DOCSLIB.ORG

Comparison of Gated Myocardial Perfusion SPECT, Echocardiography and Equilibrium Radionuclide Ventriculography in the Evaluation of Left Ventricle Contractility

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Comparison of Gated Myocardial Perfusion SPECT, Echocardiography and Equilibrium Radionuclide Ventriculography in the Evaluation of Left Ventricle Contractility Türk Kardiyol Dern Arş - Arch Turk Soc Cardiol 2014;42(4):349-357 doi: 10.5543/tkda.2014.74150 349 Comparison of gated myocardial perfusion SPECT, echocardiography and equilibrium radionuclide ventriculography in the evaluation of left ventricle contractility Sol ventrikül kontraktil fonksiyonlarının değerlendirilmesinde equilibrium radyonüklid ventrikülografi, ekokardiyografi ve miyokart perfüzyon gated SPECT görüntülemenin karşılaştırılması Filiz Hatipoğlu, M.D., Zeynep Burak, M.D.,# Özgür Ömür, M.D.# Department of Nuclear Medicine, Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar; #Department of Nuclear Medicine, Ege University Faculty of Medicine, Izmir ABSTRACT ÖZET Objectives: In this study, we investigated the reliability of Amaç: Çalışmamızda, sol ventrikül (SV) fonksiyonlarının gated myocardial perfusion single-photon emission comput- değerlendirilmesinde ‘miyokart perfüzyon gated SPECT’ erized tomography (GSPECT) for the evaluation of left ven- (GSPECT) yönteminin güvenilirliği araştırıldı, GSPECT ile tricle (LV) function. We compared left ventricle ejection frac- hesaplanan sol ventrikül ejeksiyon fraksiyonu (SVEF) orta- tion (LVEF) calculated with GSPECT with the values derived laması planar ‘equilibrium gated radyonüklid ventrikülografi’ from planar equilibrium-gated radionuclide ventriculography (ERVG) ve ekokardiyografi (EKO) ile elde edilen değerlerle (ERVG) and echocardiography (ECHO). karşılaştırıldı. Study design: Forty-eight patients with suspected coronary Çalışma planı: Koroner arter hastalığı (KAH) şüphesi olan artery disease (CAD), who were referred for evaluation of miyokart perfüzyonu ve SV fonksiyonlarının değerlendirilmesi myocardial perfusion and LV function and underwent two-day için iki gün Tc99m-MIBI protokolü ile GSPECT ve ERVG gö- 99mTc-MIBI protocol GSPECT and ERVG, were examined rüntülemeleri yapılan 48 hasta geriye dönük olarak incelendi. retrospectively. LVEF was calculated with GSPECT Myome- GSPECT Myometrix yazılımı ile SVEF, Cedars-Sinai Quantita- trix software, and wall motion and thickness were calculated tif Gated SPECT (QGS) analiz programı ile duvar hareket ve with QGS analysis program. In the ERVG study, LVEF val- kalınlık skorları belirlendi. ERVG görüntülemesinde sol ön oblik ues were calculated using left anterior oblique images. In the görüntüleri kullanılarak SVEF değerleri hesaplandı. GSPECT GSPECT and ERVG study, wall motion was evaluated visu- ve ERVG görüntülerinde; SV duvar hareketleri görsel olarak ally and scored. LVEF values and wall motion data measured değerlendirilerek skorlandı. Olguların EKO ile belirlenen SVEF with ECHO were noted. değerleri ve duvar hareket bilgileri ile karşılaştırıldı. Results: For all cases, there was a significant correlation Bulgular: Olguların GSPECT ile hesaplanan ortalama SVEF between LVEF values calculated by GSPECT and ERVG. ile ERVG verileri arasında iyi derecede korelasyon bulun- Numerical LVEF values of 30 patients measured with ECHO du. EKO ile ölçülen nümerik SVEF değeri olan 30 olgunun; showed no significant difference from the values measured GSPECT ve EKO ile hesaplanan SVEF değerleri arasında with GSPECT. When 240 segments obtained from 48 patients belirgin fark olmadığı görüldü. Kırk sekiz hastadan elde edilen were examined, the correlation between GSPECT and ERVG 240 segment incelendiğinde, görsel duvar hareketleri açısın- was 77.5% and between GSPECT and ECHO was 75.4% dan GSPECT ile ERVG arasında %77.5 segmentte, GSPECT by visual wall motion analysis. Quantitatively calculated wall ile EKO arasında %75.4 segmentte uyum saptandı. Görsel