Myocardial Perfusion and Viability Imaging in Coronary Artery Disease: Clinical Value in Diagnosis, Prognosis, and Therapeutic Guidance

Li, Dan L.; Kronenberg, Marvin W.

doi:10.1016/j.amjmed.2021.03.011

Cited by 19 publications

(12 citation statements)

References 65 publications

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“…CAD is among the most common types of cardiovascular diseases, and risk factors for CAD include hypertension, smoking, diabetes, physical inactivity, obesity, high blood cholesterol, depression, and alcohol overdose, and the underlying pathogenesis is due to cardiac atherosclerosis, which reduces blood flow as well as oxygen transfer to the myocardium [ 7 , 8 ]. Epidemiological studies [ 9 , 10 ] have shown that the number of overweight and obese people is increasing worldwide.…”

Section: Discussionmentioning

confidence: 99%

Study on the Relationship between Different Body Mass Indexes and Puncture Pain and Image Quality in Patients Undergoing Coronary Angiography with Intravenous Indwelling Needle

Ding

Chen

2022

Emergency Medicine International

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Objective. To investigate the effect of different body mass indexes (BMIs) on patients’ puncture pain, puncture success rate, and image quality in coronary angiography (CAG) performed with an intravenous indwelling needle, and to provide a basis for selecting the appropriate intravenous indwelling needle for CAG in patients with different BMIs in an outpatient clinic. Method. In this study, 300 patients undergoing CTA at the department of radiology in the First Affiliated Hospital of Wenzhou Medical University from January to May 2021 were divided into group 1 (BMI 1 ≤ 18.5), group 2 (18.5 < BMI ≤ 24), and group 3 (BMI > 24) according to their BMI, with 100 cases in each group, and a 20 G intravenous indwelling needle was used in each group. The age, sex, height, and weight of each patient were recorded, and the primary puncture success rate, contrast leakage rate, injection success rate, pain perception, and subjective ratings of image quality and objective indicators were compared in patients with different BMI values. Results. There was no statistically significant difference between the age, gender, and heart rate of the patients in the three groups ( P > 0.05 ). There was no statistically significant difference between the primary puncture success rate, injection success rate, and contrast leakage rate of the three groups of patients ( P > 0.05 ). The pain scores of group 3 during contrast injection were significantly higher than those of the remaining two groups ( P < 0.05 ), while the differences between the pain scores of group 2 and group 1 during contrast injection were not statistically significant ( P > 0.05 ); the comparison of the pain scores of the three groups during puncture and during retention was not statistically significant ( P > 0.05 ). The differences between the subjective ratings of image quality and the objective indicators of the three groups were not statistically significant ( P > 0.05 ). Conclusion. The 20 G indwelling needle can basically meet the coronary angiography examination of patients with different body mass indexes, but patients with a BMI greater than 24 are recommended to use a larger diameter indwelling needle to reduce contrast leakage as well as to reduce patient pain and improve patient comfort.

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Section: Discussionmentioning

confidence: 99%

Study on the Relationship between Different Body Mass Indexes and Puncture Pain and Image Quality in Patients Undergoing Coronary Angiography with Intravenous Indwelling Needle

Ding

Chen

2022

Emergency Medicine International

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“…The overall high use of SPECT MPI across patients of different disease states or severity indicates that physicians may be selecting imaging modalities based on local availability and expertise rather than clinical factors. Evidence suggests that SPECT MPI is more widely used due to affordability and availability [ 28 , 29 ]. PET MPI is generally only available in tertiary hospitals, while cCTA is widely available in specialist referral centres.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US

