity (SUMO) study has shown that SE, when performed appropriately with ultrasound contrast agents (whether performed with physiological or pharmacological stress), has excellent feasibility and appropriately risk stratifies morbidly obese patients, including identification of patients who require revascularization...
June 2016: Echo Research and Practice
https://www.readbyqxmd.com/read/27236251/comparison-of-rates-of-coronary-angiography-and-combined-testing-procedures-in-patients-seen-in-the-emergency-room-with-chest-pain-but-no-objective-acute-coronary-syndrome-findings-having-coronary-computed-tomography-versus-exercise-stress-testing
#20
COMPARATIVE STUDY
Brian Grunau, Jonathon Leipsic, Elizabeth Purssell, Naomi Kasteel, Kimchi Nguyen, Mikameh Kazem, Christopher Naoum, Rekha Raju, Philipp Blanke, Brett Heilbron, Carolyn Taylor, Frank X Scheuermeyer
Coronary computed tomography angiography (CCTA) appears comparable to standard care, including exercise stress testing (EST), in diagnosing acute coronary syndrome in emergency department (ED) patients with chest pain but may increase downstream testing. The objective of this study was to investigate rates of post-CCTA versus post-EST testing for (1) invasive angiography and (2) all combined cardiac testing. This was a retrospective cohort study performed at 2 urban Canadian EDs involving patients aged up to 65 years with chest pain but no objective ACS findings that were evaluated with CCTA or EST at the physician's discretion...
July 15, 2016: American Journal of Cardiology
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