motion and thickness scores of segments visually defined as olarak normokinetik segmentlerde hesaplanan hareket ve ka- normokinetic were significantly higher than segments visually lınlık skorları, kontraksiyon kusuru izlenen segmentlere oranla defined as having contraction defect. belirgin yüksek bulundu. Conclusion: GSPECT can be used safely in clinical practice Sonuç: GSPECT’in SV fonksiyonlarının değerlendirilmesi for the evaluation of LV function. Quantitatively calculated wall amacıyla klinik pratikte güvenle kullanılabileceği, kantitatif motion and thickness scores are promising methods to verify olarak hesaplanan duvar hareket ve kalınlık skorlarının görsel the visual evaluation. değerlendirmeyi desteklediği düşünülmektedir. Received: August 20, 2013 Accepted: December 30, 2013 Correspondence: Dr. Filiz Hatipoğlu. Şifa Üniversitesi Bornova Sağlık Uygulama ve Arş. Hast., Bornova, İzmir. Tel: +90 232 - 343 44 45 e-mail: [email protected] © 2014 Turkish Society of Cardiology 350 Türk Kardiyol Dern Arş t is important to measure left ventricle (LV) func- who were subjected Abbreviations: tion in patients with coronary artery disease (CAD) to GSPECT using a I CAD Coronary artery disease with LV dysfunction in order to decide the appropriate two-day 99mTc-MI- ECHO Echocardiography treatment and predict the prognosis. Thus, the diag- BI protocol and on a ERVG Equilibrium-gated radionuclide ventriculography nostic test to be used should reveal the smallest alter- separate day planar GSPECT Gated myocardial perfusion ations in global and regional dysfunction delicately, ERVG study were single-photon emission and it must be precise and easy to repeat. In clinic examined retrospec- computerized tomography LAO Left anterior oblique practice, two-dimensional echocardiography (ECHO) tively. Thirty of the LV Left ventricle is the modality preferred by cardiologists for evalu- 48 patients who had MPS Myocardial perfusion scintigraphy ating ventricular function. Its short procedure time, former numerical re- MRI Magnetic resonance imaging QGS Quantitative gated SPECT low cost and availability are the advantages of this sults of ECHO were ROI Region of interests technique; however, this test shows significant vari- grouped as Group 2. [1-3] ability. ECHO is a user-dependent modality, and in Gated myocardial perfusion SPECT protocol some cases, the acoustic window is limited. In order to make a precise distinction of endocardial lumen, Patient preparation and stress testing procedures contrast drug usage is suggested, since it is reported Cardiac medications that may interfere with the that the ventricular volume and ejection fraction (EF) stress test, such as calcium channel blockers or beta- [4] values are correlated more with standard techniques. blockers, were terminated 48 hours before GSPECT However, use of contrast drugs is not preferred in rou- imaging if there were no medical contraindications. tine clinic practice because of its burden on the pro- Long-acting nitrates were interrupted 24 hours before cedure and cost.[5] These technical disadvantages of the procedure. For pharmacological stress testing of ECHO created the need for other non-invasive imag- patients, caffeine-containing beverages (coffee, tea, ing techniques that will provide fast and safe detection cola, etc.) and methylxanthine-containing medica- of clinical problems. For this purpose, equilibrium- tions were also avoided for at least the last 12 hours gated radionuclide ventriculography (ERVG), which before the procedure. Taking a detailed cardiovascu- is a basic nuclear medicine test for the evaluation of lar medical history and baseline vital signs, patients contractile function, is preferred because of its repro- who were suitable for exercise tests were reviewed. ducibility.