Prevalence of myocardial viability and ischemic burden in chronic total occluded coronary artery disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
X Yang ◽  
J.F Tian ◽  
L.J Zhang ◽  
W Dong ◽  
J.N Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Viability ◽  
Single Photon ◽  
Photon Emission ◽  
Coronary Arteriography ◽  
Emission Computed Tomography ◽  
Funding Source ◽  
Inducible Ischemia ◽  
Coronary Ct ◽  
Transmural Infarction

Abstract Aims We assessed the viable myocardium status and investigated the relationship between collaterals with the ischemia burden and myocardial viability utilizing cardiac magnetic resonance imaging (CMR) and adenosine stress single-photon emission computed tomography (SPECT). Methods and results 150 consecutive patients with at least one native CTO artery, as confirmed by coronary arteriography or coronary CT angiography, were prospectively recruited. SPECT examination was accepted by only 50 patients while declined by the other 100 patients for reasons such as financial problems. Of all segments in the 173 CTO artery territories, only 10.4% exhibited transmural myocardial infarction and 60.2% showed no late gadolinium enhancement. Among 50 patients who completed SPECT examination, 36 patients showed inducible perfusion defect in CTO territory, and the proportion of the ischemic area of 42% patients was over 10%. Conclusion Most patients with CTO had different degrees of myocardial infarction detected by CMR, but only a minority of them showed transmural infarction and cardiac function in patients with transmural infarction declined compared to those without transmural infarction. Approximately half of CTO patients exhibited inducible ischemia in CTO territory. Based on this, a large proportion of patients potentially benefit from CTO-PCI. Figure 1. Relationship between WMSI, LVE Funding Acknowledgement Type of funding source: Other. Main funding source(s): Beijing Municipal Education Commission Science and Technology Plan for 2020, Capital Health Development Research Project (no. 2018-2-2063)

scholarly journals A case report: adenosine triggered myocardial infarction during myocardial perfusion stress test imaging in a diabetic patient

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Maarten de Mulder ◽  
Menno van Gameren ◽  
Eric A van Asperen ◽  
Martijn Meuwissen
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Perfusion ◽  
Single Photon ◽  
Thrombus Formation ◽  
Stress Test ◽  
Photon Emission ◽  
Coronary Perfusion Pressure ◽  
Emission Computed Tomography ◽  
Coronary Perfusion ◽  
Starting Point

Abstract Background Myocardial perfusion imaging (MPI) using single-photon emission computed tomography (SPECT) can in general be used safely in daily clinical practice. However, under the right circumstances, it can lead to serious complications. Case summary A 68-year-old female patient with diabetes and a history of inferior ST-elevation myocardial infarction 8 years earlier, visited our outpatient clinic with atypical chest discomfort. In order to assess whether this is due to myocardial ischaemia, MPI-SPECT was ordered. As it was suspected she would not achieve sufficient exercise levels, pharmacologic stress using adenosine was arranged. During the scan, she developed acute myocardial infarction. Subsequent urgent coronary angiography demonstrated a subtotal stenosis in the proximal left anterior descending coronary artery which was successfully stented. She was still free from angina 4 months later. Discussion The combination of a reduced systemic and coronary perfusion pressure in the presence of an exhausted coronary autoregulation, may be a starting point for local geometrical changes that initiate the classic cascade of thrombus formation and acute occlusion of coronary arteries during MPI-SPECT. This illustrates the need for continuous patient and electrocardiogram monitoring.

scholarly journals Psychological factors of suspect coronary microvascular dysfunction in patients undergoing SPECT imaging

2020 ◽  
Author(s):  
Maria T. Bekendam ◽  
Ilse A. C. Vermeltfoort ◽  
Willem J. Kop ◽  
Jos W. Widdershoven ◽  
Paula M. C. Mommersteeg
Keyword(s):  
Psychological Factors ◽  
Single Photon ◽  
Reference Group ◽  
Obstructive Coronary Artery Disease ◽  
Photon Emission ◽  
Microvascular Dysfunction ◽  
Coronary Microvascular Dysfunction ◽  
Emission Computed Tomography ◽  
Cardiac Events ◽  
Inducible Ischemia

Abstract Background Patients with myocardial ischemia in the absence of obstructive coronary artery disease (CAD) often experience anginal complaints and are at risk of cardiac events. Stress-related psychological factors and acute negative emotions might play a role in these patients with suspect coronary microvascular dysfunction (CMD). Methods and Results 295 Patients (66.9 ± 8.7 years, 46% women) undergoing myocardial perfusion single-photon-emission computed tomography (MPI-SPECT), were divided as follows: (1) a non-ischemic reference group (n = 136); (2) patients without inducible ischemia, but with a history of CAD (n = 62); (3) ischemia and documented CAD (n = 52); and (4) ischemia and suspect CMD (n = 45). These four groups were compared with regard to psychological factors and acute emotions. Results revealed no differences between the groups in psychological factors (all P > .646, all effect sizes d < .015). State sadness was higher for patients with suspect CMD (16%) versus the other groups (P = .029). The groups did not differ in the association of psychological factors or emotions with anginal complaints (all P values > .448). Conclusion Suspect CMD was not associated with more negative psychological factors compared to other groups. State sadness was significantly higher for patients with suspect CMD, whereas no differences in state anxiety and other psychological factors were found.

Sign in / Sign up

Export Citation Format

Share Document