Introduction to nuclear cardiology

2017 ◽  
Author(s):  
Nikant Sabharwal ◽  
Parthiban Arumugam ◽  
Andrew Kelion
Keyword(s):  
Nuclear Cardiology ◽  
Left Ventricular ◽  
Imaging Modalities ◽  
Non Invasive ◽  
Early Twenty ◽  
Cardiac Imaging Technique ◽  
Wide Range ◽  
History Of ◽  
X Ray Computed ◽  
Artery Disease

The cardiologist of the early twenty-first century takes for granted the wide range of imaging modalities at his/her disposal, but it was not always so. At the beginning of the 1970s, invasive cardiac catheterization was the only reliable cardiac imaging technique. Subsequently, nuclear cardiology investigations led the way in the non-invasive assessment of cardiac disease. This chapter covers the history of nuclear cardiology, including important milestones in the development of nuclear medicine. It details the relation of nuclear cardiology to other imaging modalities, covering the common imaging modalities used to evaluate left ventricular function and coronary artery disease, and the challenges of multislice X-ray computed tomography.

Introduction to nuclear cardiology

2011 ◽  
Author(s):  
Nikant Sabharwal ◽  
Chee Yee Loong ◽  
Andrew Kelion
Keyword(s):  
Nuclear Cardiology ◽  
Cardiac Disease ◽  
Imaging Technique ◽  
First Century ◽  
Imaging Modalities ◽  
Non Invasive ◽  
Early Twenty ◽  
Cardiac Imaging Technique ◽  
Wide Range ◽  
Electrocardiogram Ecg

Introduction 2Important milestones 4Relation to other imaging modalities 6The cardiologist of the early twenty-first century takes for granted the wide range of imaging modalities at his/her disposal, but it was not always so. At the beginning of the 1970s, invasive cardiac catheterization was the only reliable cardiac imaging technique. Subsequently, nuclear cardiology investigations led the way in the non-invasive assessment of cardiac disease. Some of the principles underlying these investigations [e.g. electrocardiogram (ECG)-triggered gating] have also been of great importance in the development of other imaging modalities....

scholarly journals Assessment of Myocardial Viability: A Review of Current Non Invasive Imaging Techniques

2015 ◽  
Vol 1 (3) ◽  
pp. 113 ◽  
Author(s):  
Ahmed Talib
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Ventricular Dysfunction ◽  
Imaging Techniques ◽  
Left Ventricular ◽  
Common Cause ◽  
Non Invasive ◽  
Artery Disease ◽  
Impaired Quality

Coronary artery disease (CAD) is the most prevalent and<br />single most common cause of morbidity and mortality1 with<br />the resulting left ventricular dysfunction (LVD) an important<br />complication2. Worldwide, CAD accounts for 5.7 million new<br />cases per year, of these 1.3 million in Europe alone3. In addition,<br />it imposes a substantial share of health service resources and<br />expenses, an impaired quality of life, disability and high social<br />cost3,4. Furthermore, LVD itself has been shown to be a powerful<br />determinant of survival2, 5.

PET-CT and detection of coronary artery disease

2021 ◽  
pp. 421-434
Author(s):  
Marcelo F. Di Carli
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Microvascular Dysfunction ◽  
Quantitative Information ◽  
Left Ventricular ◽  
Coronary Microvascular Dysfunction ◽  
Non Invasive ◽  
Atherosclerotic Burden ◽  
Pet Ct ◽  
Artery Disease

Myocardial perfusion PET/CT imaging has emerged as a powerful and comprehensive non-invasive approach for the management of patients with suspected or known coronary artery disease (CAD). The multiparametric PET/CT approach provides quantitative information about the extent and severity of focal and diffuse CAD, coronary microvascular dysfunction (CMD), atherosclerotic burden, and left ventricular function. Contemporary evidence demonstrates that this comprehensive approach is one of the most accurate non-invasive tools for diagnosis, risk prediction, and guiding management in patients with CAD. This chapter summarizes the versatility of the integrated PET/CT scan to provide detailed quantitative information tailored to the patient and clinical question. I then review patient-centred clinical applications using case vignettes to illustrate indications of PET/CT and how to present the findings into clinically actionable information for the practising cardiologist. In each case, I review the available data highlighting the diagnostic and prognostic value of the integrated PET/CT protocol.

scholarly journals Ventricular tachycardia storm management in a COVID-19 patient: a case report

2020 ◽  
Vol 4 (FI1) ◽  
pp. 1-6 ◽  
Author(s):  
Gianfranco Mitacchione ◽  
Marco Schiavone ◽  
Alessio Gasperetti ◽  
Giovanni B Forleo
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Arrhythmias ◽  
Cardiac Involvement ◽  
Previous History ◽  
Left Ventricular ◽  
Electrical Storm ◽  
Increased Risk ◽  
History Of ◽  
Myocardial Involvement ◽  
Artery Disease