[6] Evaluation of LV function is also possible The treadmill exercise test was performed with the by adding gated myocardial perfusion single-photon modified Bruce protocol in 44 patients. For two pa- emission computerized tomography (GSPECT) pa- tients who were unable to exercise because of physi- rameters to myocardial perfusion scintigraphy (MPS), cal conditions, pharmacological stress was applied which is used to show myocardial perfusion and vi- with dipyridamole. Dipyridamole, by intravenous ability.[7,8] The most important superiority of GSPECT administration, is a reliable substitute for exercise imaging to ECHO and ERVG is its ability to reveal during GSPECT. As the intravenous form of dipyri- post-ischemic syndromes like stunned myocardium. damole was commercially unavailable, the oral form In addition, with GSPECT imaging, it is possible to was used. When it was not possible to apply stress distinguish ischemic and non-ischemic cardiomyopa- due to the clinical condition of two patients, images thy. were obtained only at rest. Two-day MPS protocol In this study, we investigated the credibility of was applied. When the target heart rate was reached GSPECT parameters and its use in clinical practice during exercise or exercise termination criteria were for evaluating LV function. observed (physical fatigue, progressive angina, dys- pnea, ataxia, cyanosis, frequent ventricular arrhyth- mias, decrease in systolic blood pressure >20 mmHg, PATIENTS AND METHODS elevation of systolic blood pressure >250 mmHg or Our study group consisted of 48 patients with an age diastolic pressure >130 mmHg, ST-segment depres- range of 30-78 years who were referred to our depart- sion >3 mm or ST elevation >1 mm), 740 MBq (20 ment between January 2010 and October 2010 for de- mCi) 99mTc-MIBI was injected. In patients under- tection of myocardial perfusion and LV function. After going pharmacological stress, 740 MBq (20 mCi) local human ethical committee approval, all patients 99mTc-MIBI was injected intravenously 45 minutes Gated myocardial perfusion SPECT in the evaluation of left ventricle contractility 351 after oral administration of dipyridamole
Load more

Recommended publications
  • Myocardial Perfusion Imaging (Revised Edition)
    Publications · Brochures Myocardial Perfusion Imaging (Revised Edition) A Technologist’s Guide Produced with the kind Support of Editors Ryder, Helen (Dublin) Testanera, Giorgio (Rozzano, Milan) Veloso Jerónimo, Vanessa (Almada) Vidovič, Borut (Munich) Contributors Abreu, Carla (London) Koziorowski, Jacek (Linköping) Acampa, Wanda (Naples) Lezaic, Luka (Ljubljana) Assante, Roberta (Naples) Mann, April (South Hadley) Ballinger, James (London) Medolago, Giuseppe (Bergamo) Fragoso Costa, Pedro (Oldenburg) Pereira, Edgar (Almada) Figueredo, Sergio (Lisbon) Santos, Andrea (Alverca do Ribatejo) Geão, Ana (Lisbon) Vara, Anil (Brighton) Ghilardi, Adriana (Bergamo) Zampella, Emilia (Naples) Holbrook, Scott (Gray) Contents Foreword 4 Introduction 5 Borut Vidovič Chapter 1 State of the Art in Myocardial Imaging 6 Wanda Acampa, Emilia Zampella and Roberta Assante Chapter 2 Clinical Indications 16 Luka Lezaic Chapter 3 Patient Preparation and Stress Protocols 23 Giuseppe Medolago and Adriana Ghilardi EANM Chapter 4 Multidisciplinary Approach and Advanced Practice 35 Anil Vara Chapter 5 Advances in Radiopharmaceuticals for Myocardial Perfusion Imaging 42 James R. Ballinger and Jacek Koziorowski Chapter 6 SPECT and SPECT/CT Protocols and New Imaging Equipment 54 Andrea Santos and Edgar Lemos Pereira Chapter 7 PET/CT Protocols and Imaging Equipment (*) 62 April Mann and Scott Holbrook Chapter 8 Image Processing and Software 77 Sérgio Figueiredo and Pedro Fragoso Costa Chapter 9 Artefacts and Pitfalls in Myocardial Imaging (SPECT, SPECT/CT and PET/CT) 109 Ana Geão and Carla Abreu Imprint 126 n accordance with the Austrian Eco-Label for printed matters. Eco-Label with the Austrian for n accordance (*) Articles were written with the kind support Printed i Printed of and in cooperation with: 3 Foreword The EANM Technologist Committee was dural workflow and need to cooperate with created more than 20 years ago.
