scholarly journals Transient ischemic dilation as a diagnostic marker in myocardial perfusion SPECT protocols: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Nasim Namiranian ◽  
Mahmood Emami ◽  
Aryan Naghedi ◽  
Seid Kazem Razavi-Ratki
Keyword(s):  
Systematic Review ◽  
Coronary Artery ◽  
Single Photon ◽  
Selection Process ◽  
Meta Analysis ◽  
Stress Test ◽  
Photon Emission ◽  
Transient Ischemic Dilation ◽  
Pharmacological Stress ◽  
Imaging Protocol

Abstract Background: Transient ischemic dilation (TID) measures left ventricle (LV) volume changes which can be associated with combination of myocardial and endocardial ischemia. Various stress methods, single photon emission computerized tomography (SPECT) imaging protocol, camera and software incite controversy on TID cut off. The purpose of this study was to evaluate the TID ratio in detection of coronary artery disease (CAD) categories in a systematic review and meta-analysis. Method: We conducted a systematic search of electronic databases (PubMed, Scopus, Embase and Web of Science) up to 1 January 2017. The reference lists of all included studies were searched for a higher accuracy. The search strategy was according a defined PICO as P: none, I: Transient ischemic dilation, O: Coronary Artery Diseases, C: Angiographies. Statistical analysis was done by Comprehensive meta-analysis software version 2 (CMA-2). Result: After study selection process, 7 studies were selected for data extraction. TID was studied from 1987. The sample size of included studies ranged between 86 and 545. The mean age of included patients varied between 58 and 69 years old. Ranges of TID in CAD categories were excluded. The pooled estimates of TID in single and dual pharmacological stress test in three CAD categories were calculated. Conclusion: Our findings show that more studies are needed to compare the TID variability. Although in this study meta-analysis was done and TID was summarized from studies but the software differences were ignored.

scholarly journals Transient ischemic dilation as a diagnostic marker in myocardial perfusion SPECT protocols: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Nasim Namiranian ◽  
Mahmood Emami ◽  
Aryan Naghedi ◽  
Seid Kazem Razavi-Ratki
Keyword(s):  
Systematic Review ◽  
Coronary Artery ◽  
Single Photon ◽  
Selection Process ◽  
Meta Analysis ◽  
Stress Test ◽  
Photon Emission ◽  
Transient Ischemic Dilation ◽  
Pharmacological Stress ◽  
Imaging Protocol

Abstract Background: Transient ischemic dilation (TID) measures left ventricle (LV) volume changes which can be associated with combination of myocardial and endocardial ischemia. Various stress methods, single photon emission computerized tomography (SPECT) imaging protocol, camera and software incite controversy on TID cut off. The purpose of this study was to evaluate the TID ratio in detection of coronary artery disease (CAD) categories in a systematic review and meta-analysis. Method: We conducted a systematic search of electronic databases (PubMed, Scopus, Embase and Web of Science) up to 1 January 2017. The reference lists of all included studies were searched for a higher accuracy. The search strategy was according a defined PICO as P: none, I: Transient ischemic dilation, O: Coronary Artery Diseases, C: Angiographies. Statistical analysis was done by Comprehensive meta-analysis software version 2 (CMA-2). Result: After study selection process, 7 studies were selected for data extraction. TID was studied from 1987. The sample size of included studies ranged between 86 and 545. The mean age of included patients varied between 58 and 69 years old. Ranges of TID in CAD categories were excluded. The pooled estimates of TID in single and dual pharmacological stress test in three CAD categories were calculated. Conclusion: Our findings show that more studies are needed to compare the TID variability. Although in this study meta-analysis was done and TID was summarized from studies but the software differences were ignored.

scholarly journals Evaluating the use of pharmacological stress agents during single-photon emission computed tomography myocardial perfusion imaging tests after inadequate exercise stress test

2021 ◽  
Author(s):  
Hongbo Yang ◽  
Elizabeth Faust ◽  
Emily Gao ◽  
Sakshi Sethi ◽  
Therese M. Kitt ◽  
...  
Keyword(s):  
Single Photon ◽  
Stress Test ◽  
Photon Emission ◽  
Nuclear Imaging ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Emission Computed Tomography ◽  
Pharmacological Stress ◽  
Center Staff ◽  
Imaging Center

