scholarly journals Myocardial perfusion scintigraphy during the COVID-19 pandemic - findings from the university teaching hospital in Slovenia

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
B Guzic Salobir ◽  
M Dolenc Novak ◽  
M Stalc
Keyword(s):  
Nuclear Medicine ◽  
Myocardial Perfusion ◽  
Clinical Characteristics ◽  
Myocardial Perfusion Scintigraphy ◽  
Stress Tests ◽  
Pharmacological Stress ◽  
Perfusion Scintigraphy ◽  
Number Of Patients ◽  
The University ◽  
Second Wave

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Department for nuclear medicine in the University medical centre Ljubljana provides nuclear medicine diagnostic procedures for approximately 1.000.000 inhabitants of Slovenia. As many countries in Europe, Slovenia was faced with the first wave of the COVID-19 pandemic in early spring of 2020. Since our country is situated next to the northern part of Italy, where the situation was critical, our Ministry of health issued specific recommendations in March 2020. The aim was to increase hospital capacities for COVID-19 patients through limiting non-urgent diagnostic tests including myocardial perfusion scintigraphy (MPS) and to minimize the spread of the virus into hospital departments. The epidemiologic situation of the first wave resolved within 3 months. In the second wave of the pandemic in autumn 2020, the recommendations on patient care in non COVID-19 cases were less limiting to avoid worsening of non COVID-19 related diseases and patient prognosis. Purpose The aim of our study was to evaluate the influence of the COVID-19 pandemic on MPS in our medical institution. Methods Data on numbers of MPS, clinical characteristics of the patients and findings of MPS were prospectively collected for the first wave (in spring from March 15th to June 15th 2020) and second wave (in autumn from September 15th to December 15th 2020) of the pandemic and were compared with the same periods in 2019.  Results During the first wave we performed 40% less MPS, significantly more patients had pharmacological stress and were outpatients than in spring 2019. There were no significant differences in other clinical characteristics and MPS findings (Table 1 and Figure 1). In autumn 2020 we reorganized our schedule to increase the number of patients, which was once again comparable to previous year’s autumn. Although the number of patients was comparable, patients were now significantly older and had more often pharmacological stress, but there were no significant differences in other clinical data or MPS findings (Table 1 and Figure 1). Conclusions In our hospital, during the first wave of COVID-19 pandemic, we performed significantly less MPS than in the same period of the previous year. To minimize the possibility of virus transmission from asymptomatic patients, we followed international recommendations and avoided exercise stress tests but increased the percentage of pharmacological stress tests. A similar approach regarding the type of stress tests was chosen for the second wave in autumn of 2020. However, we decided to increase the number of MPS performed, in order to lessen the negative impact of the pandemic on non COVID-19 related diseases, focusing on coronary artery disease.

Myocardial perfusion scintigraphy 2007 in Germany

2009 ◽  
Vol 48 (04) ◽  
pp. 131-137 ◽  
Author(s):  
W. Burchert ◽  
F. M. Bengel ◽  
R. Zimmermann ◽  
J. vom Dahl ◽  
W. Schäfer ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Myocardial Perfusion ◽  
Working Group ◽  
Gated Spect ◽  
Myocardial Perfusion Scintigraphy ◽  
German Society ◽  
Stress Tests ◽  
University Hospitals ◽  
Pharmacological Stress ◽  
Perfusion Scintigraphy

Summary Aim: This third survey of the working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine in cooperation with the working group Nuclear Cardiology of the German Cardiac Society was to deliver information on the procedures and in particular on the development of myocardial perfusion scintigraphy (MPS) from 2005 to 2007. Method: 370 questionnaires (222 private practices (PP), 117 hospitals (HO), 31 university hospitals (UH)) were evaluated. Results: MPS of 114,374 patients were reported, 83% were investigated with 99mTc-perfusion tracers. 76% [2006=74%] were performed in PP, 15% [2006=17%] in HO and 9% [2006=9%] in UH. Diabetics represented 21% of all MPS patients in 2007. Data of 215 institutions which participated all from 2005 to 2007 showed an increase in MPS of 2.3% (PP +6.8%, HO −4.5%, UH −18.2%). The type of stress was pharmacological in 27% [2006 = 27%]; 67% adenosine (of these 25% with exercise), 31% dipyridamole (of these 55% with exercise), and 2% dobutamine. Gated SPECT was performed in 47% [2006 = 42%] of all rest and in 44% [2006 = 39%] of all stress MPS. 61% [2006 = 83%] of all institutions did not apply perfusion scores. 20% [2006 = 24%] of the institutions reported changes in the use of MPS by competing methods. Conclusion: There is a small increase of MPS between 2005 and 2007 despite competing methods. Gated SPECT has experienced more acceptance, but is still underrepresented. As compared to the European average and general standards of MPS a considerable backlog accounts to pharmacological stress tests, gated SPECT and perfusion scores.