    [Show full text]
  • The Additive Value of Combined Assessment of Myocardial Perfusion and Ventricular Function Studies*
    The Additive Value of Combined Assessment of Myocardial Perfusion and Ventricular Function Studies* Trip J. Meine, MD1; Michael W. Hanson, MD1,2; and Salvador Borges-Neto, MD1,2 1Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina; and 2Division of Nuclear Medicine, Department of Radiology, Duke University Medical Center, Durham, North Carolina This review focuses on the combined assessment of myo- In addition to providing quantitative ventricular function infor- cardial perfusion imaging and left ventricular function. Two mation, gated SPECT and radionuclide angiocardiographic clear roles for nuclear imaging in clinical practice include studies can evaluate regional wall motion and ventricular vol- the diagnosis of coronary artery disease (CAD) and assess- umes. This review focuses on the combined assessment of ment of prognosis in patients with known CAD. Combined myocardial perfusion and left ventricular function. Two clear roles for nuclear imaging in clinical practice include the diagno- nuclear imaging can play a role in both these areas, and in sis of coronary artery disease and assessment of prognosis in fact, the addition of left ventricular function data to myo- patients with known coronary artery disease. Ventricular func- cardial perfusion imaging can enhance the clinician’s ability tion information can help differentiate an attenuation artifact to both diagnose CAD and assess prognosis. from an infarct and is helpful in diagnosing 3-vessel coronary disease. Additionally, several studies have highlighted the prog- nostic benefit to combined assessment of myocardial perfusion DIAGNOSIS and ventricular function. Several new modalities have recently Assessment of ventricular function has long been recog- been reported that promise to continue to solidify the place of nuclear imaging in the diagnosis and prognosis of coronary nized as a sensitive means by which to diagnose the pres- artery disease.
    [Show full text]
  • Planar Imaging Versus Gated Blood-Pool SPECT for the Assessment of Ventricular Performance: a Multicenter Study
    Planar Imaging Versus Gated Blood-Pool SPECT for the Assessment of Ventricular Performance: A Multicenter Study Mark W. Groch, E. Gordon DePuey, Allan C. Belzberg, William D. Erwin, Mohammad Kamran, Charles A. Barnett, Robert C. Hendel, Stewart M. Spies, Amjad Ali, and Robert C. Marshall Northwestern University Medical School, Chicago; Rush-Presbyterian-St. Luke’s Medical Center, Chicago; Rush University, Chicago, Illinois; St. Luke’s-Roosevelt Hospital, New York; Columbia University, New York, New York; St. Paul’s Hospital, Vancouver, British Columbia; University of British Columbia, Vancouver, British Columbia, Canada; VA Medical Center, Martinez; University of California-Davis, Davis; and Lawrence Berkeley National Laboratory, Berkeley, California Gated blood-pool SPECT (GBPS), inherently 3-dimensional (3D), Planar equilibrium radionuclide angiography (ERNA) is has the potential to replace planar equilibrium radionuclide angiog- well established and provides a relatively simple and non- raphy (ERNA) for computation of left ventricular ejection fraction invasive method to assess ventricular function and, in par- (LVEF), analysis of regional wall motion (RWM), and analysis of right heart function. The purpose of this study was to compare ticular, left ventricular ejection fraction (LVEF) (1,2). In GBPS and ERNA for the assessment of ventricular function in a any planar projection imaging study, anatomic structures large, multicenter cohort of patients. Methods: One hundred sev- overlap. In planar equilibrium blood-pool imaging, the in- enty-eight patients referred in the usual manner for nuclear medi- ferior wall of the left ventricle is obscured by the right cine studies underwent ERNA followed by GBPS. Each clinical site ventricle in anterior and right anterior oblique (RAO) pro- followed a GBPS acquisition protocol that included 180° rotation, jections, and the left atrium may partially overlap, posteri- a 64 by 64 matrix, and 64 or 32 views using single- or double-head cameras.