Pelletier‐Galarneau

Vandenbroucke

et al. 2023

BMC Cardiovasc Disord

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Background There are limited data on the impact of imaging modality selection for the assessment of coronary artery disease (CAD) risk on downstream resource utilisation. This study sought to identify differences between patient populations in the US undergoing stress echocardiography, single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), positron emission tomography (PET) MPI, and coronary computed tomography angiography (cCTA) for the assessment of CAD risk, and associated physician referral patterns. Methods Claims and electronic health records data for 2.5 million US patients who received stress echocardiography, cCTA, SPECT MPI or PET MPI between January 2016 and March 2018, from the Decision Resources Group Real-World Evidence US Data Repository, were analysed. Patients were stratified into suspected and existing CAD cohorts, and further stratified by pre-test risk and presence and recency of interventions or acute cardiac events (within 1–2 years pre-index test). Linear and logistic regression were used to compare numeric and categorical variables. Results Physicians were more likely to refer patients to standalone SPECT MPI (77%) and stress echocardiography (18%) than PET MPI (3%) and cCTA (2%). Overall, 43% of physicians referred more than 90% of their patients to standalone SPECT MPI. Just 3%, 1% and 1% of physicians referred more than 90% of their patients to stress echocardiography, PET MPI or cCTA. At the aggregated imaging level, patients who underwent stress echocardiography or cCTA had similar comorbidity profiles. Comorbidity profiles were also similar for patients who underwent SPECT MPI and PET MPI. Conclusion Most patients underwent SPECT MPI at the index date, with very few undergoing PET MPI or cCTA. Patients who underwent cCTA at the index date were more likely to undergo additional imaging tests compared with those who underwent other imaging modalities. Further evidence is needed to understand factors influencing imaging test selection across patient populations.

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“…1 PET is on the top of list but still CMR demonstrates comparable diagnostic performance. [16][17][18] Though SPECT scan is the commonly used imaging modality but the advantage of CMR over SPECT scan can be illustrated by lack of ionizing radiation, high resolution, accuracy and lack of stochastic effects. 19 Another advantage of CMR over SPECT scan is the capability to detect even subendocardial perfusion defects.…”

Section: Discussionmentioning

confidence: 99%

Comparision of Myocardial Viability Assessment Between Cardiac Magnetic Resonance Imaging and Single Photon Emission Computed Tomography in Patients with Coronary Artery Disease

Ahmed

Nadeem²,

Mohsin³

et al. 2022

PAFMJ

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Objective: To assess the myocardial viability on cardiac magnetic resonance imaging compared with single photon emission computed tomography scan in patients with coronary artery disease. Study Design: This study was cross sectional study. Place and Duration of Study: Cardiac Magnetic Resonance Imaging and Nuclear Medicine Departments of a Tertiary Cardiac Care Center of Rawalpindi Pakistan, from Dec 2021 to May 2022. Methodology: This study was cross sectional study conducted from December 2021 to May 2022 at Cardiac Magnetic resonance imaging and Nuclear Medicine departments of a Tertiary Cardiac Care Center of Rawalpindi Pakistan. Thirty patients (n=30) with coronary artery disease were selected using non-probability consecutive sampling technique to determine the viable myocardium using cardiac magnetic resonance imaging (CMR) and single photon emission computed tomography (SPECT) scan. Patients with left ventricular dysfunction having ejection fraction equal to or less than forty-five percent and coronary artery disease were included. Results: Using 20 segment models, the mean number of viable segments in SPECT scan and CMR were 16.6±3.18 and 15.47±3.84, respectively while the non-viable segments were 3.4±3.1 and 5.17±4.6, respectively. There was statically little difference in results of Single-photon Emission Computerized Tomography and Cardiac Magnetic Resonance Imaging to determine viable myocardium (p<0.05). Conclusion: Assessment of myocardial viability has keen role in diagnostic and prognostic work up of coronary artery disease patients who are candidates of revascularization. Stunned and hibernating myocardium are two states oreversible myocardial dysfunction.....

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Myocardial Perfusion and Viability Imaging in Coronary Artery Disease: Clinical Value in Diagnosis, Prognosis, and Therapeutic Guidance

Cited by 19 publications

References 65 publications

Study on the Relationship between Different Body Mass Indexes and Puncture Pain and Image Quality in Patients Undergoing Coronary Angiography with Intravenous Indwelling Needle

Study on the Relationship between Different Body Mass Indexes and Puncture Pain and Image Quality in Patients Undergoing Coronary Angiography with Intravenous Indwelling Needle

Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US

Comparision of Myocardial Viability Assessment Between Cardiac Magnetic Resonance Imaging and Single Photon Emission Computed Tomography in Patients with Coronary Artery Disease

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