Myocardial perfusion scintigraphy in Germany

2007 ◽  
Vol 46 (02) ◽  
pp. 49-55 ◽  
Author(s):  
W. Burchert ◽  
F. M. Bengel ◽  
R. Zimmermann ◽  
J. vom Dahl ◽  
W. Schäfer ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Myocardial Perfusion ◽  
Attenuation Correction ◽  
Working Group ◽  
Primary Care Physicians ◽  
Gated Spect ◽  
Myocardial Perfusion Scintigraphy ◽  
German Society ◽  
University Hospitals ◽  
Perfusion Scintigraphy

SummaryThe working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine (DGN), in cooperation with the working group Nuclear Cardiology of the German Cardiac Society (DGK), decided to conduct a national survey on myocardial perfusion scintigraphy (MPS). Method: A questionnaire to evaluate MPS for the year 2005 was sent. Results: 346 completed questionnaires had been returned (213 private practices, 99 hospitals and 33 university hospitals). MPS of 112 707 patients were reported with 110 747 stress and 95 878 rest studies. The majority (>75%) was performed with 99mTc-MIBI or tetrofosmin. 201Tl stress-redistribution was used in 22 637 patients (20%). The types of stress were exercise in 78%, vasodilation with adenosine or dipyridamol in 21% and dobutamine in 1%. 99.97% of all MPS were SPECT studies. Gated SPECT was performed in 36% of the stress and in 32% of the rest studies. An attenuation correction was used in 21%. 29 institutions (8%) performed gated SPECT (stress and rest) and attenuation correction. 47% of all MPS were requested by ambulatory care cardiologists, 17% by internists, 12% by primary care physicians, 21% by hospital departments and 2% by others. Conclusion: In Germany, MPS is predominantly performed with 99mTc-perfusion agents. The common type of stress is ergometry. Gated SPECT and attenuation correction do not yet represent standards of MPS practice in Germany, which indicates some potential of optimization.

scholarly journals Regadenoson myocardial perfusion scintigraphy for the evaluation of coronary artery disease in patients with lung disease: A series of five cases

2019 ◽  
Vol 27 (1) ◽  
pp. 315-321 ◽  
Author(s):  
Eliana Reyes ◽  
Stephen Richard Underwood
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Myocardial Perfusion Scintigraphy ◽  
Case Series ◽  
Pharmacological Stress ◽  
Perfusion Scintigraphy ◽  
Serious Adverse Events ◽  
Artery Disease ◽  
Respiratory Conditions

AbstractCoronary artery disease (CAD) is a leading cause of death and morbidity globally. Myocardial perfusion scintigraphy (MPS) is commonly used for the diagnosis of CAD, necessitating hyperaemia achieved either by physical exertion or by pharmacological stress, most commonly through use of a coronary arteriolar dilator. This is challenging in patients with respiratory conditions because exercise may be submaximal and adenosine is contraindicated because of the risk of bronchoconstriction. Regadenoson is the only selective adenosine A2A receptor agonist approved as a vasodilator in MPS. The risk of bronchospasm with regadenoson has been investigated in large, randomised trials; however, patients with the most severe respiratory conditions were not included. In this case series, we present the use of regadenoson MPS in five patients with moderate-to-severe lung conditions, including patients requiring lung volume reduction surgery and lung transplant. In all cases, regadenoson MPS provided valuable information for risk assessment and treatment optimisation. Although dyspnoea occurred in all patients, regadenoson was well tolerated without serious adverse events or bronchospasm; in no case was intervention required to treat dyspnoea.