    [Show full text]
  • Pdf 296.03 K
    Original Article Evaluation of myocardial perfusion and function after kidney transplantation by Gated SPECT myocardial perfusion scintigraphy Armaghan Fard-Esfahani1, Babak Fallahi1, Sahar Mirpour 1, Ali Gholamrezanezhad1, Ezatollah Abdi2, Mohammad Karimi1, Davood Beiki1, Alireza Emami-Ardekani1, Fariba Akhzari3, Mojtaba Ansari4, Mohammad Eftekhari1 1 Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran 2 Hasheminejad Kidney Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3 Nuclear Medicine Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 4 Nuclear Medicine Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran (Received 12 September 2012, Revised 14 October 2012, Accepted 20 October 2012) ABSTRACT Introduction: The aim of this study was to evaluate the effect of successful kidney transplantation (KT) on myocardial perfusion and left ventricular function by both qualitative (visual) interpretation and semiquantitative parameters, using myocardial perfusion scintigraphy with gated-single photon emission computed tomography (gated-SPECT) in patients suffering from end-stage renal disease. Methods: From a total of 38 patients who were candidates of KT, twenty-six patients (16 female, 10 male, mean age: 47.5 yr, range: 24-64 yr) who had successful KT were included. Myocardial perfusion scintigraphy was performed by Gated Single Photon Emission Computed Tomography (Gated-SPECT) method, before and after surgery (mean: 24 months). Perfusion and function status was evaluated by qualitative and semiquantitative parameters. Results: Our data showed qualitative evidence of perfusion and functional abnormality in pre-transplant scans as follows: Abnormal perfusion in left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) territories in 42.5%, 53.8% and 65.4% of cases, respectively; dilation in 57.7% and inhomogenity of uptake in 53.8% of cases.
    [Show full text]
  • Non-Coding Rnas in the Cardiac Action Potential and Their Impact on Arrhythmogenic Cardiac Diseases
    Review Non-Coding RNAs in the Cardiac Action Potential and Their Impact on Arrhythmogenic Cardiac Diseases Estefania Lozano-Velasco 1,2 , Amelia Aranega 1,2 and Diego Franco 1,2,* 1 Cardiovascular Development Group, Department of Experimental Biology, University of Jaén, 23071 Jaén, Spain; [email protected] (E.L.-V.); [email protected] (A.A.) 2 Fundación Medina, 18016 Granada, Spain * Correspondence: [email protected] Abstract: Cardiac arrhythmias are prevalent among humans across all age ranges, affecting millions of people worldwide. While cardiac arrhythmias vary widely in their clinical presentation, they possess shared complex electrophysiologic properties at cellular level that have not been fully studied. Over the last decade, our current understanding of the functional roles of non-coding RNAs have progressively increased. microRNAs represent the most studied type of small ncRNAs and it has been demonstrated that miRNAs play essential roles in multiple biological contexts, including normal development and diseases. In this review, we provide a comprehensive analysis of the functional contribution of non-coding RNAs, primarily microRNAs, to the normal configuration of the cardiac action potential, as well as their association to distinct types of arrhythmogenic cardiac diseases. Keywords: cardiac arrhythmia; microRNAs; lncRNAs; cardiac action potential Citation: Lozano-Velasco, E.; Aranega, A.; Franco, D. Non-Coding RNAs in the Cardiac Action Potential 1. The Electrical Components of the Adult Heart and Their Impact on Arrhythmogenic The adult heart is a four-chambered organ that propels oxygenated blood to the entire Cardiac Diseases. Hearts 2021, 2, body. It is composed of atrial and ventricular chambers, each of them with distinct left and 307–330.