Abstract Background Coronavirus disease 2019 (COVID-19) has been associated with myocardial involvement. Among cardiovascular manifestations, cardiac arrhythmias seem to be fairly common, although no specifics are reported in the literature. An increased risk of malignant ventricular arrhythmias and electrical storm (ES) has to be considered. Case summary We describe a 68-year-old patient with a previous history of coronary artery disease and severe left ventricular systolic disfunction, who presented to our emergency department describing cough, dizziness, fever, and shortness of breath. She was diagnosed with COVID-19 pneumonia, confirmed after three nasopharyngeal swabs. Ventricular tachycardia (VT) storm with multiple implantable cardioverter defibrillator (ICD) shocks was the presenting manifestation of cardiac involvement during the COVID-19 clinical course. A substrate-based VT catheter ablation procedure was successfully accomplished using a remote navigation system. The patient recovered from COVID-19 and did not experience further ICD interventions. Discussion To date, COVID-19 pneumonia associated with a VT storm as the main manifestation of cardiac involvement has never been reported. This case highlights the role of COVID-19 in precipitating ventricular arrhythmias in patients with ischaemic cardiomyopathy who were previously stable.

scholarly journals Prevalence of non-acute ischaemic cardiomyopathy in a Pakistani cohort

Heart Asia ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. e011043
Author(s):  
Muhammad Salman Ghazni ◽  
Saba Aijaz ◽  
Rehan Malik ◽  
Asad Z Pathan
Keyword(s):  
Stress Testing ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Rank Test ◽  
Ventricular Ejection Fraction ◽  
Primary Indication ◽  
History Of ◽  
Artery Disease

Heart failure with reduced left ventricular ejection fraction (HFrEF) is a frequently encountered clinical scenario. Coronary angiography (CAG) is usually performed to assess obstructive epicardial coronary artery disease (CAD) and the resultant ischaemia as causes of HFrEF.ObjectivesTo determine the frequency of obstructive CAD (OCAD) in patients with HFrEF and its independent predictors and outcomes.MethodsRetrospective observational study in Tabba Heart Institute on patients who underwent CAG during the past 4 years. Patients with prior known CAD or revascularisation were excluded. OCAD was defined as per the criteria from Felker et al. Regression modelling was performed to evaluate the predictors of OCAD. Survival was compared between the groups using the log rank test.ResultsOut of 2235 patients who underwent CAG, 260 had HFrEF as a primary indication for CAG and, of these, 119 (45.8%) had OCAD. Major predictors of OCAD were age >50 years at presentation (OR 2.0, 95% CI 1.1 to 3.7), presence of chest pain (OR 4.3, 95% CI 2.3 to 8.1), family history of premature CAD (OR 2.8, 95% CI 1.3 to 5.9) and utilisation of non-invasive (NIV) stress testing before CAG (OR 3.6, 95% CI 1.8 to 7.1). Survival was significantly lower (log rank p<0.001) in patients with OCAD with no revascularisation compared with OCAD with revascularisation or those who had non-obstructive CAD, and the latter two groups had comparable survival.ConclusionsOCAD is detected in nearly half of the patients with reduced left ventricular systolic function undergoing CAG. Clinical judgement based on thorough history and use of NIV stress testing can help in appropriate patient selection for this test.

scholarly journals Giant left ventricular pseudoaneurysm: The diagnostic contribution of different non-invasive imaging modalities

2012 ◽  
Vol 31 (6) ◽  
pp. 439-444
Author(s):  
Sílvia Marta Oliveira ◽  
Paula Dias ◽  
Teresa Pinho ◽  
Cristina Gavina ◽  
Pedro Bernardo Almeida ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Imaging Modalities ◽  
Left Ventricular Pseudoaneurysm ◽  
Non Invasive

scholarly journals Non-invasive stimulation of angiogenesis with shock-wave therapy in patients with coronary artery disease (literature review). Part 2

2017 ◽  
Vol 8 (2) ◽  
pp. 30-34
Author(s):  
S. T Matskeplishvili ◽  
B. M Borbodoeva
Keyword(s):  
Shock Wave ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Revascularization ◽  
Left Ventricular ◽  
Published Data ◽  
Shock Wave Therapy ◽  
Non Invasive ◽  
Artery Disease ◽  
Contemporary Management

The article presents a review of published data regarding the most important problem in cardiology - treatment of patients with coronary artery disease and left ventricular dysfunction and improvement of quality of life in this group. The review covers the contemporary management of coronary artery disease, new approaches to the treatment of coronary artery disease in patients without possibility of myocardial revascularization or having undergone revascularization. The safety and effectiveness of shock-wave therapy in this group of patients is presented.

