Myocardial Perfusion PET Predicts Cardiac Death in Diabetes

FRIDAY, June 28, 2019 -- Myocardial perfusion positron emission tomography (PET) imaging can improve risk prediction of cardiac death for patients with diabetes, according to a study published online June 27 in Radiology: Cardiothoracic...
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AbstractDiabetes represents a worldwide increasing problem and cardiovascular disease is the most common cause of death in diabetic patients. Pathophysiology that links diabetes to cardiovascular disease is a complex and multifactorial phenomenon evolving over time and involving both large blood vessels (macrovasculature) and small blood vessels (microvasculature). Myocardial perfusion imaging (MPI) imaging by both single-photon emission computer tomography and positron emission tomography with different specific tracers has become an indispensable tool for discriminating normal from diseased myocardial tissues and left ve...
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
In this study, we identify a link between members of the genus Veillonella and exercise performance. We observed an increase in Veillonella relative abundance in marathon runners postmarathon and isolated a strain of Veillonella atypica from stool samples. Inoculation of this strain into mice significantly increased exhaustive treadmill run time. Veillonella utilize lactate as their sole carbon source, which prompted us to perform a shotgun metagenomic analysis in a cohort of elite athletes, finding that every gene in a major pathway metabolizing lactate to propionate is at higher relative abundance postexercise. Us...
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36Objectives: In type II diabetes, glucose metabolism is compromised. This impairment is known to increase cardiac fatty acid consumption, but its effect on other substrates, such as ketones (acetoacetate and beta-hydroxybutyrate) is poorly understood. A recent study (EMPA-REG)[asterisk] evaluating the inhibition of glucose reabsorption by kidneys in type II diabetes has shown a reduction of sudden cardiac death and heart failure hospitalization. The treatment also led to a slight decrease in HbA1c and an increase in blood ketones. The aim of the present study is to use [11C]-acetoacetate as a direct index to characterize ...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Basic Science: Metabolism and Molecular Imaging Source Type: research
309Objectives: The significance of post-stress reduction in left ventricular ejection fraction (LVEF) in patients who underwent an adenosine stress/rest study with no evidence of reversible perfusion defects remains controversial with only few studies comprising a large number of patients. The aim of this study is to determine the prognostic value of post-adenosine stress decrease in LVEF in these patients. Materials and Methods: We have identified all patients who had a two-day adenosine stress/rest 99mTc-sestamibi scan performed between 1/2015 and 10/2017 at Jordan University Hospital, no evidence of reversible perfusion...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science: Improving Prognostication from Cardiac Nuclear Imaging Source Type: research
1423Objectives: Gastric wall tracer uptake (GWU) of 99mTc-Sestamibi (MIBI) is a less studied phenomenon in single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy (MPS), and known to cause imaging artifacts in the inferior LV myocardium, lowering the diagnostic accuracy. Significant GWU has been observed with prolonged intake of proton pump inhibitors (PPI) without any reasonable explanation. The present prospective study was conducted with primary objective to establish the association of GWU if any with PPI and H2 receptor antagonists (H2A) intake. The secondary objectives were to compare the...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science Posters Source Type: research
Conclusions: The present study shows the significance of estimation of myocardial blood flow and myocardial flow reserve in diabetic patients asymptomatic for CAD. Based on our study, rest and stress MPI using 13N-NH3 cardiac PET serves to be a valuable modality in early detection of coronary microvascular dysfunction in asymptomatic diabetic patients. This modality could be of great help in understanding both the coronary blood flow abnormalities as well as the detection of coronary artery disease in diabetic patients asymptomatic for coronary artery disease.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science Posters Source Type: research
1448Introduction: Cardiovascular disease has found to be the leading cause of morbidity and mortality, especially in developing countries like India with a prevalence of 11%. This can be attributed to the high prevalence of risk factors like high levels of blood cholesterol and triglycerides, diabetes, hypertension, obesity etc., all of which have found to independently increase the epicardial fat volume (EFV) which is a known source of pro-inflammatory cytokines in the pericardial region augmenting the formation of atherosclerosis and eventual myocardial infarction. Myocardial perfusion imaging using SPECT.CT is commonly ...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science Posters Source Type: research
Conclusions: Among patients with zero CAC, the rate of ischemia is low (3%) as well as obstructive CAD on angiography (1%). A zero CAC is associated with low event rate in this population. Future randomized multicenter studies are needed to determine the safety and outcomes of using zero CAC as a gatekeeper to MPI.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science Posters Source Type: research
162Objectives: Stress myocardial blood flow (sMBF) and coronary flow reserve (CFR) by cardiac positron emission tomography (cPET) have been shown to provide prognostic information supplemental to relative perfusion images. However, myocardial blood flow (MBF) has not been characterized in patients with end stage liver disease (ESLD). Characterization of MBF may provide additional physiologic information to further assist with management and risk stratification for patients undergoing liver transplantation. Methods: A total of 126 patients with ESLD undergoing liver transplant evaluation that underwent rubidium-82 cPET with...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science: Advances in Clinical Utility of Myocardial Blood Flow Quantification Source Type: research
AbstractPurpose of ReviewRadionuclide myocardial perfusion imaging (MPI) continues to be the most reliable modality for diagnosis of hemodynamically significant coronary artery disease (CAD). The application of radionuclide MPI using single photon emission computed tomography (SEPCT) and positron emission tomography (PET) for CAD is reviewed, with emphasis on diagnosis and risk stratification.Recent FindingsContemporary studies have reported the diagnostic and prognostic value of novel imaging protocols, employing stress-first or stress-only approach. In addition, the superior diagnostic value of PET has been established w...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
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