    [Show full text]
  • Presentation and Evaluation of Gated-SPECT Myocardial Perfusion Images
    Presentation and evaluation of gated-SPECT myocardial perfusion images Niloufar Darvish F.Nadideh Öçba Master of Science Thesis in Medical Imaging Stockholm 2013 i This master thesis project was performed in collaboration with [Karolinska university hospital-Thorax] Supervisor at [Karolinska hospital]: Dianna Bone Presentation and evaluation of gated-SPECT myocardial perfusion images Niloufar Darvish F.Nadideh Öçba Master of Science Thesis in Medical Imaging 30credits Supervisor at KTH: Hamed Hamid Muhammad Examinator: Fredrik Bergholm School of Technology and Health TRITA-STH. EX 2011:51 Royal Institute of Technology KTH STH SE-141 86 Flemingsberg, Sweden http://www.kth.se/sth ii Abstract Single photon emission tomography (SPECT) data from myocardial perfusion imaging (MPI) are normally displayed as a set of three slices orthogonal to the left ventricular (LV) long axis for both ECG-gated (GSPECT) and non-gated SPECT studies. The total number of slices presented for assessment depends on the size of the heart, but is typically in excess of 30. A requirement for data presentation is that images should be orientated about the LV axis; therefore, a set of radial slice would fulfill this need. Radial slices are parallel to the LV long axis and arranged diametrically. They could provide a suitable alternative to standard orthogonal slices, with the advantage of requiring far fewer slices to adequately represent the data. In this study a semi-automatic method was developed for displaying MPI SPECT data as a set of radial slices orientated about the LV axis, with the aim of reducing the number of slices viewed, without loss of information and independent on the size of the heart.
    [Show full text]
  • Gated SPECT Myocardial Perfusion Imaging with Cadmium-Zinc-Telluride Detectors Allows Real-Time Assessment of Dobutamine-Stress
    ORIGINAL ARTICLE Gated SPECT myocardial perfusion imaging with cadmium-zinc-telluride detectors allows real- time assessment of dobutamine-stress-induced wall motion abnormalities Rene Nkoulou, MD,a,b Mathias Wolfrum, MD,a Aju P. Pazhenkottil, MD,a Michael Fiechter, MD,a Ronny R. Buechel, MD,a Oliver Gaemperli, MD,a and Philipp A. Kaufmann, MDa a Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland b Department of Cardiology, University Hospital Geneva, Geneva, Switzerland Received Mar 25, 2017; accepted Dec 18, 2017 doi:10.1007/s12350-018-1187-x Background. Left ventricular (LV) ejection fraction (EF) during high dobutamine stress (HD) by real-time gated-SPECT myocardial perfusion imaging (MPI) on a cadmium-zinc- telluride (CZT) gamma camera was validated versus cardiac magnetic resonance imaging (CMR). Methods and results. After injecting 99mTc-tetrofosmin (320 MBq) in 50 patients (mean age 64 1/2 11 years), EF at rest and post-stress as well as relevant changes in EF at HD (DEF ‡ 5%) were assessed. CZT and CMR rest EF values yielded an excellent correlation and agreement (r = 0.96; P < 0.001; Bland–Altman limits of agreement (BA): 1 0 to 14.8%). HD EF acquisition was feasible using CZT and correlated better to HD CMR EF than did post-stress CZT EF (r = 0.85 vs 0.76, respectively, all P < 0.001). Agreement in DEF detection between HD CMR and immediate post-stress CZT (reflecting standard acquisition using conventional SPECT camera unable to scan during stress) was 45%, while this increased to 85% with real- time HD CZT scan.