Myocardial perfusion scintigraphy 2008 in Germany

2010 ◽  
Vol 49 (02) ◽  
pp. 65-72 ◽  
Author(s):  
W. Burchert ◽  
F. M. Bengel ◽  
R. Zimmermann ◽  
J. vom Dahl ◽  
W. Schäfer ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Myocardial Perfusion ◽  
Working Group ◽  
Gated Spect ◽  
Myocardial Perfusion Scintigraphy ◽  
German Society ◽  
University Hospitals ◽  
Perfusion Scintigraphy ◽  
German Standard ◽  
Patient Radiation Exposure

Summary Aim: The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine in cooperation with the working group Nuclear Cardiology of the German Cardiac Society herewith present the results of the 4th survey on myocardial perfusion scintigraphy (MPS) of the year 2008. Method: 310 questionnaires (191 private practices (PP), 93 hospitals (HO), 31 university hospitals (UH)) were evaluated. Results: MPS of 98 947 patients were reported. 15% of them were younger than 50 y, 57% between 50 and 70 y and 28% older than 70 y. 88% [2007: 83%] of all were studied with Tc-99m perfusion tracers. The patient radiation exposure of a stress and rest protocol considering German standard recommended doses was 8.5 mSv, of a stress-only protocol 1.9 mSv. 77% [2007: 76%] of the MPS were performed in PP, 15% [2007: 15%] in HO and 8% [2007: 9%] in UH. From 2005 to 2008 there was a mild increase in the MPS numbers by 1.2% (PP +7.1%, HO −5.5%, UH −31.4%). The type of stress was pharmacological in 30% [2007: 27%]; 68% adenosine (of these 22% with exercise), 29% dipyridamole (of these 64% with exercise), and <1% dobutamine. Gated SPECT was performed in 46% [2007: 47%] of all rest and in 42% [2007: 44%] of all stress MPS. 62% [2007: 61%] of all institutions did not use perfusion scores. Conclusion: The MPS numbers from 2005 to 2008 in Germany can be regarded as stable. However, there are considerable shifts from HO and UH to PP. The well known potential of MPS considering risk stratification and functional analysis has not been tapped so far. Both gated SPECT and a quantitative perfusion analysis should be performed routinely in every patient.

Paradoxical Hypotension during Dobutamine Infusion for Myocardial Perfusion Scintigraphy

1998 ◽  
Vol 37 (08) ◽  
pp. 268-271
Author(s):  
B. Caner ◽  
E. Atalar ◽  
A. Karanfil ◽  
L. Tokgözoğlu ◽  
E. L. Ergün
Keyword(s):  
Blood Pressure ◽  
Myocardial Perfusion ◽  
Systolic Blood Pressure ◽  
Myocardial Perfusion Scintigraphy ◽  
Stress Test ◽  
Dobutamine Infusion ◽  
Perfusion Scintigraphy ◽  
Tilt Table ◽  
Study Results ◽  
Group A

Summary Aim: Dobutamine as a predominant beta-1 agonist increases heart rate and myocardial contractility and at sufficient high doses, it also increases systolic blood pressure. This study was undertaken to describe instances of paradoxical hypotension during dobutamine infusion for TI-201 myocardial perfusion SPECT study and the relationship between scintigraphic findings and hypotension occurred during dobutamine infusion. Methods: In 201 consecutive patients unable to perform adequate exercise, dobutamine TI-201 myocardial SPECT was performed. Dobutamine was infused starting from 10 μg/kg/min increasing to 40 μg/kg/min. Paradoxical hypotension was defined as a decrease in systolic blood pressure ≥ 20 mmHg compared with baseline study. Results: Paradoxical hypotension was observed in 40 patients (Group A) out of 201 (19.9%) while no significant change in systolic blood pressure was detected in the remaining 161 patients (Group B). Mean maximum fall in systolic blood pressure was 39 ± 18 mmHg (range: 20-90). In 33 of 40 patients (83%) with paradoxical hypotension, scintigraphy was normal compared to 131 (81%) of the remaining 161 patients. In patients of Group A, angiography, echocardiography and tilt table tests were performed in 13, 11 and 6 patients respectively. Nine of 13 angiographic evaluations (69%), 10 of 11 echocardiographic evaluations (91%), all of the tilt table tests were normal. Additionally, all of the patients of Group A were clinically followed up at least 6 months after the myocardial perfusion scintigraphy. None of the patients had a cardiac event except one patient during the follow-up period. Conclusion: Paradoxical hypotension during dobutamine infusion for myocardial scintigraphy is not an uncommon finding and up to 19.9% patients may develop such hypotension. To maximize test safety, precautions should be taken during dobutamine myocardial stress test, since remarkable decrease in systolic blood pressure may occur. Unlike hypotension occurring with exercise test, hypotension response to dobutamine is not always a marker for coronary artery disease.

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