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The clinical usefulness of epicardial adipose tissue in patients with high-intermediate pre-test probability for coronary artery disease.

The clinical usefulness of epicardial adipose tissue in patients with high-intermediate pre-test probability for coronary artery disease. Kardiol Pol. 2018 Feb 05;: Authors: Zehir R, Güner A, Hayiroglu MI, Oz TK, Osken A, Aksu H, Dayi SU, Hobikoğlu GF Abstract BACKGROUND: Epicardial adipose tissue [EAT] is thought to be associated with extension and severity of coronary artery disease [CAD] and echocardiographic measurement of EAT thickness has been considered to be a possible cardiovascular risk indicator. ESC Task Force recommends further non-invasive testing in patients with an intermediate pre-test probability [PTP] for the diagnosis of CAD. AIM: The purpose of this study was to evaluate the clinical usefulness of performing EAT measurements in patients with a high-intermediate PTP. METHODS: Patients referred to an outpatient clinic with stable chest pain symptoms who had PTP between 66-85% for CAD were included in the study. Echocardiographic measurement of the EAT was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium. Single photon emission computed tomography [SPECT] was performed in all patients. The diagnosis of CAD was based on the presence of reversible perfusion defects on SPECT. RESULTS: A total of 126 patients [76 males, 60.3%] with a mean age of 65.3 [±9.1] years were recruited. The EAT thickness was 7.3 ± 0.7 mm in patients with positive ...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research

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If all three major coronary branches have similar degree of stenosis, the radionuclide used for perfusion study will have equal uptake in all regions of the myocardium. Thus a balanced three vessel coronary artery disease can produce a false negative myocardial perfusion scan. This situation is called balanced myocardial ischemia. In most cases this is picked up by the treadmill ECG usually done along with stress myocardial perfusion imaging. Since the ECG findings of myocardial ischemia does not depend on the relative perfusion in the coronary tree, ischemic changes will be noted in treadmill ECG even when nuclear ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Nuclear Cardiology Source Type: blogs
CONCLUSIONS: We demonstrated therapy-related and stimulus-free longitudinal CBF changes in core areas of the pain matrix using ASL. ASL may act as a complementary noninvasive method to functional MRI and single-photon emission computed tomography / positron emission tomography, especially in the longitudinal assessment of pain response in clinical trials. PMID: 28770549 [PubMed - in process]
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
AbstractAnomalous aortic origin of a coronary artery is a rare congenital condition that has variable presentations from atypical chest pain to syncope and cardiac arrest. Commonly used myocardial perfusion imaging techniques, stress agents, and perfusion agents may have limited ability to detect inducible ischemia in this rare patient group. We herein describe a unique case of anomalous left main coronary artery from a common right coronary sinus ostium with a subpulmonic and intramyocardial course. This patient had multiple atypical chest pain presentations and multiple-negative pharmacologic single-photon emission-compu...
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
ConclusionsProne acquisition and CTAC images improve the ability to assess the inferior/inferolateral area.
Source: Annals of Nuclear Medicine - Category: Nuclear Medicine Source Type: research
Authors: Goldkorn R, Naimushin A, Beigel R, Naimushin E, Narodetski M, Matetzky S Abstract BACKGROUND: While patients presenting to emergency departments (ER) with chest pain are increasingly managed in chest pain units (CPU) that utilize accelerated diagnostic protocols for risk stratification, such as single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), data are lacking regarding the prognostic implications of mildly abnormal scans in this population. OBJECTIVES: To evaluate the prognostic implications of mildly abnormal SPECT MPI results in patients with acute chest pain. ...
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
Conclusions: Patients who experience higher NA are more likely to report experiencing chest pain. In patients without ischemia, high NA and PA was also associated with a higher likelihood of reporting chest pain. Results suggest that high levels of PA as well as NA may increase the experience and/or reporting of chest pain.
Source: Psychosomatic Medicine - Category: Psychiatry & Psychology Tags: Original Articles Source Type: research
 BACKGROUND: Normal single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has a high negative predictive value for ischemic heart disease. Thus, the presence of subclinical coronary atherosclerosis detected by coronary artery calcification (CAC) score in patients who have under-gone SPECT MPI is unknown. OBJECTIVES:Determine the prevalence of coronary artery calcification (CAC) in patients with normal SPECT MPI and examine the association of CAC with conventional coronary artery disease (CAD) risk factors. DESIGN: Cross-sectional analytical study using medical records from Feb...
Source: Annals of Saudi Medicine - Category: Journals (General) Tags: ISSUE 2 Source Type: research
Abstract AIM: To investigate the relationship of inferior wall ischemia on myocardial perfusion imaging in patients with non-dominant right coronary artery anatomy. METHODS: This was a retrospective observational analysis of consecutive patients who presented to the emergency department with primary complaint of chest pain. Only patients who underwent single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) were included. Patients who showed a reversible defect on SPECT MPI and had coronary angiography during the same hospitalization was analyzed. Patients with prior history of co...
Source: World Journal of Cardiology - Category: Cardiology Authors: Tags: World J Cardiol Source Type: research
This study evaluated the hemodynamic significance of MB by detecting severity and extent of perfusion abnormality using 99mTc-sestamibi (MIBI) gated single photon emission computed tomography (SPECT)/CT myocardial perfusion imaging (MPI), its correlation with coronary angiography and role in patient’s management. Five patients with complaints of atypical chest pain, exertional angina, or dyspnea underwent stress/rest 99mTc-MIBI SPECT/CT MPI. The gated stress and rest SPECT/CT images on 17 segment model using quantitative gated-SPECT (QGS) softwarewere analyzed and compared with coronary angiography. Four out of five ...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
Conclusions Higher CAC scores are associated with the initiation of aspirin and statin therapy in patients with normal SPECT MPI. In patients with lower CAC scores, discontinuation of cardioprotective medication is more likely. CAC score is independently associated with posttest statin and aspirin use.
Source: American Heart Journal - Category: Cardiology Source Type: research
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