    [Show full text]
  • Variability in Ejection Fraction Measured by Echocardiography
    Touro Scholar NYMC Faculty Publications Faculty 8-1-2018 Variability in Ejection Fraction Measured By Echocardiography, Gated Single-Photon Emission Computed Tomography, and Cardiac Magnetic Resonance in Patients With Coronary Artery Disease and Left Ventricular Dysfunction P. A. Pellikka Lilin She T. A. Holly G. Lin P. Varadarajan See next page for additional authors Follow this and additional works at: https://touroscholar.touro.edu/nymc_fac_pubs Part of the Medicine and Health Sciences Commons Recommended Citation Pellikka, P., She, L., Holly, T., Lin, G., Varadarajan, P., Panza, J., & Oh, J. (2018). Variability in Ejection Fraction Measured By Echocardiography, Gated Single-Photon Emission Computed Tomography, and Cardiac Magnetic Resonance in Patients With Coronary Artery Disease and Left Ventricular Dysfunction. JAMA Network Open, 1 (4), e181456. https://doi.org/10.1001/jamanetworkopen.2018.1456 This Article is brought to you for free and open access by the Faculty at Touro Scholar. It has been accepted for inclusion in NYMC Faculty Publications by an authorized administrator of Touro Scholar. For more information, please contact [email protected]. Authors P. A. Pellikka, Lilin She, T. A. Holly, G. Lin, P. Varadarajan, Julio Panza, and J. K. Oh This article is available at Touro Scholar: https://touroscholar.touro.edu/nymc_fac_pubs/1547 Original Investigation | Cardiology Variability in Ejection Fraction Measured By Echocardiography, Gated Single-Photon Emission Computed Tomography, and Cardiac Magnetic Resonance in Patients With Coronary Artery Disease and Left Ventricular Dysfunction Patricia A. Pellikka, MD; Lilin She, PhD; Thomas A. Holly, MD; Grace Lin, MD; Padmini Varadarajan, MD; Ramdas G. Pai, MD; Robert O. Bonow, MD, MS; Gerald M.
    [Show full text]
  • Clinical Characteristics and Prognosis Of
    Lyu et al. BMC Cardiovascular Disorders (2019) 19:209 https://doi.org/10.1186/s12872-019-1177-1 RESEARCH ARTICLE Open Access Clinical characteristics and prognosis of heart failure with mid-range ejection fraction: insights from a multi-centre registry study in China Lyu Siqi, Yu Litian* , Tan Huiqiong, Liu Shaoshuai, Liu Xiaoning, Guo Xiao and Zhu Jun Abstract Background: Heart failure (HF) with mid-range ejection fraction (EF) (HFmrEF) has attracted increasing attention in recent years. However, the understanding of HFmrEF remains limited, especially among Asian patients. Therefore, analysis of a Chinese HF registry was undertaken to explore the clinical characteristics and prognosis of HFmrEF. Methods: A total of 755 HF patients from a multi-centre registry were classified into three groups based on EF measured by echocardiogram at recruitment: HF with reduced EF (HFrEF) (n = 211), HFmrEF (n = 201), and HF with preserved EF (HFpEF) (n = 343). Clinical data were carefully collected and analyzed at baseline. The primary endpoint was all-cause mortality and cardiovascular mortality while the secondary endpoints included hospitalization due to HF and major adverse cardiac events (MACE) during 1-year follow-up. Cox regression and Logistic regression were performed to identify the association between the three EF strata and 1-year outcomes. Results: The prevalence of HFmrEF was 26.6% in the observed HF patients. Most of the clinical characteristics of HFmrEF were intermediate between HFrEF and HFpEF. But a significantly higher ratio of prior myocardial infarction (p = 0.002), ischemic heart disease etiology (p = 0.004), antiplatelet drug use (p = 0.009), angioplasty or stent implantation (p = 0.003) were observed in patients with HFmrEF patients than those with HFpEF and HFrEF.
    [Show full text]
  • The Evolution of Heart Failure with Reduced Ejection Fraction Pharmacotherapy: What Do We Have and Where Are We Going?
    Pharmacology & Therapeutics 178 (2017) 67–82 Contents lists available at ScienceDirect Pharmacology & Therapeutics journal homepage: www.elsevier.com/locate/pharmthera Associate editor: M. Curtis The evolution of heart failure with reduced ejection fraction pharmacotherapy: What do we have and where are we going? Ahmed Selim, Ronald Zolty, Yiannis S. Chatzizisis ⁎ Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA article info abstract Available online 21 March 2017 Cardiovascular diseases represent a leading cause of mortality and increased healthcare expenditure worldwide. Heart failure, which simply describes an inability of the heart to meet the body's needs, is the end point for many Keywords: other cardiovascular conditions. The last three decades have witnessed significant efforts aiming at the discovery Heart failure of treatments to improve the survival and quality of life of patients with heart failure; many were successful, Reduced ejection fraction while others failed. Given that most of the successes in treating heart failure were achieved in patients with re- Pharmacotherapy duced left ventricular ejection fraction (HFrEF), we constructed this review to look at the recent evolution of Novel drugs HFrEF pharmacotherapy. We also explore some of the ongoing clinical trials for new drugs, and investigate poten- tial treatment targets and pathways that might play a role in treating HFrEF in the future. © 2017 Elsevier Inc. All rights reserved. Contents 1. Introduction..............................................
