scholarly journals Perfusion Computed Tomography for the Assessment of Myocardial Viability — a Case Series

2016 ◽  
Vol 1 (1) ◽  
pp. 83-87
Author(s):  
Mirabela Morariu ◽  
Diana Opincariu ◽  
Alexandra Stănescu
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Myocardial Perfusion ◽  
Myocardial Viability ◽  
Stress Test ◽  
Left Ventricular ◽  
Ct Coronary Angiography ◽  
Viable Myocardium ◽  
Adenosine Stress ◽  
Emission Computed Tomography

Abstract Myocardial viability plays an important role in preventing the development of left ventricular remodeling following an acute myocardial infarction. A preserved viability in the infarcted area has been demonstrated to be associated with a lower amplitude of the remodeling process, while the extent of the non-viable myocardium is directly correlated with the amplitude of the remodeling process. A number of methods are currently in use for the quantification of the viable myocardium, and some of them are based on the estimation of myocardial perfusion during pharmacologic stress. 64-slice Multi-detector Computed Tomography (MDCT) during vasodilator stress test, associated with CT Coronary Angiography (CCTA) has a high diagnostic accuracy in evaluating myocardial perfusion. In this article, we present a sequence of 3 clinical cases that presented with symptoms of myocardial ischemia, who underwent 64-slice MDCT imaging at rest and during adenosine stress test, in order to assess the extent of the hypoperfused myocardial areas. Coronary artery anatomy and the Coronary Calcium Score was assessed for all 3 patients by performing CT Coronary Angiography. The combination of CT Angiography and adenosine stress CT myocardial perfusion imaging can accurately detect atherosclerosic lesions that cause perfusion abnormalities, compared with the combination of invasive angiography and single-photon emission computed tomography (SPECT).

scholarly journals Imaging Techniques for the Assessment of Myocardial Perfusion

2016 ◽  
Vol 1 (3) ◽  
pp. 247-251
Author(s):  
Laura Jáni ◽  
Lehel Bordi ◽  
Mirabela Morariu ◽  
Tiberiu Nyulas ◽  
István Kovács ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Myocardial Perfusion ◽  
Single Photon ◽  
Imaging Techniques ◽  
Color Doppler ◽  
Photon Emission ◽  
Left Ventricular ◽  
Myocardial Imaging ◽  
Emission Computed Tomography ◽  
Emission Computed

Abstract One of the most significant causes of heart failure is coronary heart disease and subsequent left ventricular dysfunction. The prognosis and perioperative mortality are influenced by left ventricular function, which is also an important predictor marker following revascularization. The evaluation of myocardial perfusion is of utmost importance in patients who present several symptoms before choosing cardiac catheterization as treatment. The evaluation of myocardial perfusion and myocardial viability leads to superior diagnostic and treatment algorithms, thus resulting in an important improvement in the outcomes of patients with coronary artery disease. Color Doppler myocardial imaging, single-photon emission computed tomography (SPECT), contrast perfusion echocardiography, positron emission computed tomography (PET) and magnetic resonance imaging (MRI) are currently used methods for assessing myocardial perfusion. This review aims to summarize the benefits and disadvantages of each of these techniques.

scholarly journals Effects of Cardioprotective Tactics on the Myocardial Perfusion and Contractile Function of the Left Ventricular Myocardium in Cancer Patients with Evidence of Doxorubicin-Induced Cardiotoxicity

Kardiologiia ◽  
2021 ◽  
Vol 61 (1) ◽  
pp. 22-27
Author(s):  
Yu. A. Prus ◽  
A. A. Ansheles ◽  
I. V. Sergienko
Keyword(s):  
Computed Tomography ◽  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Left Ventricular ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Emission Computed ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Aim      To study the effect of cardioprotective tactics on parameters of left ventricular myocardial perfusion and contractility as per data from single-photon emission computed tomography in oncological patients with signs of anthracycline-induced cardiotoxicity.Material and methods  The study included patients with oncological diseases (n=61) referred to polychemotherapy (PCT). For patients with signs of anthracycline-induced cardiotoxicity, a cardioprotective tactics was used, which included changing the PCT schedule and administering beta-blockers and angiotensin-converting enzyme inhibitors. For all patients at baseline, after the first four PCH courses, after initiation of the cardioprotective tactics and the next four PTC courses, the level of N-terminal pro-brain natriuretic peptide was measured and echocardiography and perfusion single-photon emission computed tomography were performed with assessment of left ventricular (LV) perfusion heterogeneity, systolic and diastolic function.Results Following four PTC courses, signs of cardiotoxicity were detected in 13 (21.3 %) patients. On the background of the cardioprotective tactics, a further decrease in LV ejection fraction (EF) by –9±2 % (p<0.01) was observed in 4 (30.8 %) patients. In 9 (69.2 %) patients, LV EF increased by 4±2 % (p<0.01). Standard indexes of LV myocardial perfusion did not significantly change. In 7 patients, the cardioprotective tactics was associated with reduced severity of myocardial perfusion disorder, LV∆σТ = –1.37±1.29 (p<0.05), and in 4 patients, with reduced heterogeneity of myocardial perfusion, LV∆σН = –1.20±0.70 (p<0.05).Conclusion      The cardioprotective tactics prevents both further disorder of perfusion and decreases in parameters of left ventricular myocardial contractility in patients with anthracycline-induced cardiotoxicity.