Abstract Background Past clinical trial findings suggest that the availability of regadenoson in a nuclear imaging center may affect real-world center practices related to the transition of patients from an inadequate exercise stress test (EST) to a pharmacological stress agent (PSA). Methods and Results This was a cross-sectional study using one-on-one telephone interviews with nuclear imaging center staff to facilitate survey development, followed by an online survey to evaluate patterns and processes around use of PSAs during single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in patients with inadequate ESTs. Of the 50 participants, 35 (70%) used only regadenoson, 3 (6%) only adenosine, 3 (6%) regadenoson and adenosine, 7 (14%) regadenoson and dipyridamole, and 2 (4%) all 3 agents for converting patients from an inadequate EST to a PSA. Nearly all centers (94%) used protocols to guide conversions. Of 12 centers using > 1 PSA, 11 reported regadenoson to be the most preferred PSA. Total staff time required from PSA transition to post-test monitoring was shortest for regadenoson. Conclusions Compared to adenosine and dipyridamole, regadenoson is preferred by nuclear imaging center staff and associated with operational efficiencies after inadequate EST in real-world practice SPECT-MPI.

Abstract 340: Evaluating the Use of Pharmacological Stress Agents During Single-photon Emission Computed Tomography Myocardial Perfusion Imaging Tests After Inadequate Exercise Stress Test

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Hongbo Yang ◽  
Elizabeth Faust ◽  
Emily Gao ◽  
Sakshi Sethi ◽  
Therese M Kitt ◽  
...  
Keyword(s):  
Single Photon ◽  
Stress Test ◽  
Photon Emission ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Emission Computed Tomography ◽  
Pharmacological Stress ◽  
Center Staff ◽  
Spect Mpi ◽  
Imaging Center

Objective: To evaluate how pharmacological stress agents (PSAs) are used during single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) for patients (pts) with an inadequate exercise stress test (EST). Methods: This was a cross-sectional study. One-on-one telephone interviews with nuclear imaging center staff were used to develop an online survey, which was administered to evaluate patterns/processes around PSA use during SPECT-MPI in pts with inadequate EST. Eligible survey participants included nuclear technicians, nurses, physicians, and imaging center managers/directors with sufficient familiarity with SPECT-MPI/use of PSAs. Primary endpoint measures included gaining insights on how imaging centers convert to PSAs after inadequate EST and associated resource use. Results: Of 50 participating centers, 35 (70%) used only regadenoson (REG), 3 (6%) only adenosine (ADN), 3 (6%) REG and ADN, 7 (14%) REG and dipyridamole (DP), and 2 (4%) all 3 agents for converting pts after inadequate EST. Most centers (94%) used protocols to guide conversions. Post-test monitoring, including monitoring of pt performance and managing adverse reactions after completion of SPECT-MPI following PSA, was not conducted by 66%, 38%, and 56% of centers using REG, ADN, and DP, respectively. Same-day conversion occurred for 92%, 89%, and 98% of pts for REG, ADN, DP, respectively; the mean (standard deviation) number of pts converted in the past 30 days were 29.6 (44.1), 9.3 (9.9), and 1.9 (1.8), respectively. After an inadequate EST, average pt wait times to receiving REG, ADN, or DP were 4.9, 12.4 or 17.4 min, respectively; among centers using REG, 60% administered the PSA within a mean of 3 min, compared to 11% (1 center) using DP and no centers using ADN. Nearly 100%, 38%, and 11% of REG, ADN, and DP centers, respectively, reported that PSA administration was “not at all complex.” Of the centers using >1 PSA, 92% found REG to be the most preferred PSA (overall) among staff. Total staff time (aggregating time for multiple staff members who may have worked concurrently at each step) required from PSA transition to post-test monitoring was shortest for REG ( Table ). Conclusions: Imaging center staff prefer REG and its use is associated with operational efficiencies during SPECT-MPI after inadequate EST.

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