    [Show full text]
  • EANM Procedural Guidelines for Radionuclide Myocardial Perfusion Imaging with SPECT and SPECT/CT
    EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT Chair of writing committee (responsible for the coordination of the overall process): Hein J. Verberne and Birger Hesse Authors: Hein J. Verberne, Wanda Acampa, Constantinos Anagnostopoulos, Jim Ballinger, Frank Bengel, Pieter De Bondt, Ronny R. Buechel, Alberto Cuocolo, Berthe L.F. van Eck-Smit, Albert Flotats, Marcus Hacker, Cecilia Hindorf, Philip A. Kaufmann, Oliver Lindner, Michael Ljungberg, Markus Lonsdale, Alain Manrique, David Minarik, Arthur J.H.A. Scholte, Riemer H.J.A. Slart, Elin Trägårdh, Tim C. de Wit, Birger Hesse Correspondence to: H.J. Verberne, MD PhD Department of Nuclear Medicine, F2-238 Academic Medical Center University of Amsterdam Meibergdreef 9 1105 AZ Amsterdam The Netherlands Tel: *31-20-5669111, pager 58 436 Fax: *31-20-5669092 E-mail: [email protected] 1 Author affiliations: H.J. Verberne Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Tel: +31 20 566 9111, pager 58 436 Fax: +31 20 566 9092 E-mail: [email protected] W. Acampa Institute of Biostructures and Bioimaging, National Council of Research, Naples, Italy Tel: +39 0812203409 Fax: +39 0815457081 E-mail: [email protected] C. Anagnostopoulos Center for Experimental surgery, Clinical and Translational Research, Biomedical research foundation, Academy of Athens, Greece Tel: +30 210 65 97 126 or +30 210 65 97 067 Fax: +30 210 65 97 502 E-mail: [email protected] J. Ballinger Department of Nuclear Medicine, Guy's Hospital - Guy's & St Thomas' Trust Foundation, London, United Kingdom Tel: +44 207 188 5521 Fax: +44 207 188 4094 E-mail: [email protected] F.
    [Show full text]
  • Calcium-Activated Ion Currents in Heart Failure and Ischemia: Point Counter Point
    Open Access Full Text Article Journal of Cardiovascular Disorders A Austin Publishing Group Review Article Calcium-activated Ion Currents in Heart Failure and Ischemia: Point Counter Point William T Clusin* Division of Cardiology, Stanford University School of Abstract Medicine, USA A fundamental principle of cellular electrophysiology is that certain ionic *Corresponding author: William T Clusin, Division currents are activated (i.e. controlled) by the rise in and fall of cytosolic free of Cardiology, Stanford University School of Medicine, calcium at the inner surface of the cell membrane during action potentials and Stanford, CA, 94305, USA, Email: [email protected] the intervals between them. Knowledge about calcium-activated currents has developed in parallel with, and has been incorporated into emerging ideas Received: August 14, 2014; Accepted: September 17, about the mechanisms of cardiac arrhythmias and sudden death in patients with 2014; Published: September 19, 2014 heart disease. Among the earliest discoveries in this field was the recognition that calcium- activated inward current through the sodium calcium exchanger can lead to early or late after-depolarization’s (EAD’s and DAD’s) that trigger premature beats. More recently it has been found that calcium activated outward currents are more important in the heart than initially recognized because a group of calcium activated potassium channels known as SK channels is up-regulated in the ventricles during heart failure. Finally the idea that action potential shortening, which accompanies acute myocardial infarction, is a consequence of impaired calcium sequestration during ischemia, leading to increased outward potassium current, is supported by very recent research. The manner in which these different calcium activated ion currents in the heart regulate membrane potential and can cause – or in some cases prevent – arrhythmias is reconsidered in light of new evidence.
    [Show full text]