ABSTRACT
Patient preparation is crucial for reliable interpretation of cardiac inflammation FDG PET. We share our experience of improved reporting confidence and propose a simple approach of prolonging preparation (from 24 to 48 hours) with the high-fat, no-carbohydrate, and protein-permitted diet followed by fasting in cardiac sarcoidosis in cases with diffuse or focal-on-diffuse myocardial FDG uptake.
Subject(s)
Cardiomyopathies , Myocarditis , Sarcoidosis , Humans , Fluorodeoxyglucose F18 , Positron Emission Tomography Computed Tomography/methods , Cardiomyopathies/diagnostic imaging , Radiopharmaceuticals , Positron-Emission Tomography/methods , Sarcoidosis/diagnostic imagingABSTRACT
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
ABSTRACT
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
Subject(s)
Tomography, Emission-Computed, Single-Photon , HumansABSTRACT
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
Subject(s)
Coronary Artery Disease , Myocardial Perfusion Imaging , Humans , Tomography, Emission-Computed, Single-PhotonABSTRACT
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
Subject(s)
Nuclear Medicine , HumansABSTRACT
BACKGROUND: An absent left ventricular ejection fraction (LVEF) reserve with vasodilator stress with PET cardiac imaging has been shown to provide significant independent and incremental value to the perfusion images for prediction of future cardiovascular adverse events. However, the prognostic value of LVEF reserve has not been well characterized with SPECT myocardial perfusion imaging (MPI). METHODS: We studied 858 consecutive patients with normal and abnormal perfusion pattern with regadenoson SPECT MPI. Change in LVEF was calculated as post-stress LVEF-rest LVEF. Absent LVEF reserve was defined as a drop in LVEF by 5% or more on the post-stress images. The primary outcome was a composite of cardiac death, non-fatal myocardial infarction and late coronary revascularization. RESULTS: An absent LVEF reserve was more common in patients with abnormal vs normal MPI (31% vs 19%, P = .001). During a median follow-up of 32 months, the primary outcome was experienced by 31% of the study population. An absent LVEF reserve was not associated with an increased risk of the primary outcome in patients with normal (hazard ratio 1.1, 95% CI .4-2.7, P = .8) or abnormal (.75, .56-1.00, P = .05) MPI. There was no significant correlation between extent of ischemia and post-stress change in LVEF (Pearson r = - .072, P = .07). CONCLUSIONS: In patients undergoing regadenoson SPECT MPI, absent LVEF reserve is not associated with worse cardiac outcomes. Thus, routine reporting of both post-stress and rest LVEF measurements in this setting may not be necessary.
Subject(s)
Myocardial Perfusion Imaging , Humans , Myocardial Perfusion Imaging/methods , Prognosis , Purines , Pyrazoles , Stroke Volume , Tomography, Emission-Computed, Single-Photon/methods , Ventricular Function, LeftSubject(s)
Myocardial Ischemia , Myocardial Perfusion Imaging , Ammonia , Coronary Circulation , Humans , Ischemia , Myocardial Ischemia/diagnostic imaging , Myocardial Perfusion Imaging/methods , Nitrogen Radioisotopes , Papillary Muscles/diagnostic imaging , Positron-Emission Tomography/methods , Tomography, Emission-ComputedABSTRACT
BACKGROUND: SPECT myocardial perfusion imaging (MPI) provides an assessment of LV mechanical dyssynchrony (LVMD) which correlates with CVD outcomes in diverse populations including those awaiting renal transplant (RT). The current study examines the association of LVMD on pre-transplant MPI with long-term CVD mortality post RT. METHODS: We identified consecutive patients who underwent RT at the University of Alabama at Birmingham between 2008 and 2012 from our prospectively collected database. 675 patients in the database underwent MPI and had images amenable for phase analysis. A blinded investigator retrieved the studies and derived LVMD indices including histogram bandwidth (BW), standard deviation (SD), phase peak, phase skewness, and phase kurtosis. The primary outcome was CVD death after RT. RESULTS: The study cohort had a median age of 54 years, 56% were men, 43% had diabetes, and 7% had prior myocardial infarction. Patients were on dialysis for a median of 3.4 years prior to RT and 34% received living donor transplants. During a median follow-up time after RT of 4.7 years (IQR 3.5 to 6.3 years) 59 patients (9%) succumbed to CVD death. Patients with wider BW, wider SD, lower skewness, and lower kurtosis had an increased risk of CVD death. On multivariate adjustment, BW and skewness remained as independent predictors of CVD deaths. CONCLUSIONS: LVMD by phase analysis of gated SPECT MPI is associated with increased risk of CVD death after RT. This association is independent of demographics, comorbidities, and traditional findings on MPI and added incremental prognostic information. Assessment of LVMD should be considered for risk stratification in these patients.
Subject(s)
Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography , Kidney Transplantation , Myocardial Perfusion Imaging , Ventricular Dysfunction, Left , Male , Humans , Middle Aged , Female , Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography/methods , Tomography, Emission-Computed, Single-Photon/methods , Prognosis , Myocardial Perfusion Imaging/methodsABSTRACT
CFTR function is required for normal mucociliary clearance (MCC) and cough-assisted clearance (CC). Lumacaftor-ivacaftor is approved for use in people with cystic fibrosis (CF) carrying two copies of F508del-CFTR. In this observational study performed at four study sites, we characterized the effect of lumacaftor-ivacaftor on mucociliary and cough clearance and related this to other clinical and research endpoints after one month of treatment. Twenty-five adolescents and adults were enrolled. No effect on whole lung MCC was observed, but CC was significantly increased. Sweat chloride improved by 18 mEq/L in this group, indicating a modest restoration of CFTR activity, but no demonstrable change in FEV1 or lung clearance index was observed. We speculate that the modest effect of lumacaftor-ivacaftor on CFTR function was insufficient to yield an improvement in MCC.
Subject(s)
Aminophenols/therapeutic use , Aminopyridines/therapeutic use , Benzodioxoles/therapeutic use , Cystic Fibrosis/drug therapy , Mucociliary Clearance/drug effects , Quinolones/therapeutic use , Adolescent , Adult , Child , Chloride Channel Agonists/therapeutic use , Cohort Studies , Cystic Fibrosis Transmembrane Conductance Regulator/therapeutic use , Drug Combinations , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Young AdultABSTRACT
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
ABSTRACT
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
Subject(s)
Cardiac Imaging Techniques , Cardiology , Cardiovascular Diseases/diagnostic imaging , Nuclear Medicine , Cardiovascular Diseases/etiology , Cardiovascular Diseases/therapy , HumansABSTRACT
Cardiovascular disease is the leading cause of death worldwide. Given the increased availability of radiopharmaceuticals, improved positron emission tomography (PET) camera systems and proven higher diagnostic accuracy, PET is increasingly utilized in the management of various cardiovascular diseases. PET has high temporal and spatial resolution, when compared to Single Photon Emission Computed Tomography. In clinical practice, hybrid imaging with sequential PET and Computed Tomography acquisitions (PET/CT) or concurrent PET and Magnetic Resonance Imaging are standard. This article will review applications of cardiovascular PET/CT including myocardial perfusion, viability, cardiac sarcoidosis/inflammation, and infection.
Subject(s)
Cardiovascular Diseases/diagnostic imaging , Myocardial Perfusion Imaging/trends , Positron-Emission Tomography/trends , Cardiomyopathies/diagnostic imaging , Fluorodeoxyglucose F18 , Humans , Myocarditis/diagnostic imaging , Radiopharmaceuticals , Sarcoidosis/diagnostic imagingABSTRACT
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