Abstract 17234: Cisplatin Induced Coronary Artery Atherosclerosis Leading To St-elevation Myocardial Infarction: A Case Report

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Sheikh Bilal B Khalid ◽  
Javaria Mahmood
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Premature Coronary Artery Disease ◽  
Chemotherapeutic Regimen ◽  
History Of ◽  
St Elevation ◽  
Artery Disease

Introduction: Cisplatin-based chemotherapeutic regimen (CBCR) is known for increasing risk of venous thromboembolic (TE) disease. We report a unique case of STEMI associated with CBCR which we believe was caused by coronary artery thrombosis. Case description: A 31-yo man with a past history of germ cell tumor presented with chest pain radiating to back and left arm. It started this morning and intensity did not worsen with exertion. He denied any dyspnea, diaphoresis or palpitations. He was non-smoker and non-obese. He denied any family history of premature coronary artery disease. He had undergone unilateral orchiectomy a year ago, and was currently receiving chemotherapy with bleomycin, etoposide and cisplatin; the last dose of his 3 rd cycle was given the day before. EKG showed ST elevation in leads I, aVL, V4 and V5. Troponin I was high to 6.9 ng/ml (ULN 0.045 ng/ml). He received intravenous infusion of thrombolytic. An angiogram done the next day showed moderate mid-LAD disease with residual clot. A CT scan and an echocardiogram later showed left ventricular thrombus (LVT). He was kept on therapeutic enoxaparin along with aspirin. Follow up echocardiogram showed resolution of the thrombus. His chemotherapy was stopped, and he has been kept on active surveillance since then. Discussion: Most cases of CBCR-associated myocardial infarction that have been reported have been seen in the older population with other risk factors for coronary artery disease. Cases where angiographic data was available, coronary artery vasospasm appeared to be the culprit rather than a true plaque rupture. While the presence of LVT raises possibility of thromboembolism to coronaries causing MI, the angiographic findings support accelerated plaque formation to be the cause of infarction. In earlier reports, elevated pre-treatment level of von Willebrand factor has been postulated to have some role in the disease pathogenesis. Other possible mechanisms for pathogenesis include endothelial cell damage, platelet activation, and imbalance between thromboxane-prostacyclin levels. This case emphasizes the need to keep cardiac etiologies of chest pain in the differential when evaluating patients on CBCR as timely intervention is life saving and prevent morbidity.

Abstract 15359: Cost-effectiveness of Different Strategies for the Diagnosis of Stable Coronary Artery Disease: Results from the Evinci Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Giuseppe Turchetti ◽  
Valentina Lorenzoni ◽  
Stefania Bellelli ◽  
Francesca Pierotti ◽  
Daniele Rovai ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cost Effectiveness ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stable Angina ◽  
Imaging Modalities ◽  
Fractional Flow ◽  
Stress Imaging ◽  
Non Invasive ◽  
Artery Disease

Introduction: In patients with suspected coronary artery disease (CAD) the comparative value of non invasive diagnostic imaging modalities or strategies is not yet defined. Hypothesis: We hypothesized that a comparative cost-effectiveness (CE) analysis of different non-invasive imaging strategies in a European population of patients with stable angina could identify the best approach for the diagnosis of significant CAD. Methods: In 475 pts (291 males, 60±9 yrs) with stable angina enrolled in the EVINCI multicenter study, CT coronary angiography (CTCA) and stress imaging were performed before invasive coronary angiography (ICA). Significant CAD was defined as >50% stenosis in the left main or >70% stenosis in a major coronary vessel or 30-70% stenosis with fractional flow reserve ≤0.8. Non-invasive imaging strategies included CTCA or stress imaging (ECHO, CMR, SPECT or PET) alone or in combination. Combinations were positive if both CTCA and the stress test were positive. CE analysis was performed using per patient data. Effectiveness was defined as percentage of correct diagnosis. Costs were calculated by country-specific reimbursements for each test considered plus ICA costs when non invasive tests were positive. Incremental cost-effectiveness ratios (ICERs) were obtained by regression analysis and using a propensity-score adjustment. Results: Significant CAD was diagnosed at ICA in 140 pts (29%). CTCA had the highest diagnostic performance among single imaging modalities and CTCA-PET among combinations (Table). At CE analysis, ECHO approach was the least costly but also the least effective, while CTCA alone or in combination with PET had increasingly higher effectiveness for a willingness to pay (WTP) exceeding 2,000 Euro and 5,000 Euro, respectively (Table). Conclusion: Stress ECHO is a cost-effective approach to diagnose stable CAD when the WTP is low. CTCA alone or combined with stress PET allows a more effective diagnostic workflow for higher WTP.

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