P2716Correlation between computed tomography derived ischemia index and conventional fractional flow reserve

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Yamaji ◽  
A Katsuki ◽  
H Haque ◽  
N Uetake ◽  
A Miyazaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Myocardial Ischemia ◽  
Left Ventricular Volume ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Ct Coronary Angiography ◽  
Artery Disease

Abstract Background Computed tomography (CT) derived ischemia index is a novel tool to determine the significance of coronary artery disease, however, its ability to identify myocardial ischemia has not been examined. Methods From Jan. 2013 to Dec. 2015, 14,000 patients underwent ECG-gated CT coronary angiography for suspected coronary artery disease. From Jan. 2013 to Jan. 2016, 483 patients (589 vessels) underwent conventional FFR to assess myocardial ischemia. Among those, FFR was assessed in 148 patients (167 vessels) within 30 days after CT coronary angiography. We further excluded 24 patients with prior stenting or bypass grafting, 3 patients with multiple MDCT or FFR, and 6 patients with insufficient datasets. Finally, we included 117 patients (127 vessels) to assess the correlation between CT derived ischemia index and conventional FFR. CT derived ischemia index was calculated as follows: left ventricular volume distally to the coronary artery lumen (cm3)/coronary artery lumen area (mm2). Left ventricular volume was automatically determined using Advantage Workstation and divided according to the nearest coronary artery tree. Center of coronary arteries were manually traced and contours of coronary artery lumen were automatically depicted. CT derived ischemia index was calculated at approximately every 0.625mm point of coronary artery. Moving median of consecutive 5 points (approximately 3.125mm) were used to remove outliers. Maximum value of CT derived ischemia index per coronary artery segment was calculated to determine the significance of coronary artery disease. Results Mean age was 71.3±10.5 years and 63.8% of patients were male. Coronary angiography was performed to assess conventional FFR at the median of 13 days (IQR 7 to 18 days) after CT. Majority of the target vessel was left anterior descending artery (71.7%), followed by right coronary artery (14.2%), left circumflex artery (13.4%) and left main coronary artery (0.8%). According to the quantitative coronary angiography, minimum lumen diameter was 1.47±0.32mm with percent diameter stenosis of 48.3±10.4%. Median FFR value was 0.83 (IQR 0.76 to 0.88) and positive test for myocardial ischemia (FFR <0.80) was observed in 42 vessels (33.1%). Maximum CT derived ischemia index per segment ranged from 1.825 to 57.296 (median 8.333, IQR 4.911 to 14.484). There was a negative correlation between CT derived ischemia index and FFR (r=−0.319, 95% confidence interval −0.467 to −0.153, P<0.001). Receiver operating characteristic analysis indicated CT derived ischemia index of 9.962 has 76.2% sensitivity and 70.6% specificity for the presence of FFR<0.80 (AUC 0.73, 95% CI 0.64 to 0.82). Conclusions A novel tool of CT derived ischemia index has a significant negative correlation with conventional FFR in lesions with mild to moderate stenosis. Larger multicenter prospective studies are needed to fully determine the impact of CT derived ischemia index.

Measuring Left Ventricular Ejection Fraction – Techniques and Potential Pitfalls

2012 ◽  
Vol 8 (2) ◽  
pp. 108 ◽  
Author(s):  
Thomas A Foley ◽  
Sunil V Mankad ◽  
Nandan S Anavekar ◽  
Crystal R Bonnichsen ◽  
Michael F Miller ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Left Ventricular Ejection Fraction ◽  
Myocardial Perfusion ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Imaging Modalities ◽  
Left Ventricular Ejection ◽  
Emission Computed Tomography ◽  
Ventricular Ejection Fraction

Prognosis and therapeutic decisions are often based on left ventricular ejection fraction (LVEF), which means the LVEF needs to be accurately measured. Many imaging modalities can measure LVEF. Each of these modalities is subject to measurement errors that can lead to the inaccurate calculation of LVEF. This article reviews the most common non-invasive imaging modalities – i.e., echocardiography, magnetic resonance imaging (MRI), computed tomography (CT), radionuclide angiography, gated myocardial perfusion single-photon emission computed tomography (SPECT) and gated myocardial perfusion positron emission tomography (PET) – used to measure LVEF, as well as the common sources of error with each of them. It is important to understand these sources of errors in order to prevent them, and recognise them when they do occur so that they can be corrected if possible.

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