Pharmacological stress myocardial perfusion imaging after an inadequate exercise stress test

Sharedalal, Parija; Gerard, Perry; Jain, Diwakar

doi:10.1007/s12350-021-02661-3

Cited by 5 publications

(1 citation statement)

References 14 publications

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“…In rodents, regadenoson was found to transiently disrupt the BBB, allowing entry of a 70 kD dextran, disabling p-glycoprotein pumps, and facilitating the entry of lymphocytes into the brain. Regadenoson is FDA approved for patients who need a cardiac stress test but cannot walk on a treadmill [ 59 ]. There have been three pilot studies evaluating whether regadenoson administered at the FDA-approved dose for cardiac stress tests is able to open the BBB in patients.…”

Section: Resultsmentioning

confidence: 99%

Transient Opening of the Blood-Brain Barrier by Vasoactive Peptides to Increase CNS Drug Delivery: Reality Versus Wishful Thinking?

Smith-Cohn

Burley

Grossman

2022

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Background: The blood-brain barrier inhibits the central nervous system penetration of 98% of small molecule drugs and virtually all biologic agents, which has limited progress in the treatment of neurologic disease. Vasoactive peptides have been shown in animal studies to transiently disrupt the blood-brain barrier and regadenoson is currently being studied in humans to determine if it can improve drug delivery to the brain. However, there are many other vasoactive peptides that could potentially be used for this purpose. Methods: We performed a review of the literature evaluating the physiologic effects of vasoactive peptides on the vasculature of the brain and systemic organs. To assess the likelihood that a vasoactive peptide might transiently disrupt the blood-brain barrier, we devised a four-tier classification system to organize the evidence available. Results: We identified 33 vasoactive peptides with potential blood-brain barrier permeability-altering properties. To date, none of these are shown to open the blood-brain barrier in humans. 12 vasoactive peptides increased blood-brain barrier permeability in rodents. The remaining 23 had favorable physiologic effects on blood vessels but lacked specific information on permeability changes to the blood-brain barrier. Conclusion: Vasoactive peptides remain an understudied class of drugs with the potential to increase drug delivery and improve treatment in patients with brain tumors and other neurologic diseases. Dozens of vasoactive peptides have yet to be formally evaluated for this important clinical effect. This narrative review summarizes the available data on vasoactive peptides, highlighting agents that deserve further in vitro and in vivo investigations.

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Section: Resultsmentioning

confidence: 99%

Transient Opening of the Blood-Brain Barrier by Vasoactive Peptides to Increase CNS Drug Delivery: Reality Versus Wishful Thinking?

Smith-Cohn

Burley

Grossman

2022

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“Global” cardiac atherosclerotic burden assessed by artificial intelligence-based versus manual segmentation in 18F-sodium fluoride PET/CT scans: Head-to-head comparison

Piri

Edenbrandt

Larsson³

et al. 2022

Journal of Nuclear Cardiology

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Background: Artificial intelligence (AI) is known to provide effective means to accelerate and facilitate clinical and research processes. So in this study it was aimed to compare a AI-based method for cardiac segmentation in positron emission tomography/computed tomography (PET/CT) scans with manual segmentation to assess global cardiac atherosclerosis burden.Methods: A trained convolutional neural network (CNN) was used for cardiac segmentation in 18 Fsodium fluoride PET/CT scans of 29 healthy volunteers and 20 angina pectoris patients and compared with manual segmentation. Parameters for segmented volume (Vol) and mean, maximal, and total standardized uptake values (SUVmean, SUVmax, SUVtotal) were analysed by Bland-Altman Limits of Agreement. Repeatability with AI-based assessment of the same scans is 100%.Repeatability (same conditions, same operator) and reproducibility (same conditions, two different operators) of manual segmentation was examined by re-segmentation in 25 randomly selected scans.

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Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2022: single photon emission computed tomography

AlJaroudi

Hage

2023

Journal of Nuclear Cardiology

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Pharmacological stress myocardial perfusion imaging after an inadequate exercise stress test

Cited by 5 publications

References 14 publications

Transient Opening of the Blood-Brain Barrier by Vasoactive Peptides to Increase CNS Drug Delivery: Reality Versus Wishful Thinking?

Transient Opening of the Blood-Brain Barrier by Vasoactive Peptides to Increase CNS Drug Delivery: Reality Versus Wishful Thinking?

“Global” cardiac atherosclerotic burden assessed by artificial intelligence-based versus manual segmentation in 18F-sodium fluoride PET/CT scans: Head-to-head comparison

Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2022: single photon emission computed tomography

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