The Experts below are selected from a list of 132 Experts worldwide ranked by ideXlab platform
Jeffrey S. Borer - One of the best experts on this subject based on the ideXlab platform.
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assessment of coronary artery disease by radionuclide Cineangiography history current applications and new directions
Cardiology Clinics, 1994Co-Authors: Jeffrey S. Borer, Stephen L. Bacharach, Phyllis G Supino, Detlef Wencker, Michael Aschermann, Michael V. GreenAbstract:In recent years, the utility of radionuclide Cineangiography in prognostication has made it a mainstay of management decision making. With evolution of therapeutic modalities and concomitant alteration in management strategies, however, the technique and its application are undergoing parallel evolution to optimize response to current needs. Thus, in addition to standard planar rest and exercise assessment of left ventricular function, newer approaches are involving combined perfusion and function assessment, application of pharmacological stress to permit technically advantageous variations in imaging protocols, and application of SPECT technology in collecting blood pool data for tomographic display and analysis
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risk stratification in the elderly patient after coronary artery bypass grafting the prognostic value of radionuclide Cineangiography
Journal of Nuclear Cardiology, 1994Co-Authors: Phyllis G Supino, James B Wallis, Gregory Chlouverakis, Jeffrey S. BorerAbstract:Background Recent data have shown that assessment of left ventricular function by radionuclide Cineangiography (RNCA) predicts survival and cardiac events among non-age-selected patients who have previously undergone coronary artery bypass grafting (CABG). However, the prognostic value of this noninvasive approach is not known for elderly patients who now undergo CABG with progressively increasing frequency and who survive longer because of operation. Such easily applied prognostic indexes may be useful to determine whether survival benefits are likely to be maintained or additional therapy should be considered.
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identification of surgical coronary anatomy by exercise radionuclide Cineangiography
American Journal of Cardiology, 1991Co-Authors: James B Wallis, Jeffrey S. BorerAbstract:Abstract Radionuclide Cineangiography with exercise has been used to identify patients with coronary arteriographic patterns for which bypass grafting has been shown to prolong life. However, patients with severe prior myocardial damage were included in these studies, although the randomized medicine versus surgery trials recognized an effect of resting ejection fraction on operative risk and excluded patients with severely compromised function. Moreover, continuing reports from trials of surgery and from an ancillary evaluation of angioplasty have refined the set of coronary anatomic patterns for which mechanical therapy prolongs life, although stenosis severity criteria varied (50 vs 70 to 75%) between these trials. In this study, we have focused on patients who would have been eligible for the randomized trials of surgical therapy, and included only those with at least moderately preserved ventricular function at rest (ejection fraction ≥30%). In such patients, exercise parameters were significantly more accurate than rest variables in identifying all anatomic patterns appropriately treated mechanically; logistic regression selected ejection fraction change with exercise, followed by systolic blood pressure change with exercise, as the 2 most powerful independent covariates among patients with “surgical” coronary anatomy defined by a 70% stenosis criterion; absolute exercise ejection fraction contributed no significant independent information. When defined at a 50% stenosis severity level, blood pressure change and angina class were more powerful than absolute exercise ejection fraction, but a crude, noninvasively determined analog of stroke work, incorporating change in both ejection fraction and blood pressure, was most accurate. Coronary anatomic patterns appropriately managed mechanically are identifiable by results of radionuclide Cineangiography with exercise most efficiently by use of change in ejection fraction and blood pressure induced by exercise.
A Pines - One of the best experts on this subject based on the ideXlab platform.
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Exercise Radionuclide Cineangiography for Predicting Long Term Prognosis in Elderly Post Coronary Artery Bypass Graft Patients
American Journal of Geriatric Cardiology, 2020Co-Authors: Itzhak Shapira, Aharon Isakov, Israel Heller, M. Topilsky, Yael Villa, A PinesAbstract:Issue. The immediate benefits of coronary artery bypass grafting may only be transient. Recent studies which showed that exercise radionuclide Cineangiography studies may predict cardiac events and survival had evaluated post coronary artery bypass grafting patients of all ages. This prospective study was done on an elderly subgroup. Methods. The results of exercise radionuclide Cineangiography performed early (4–8 months) post coronary artery bypass grafting were correlated over six years of follow up with mortality, major surgical and nonsurgical cardiac events, and cardiac event free survival in 87 consecutive patients ≥65 years. Results. The rest to peak exercise difference in left ventricular ejection fraction correlated with later cardiac death and the need for surgical interventions, while rest left ventricular ejection fraction correlated only with the latter parameter. Conclusions. Assessment of left ventricular ejection fraction at rest and at exercise has prognostic values after coronary artery bypass grafting in elderly patients. Exercise radionuclide Cineangiography carried out soon after coronary artery bypass grafting might be considered an useful tool to assess patient prognosis. The efficacy of exercise radionuclide Cineangiography carried out soon after coronary artery bypass grafting should be confirmed in larger and more varied patient subgroups.
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impact of early exercise radionuclide Cineangiography on long term prognosis after cabg
The Annals of Thoracic Surgery, 1997Co-Authors: Itzhak Shapira, Aharon Isakov, Israel Heller, M. Topilsky, Yael Villa, Jacob Gurevitch, Vladimir Yakirevich, A PinesAbstract:Background. The immediate benefits of coronary artery bypass grafting might be only transient. This prospective study examined the capability of exercise radionuclide Cineangiography done shortly after coronary artery bypass grafting to predict outcome and long-term prognosis. Methods. Results of exercise radionuclide Cineangiography at 5.5 ± 0.7 months (range, 4 to 8 months) postoperatively were correlated with mortality, major surgical and nonsurgical cardiac events, and cardiac event-free survival in 100 consecutive patients who underwent coronary artery bypass grafting. Stepwise logistic regression analysis was used to evaluate the incremental value of radionuclide Cineangiography beyond the commonly used variables. Results. Left ventricular ejection fraction at rest was normal (≥0.45) in 72 patients and increased on exercise in 58. The exercise radionuclide variables that correlated with future cardiac events were change and fractional change in heart rate, ST segment changes, anginal pain and congestive heart symptoms during exercise, rest ejection fraction, and change and fractional changes in ejection fraction. Predictors of event-free survival were exercise heart rate, rest ejection fraction, and change and fractional change in ejection fraction during exercise. Logistic regression analysis revealed that change in ejection fraction was an independent predictor of cardiac death and surgical interventions, whereas resting ejection fraction was a predictor of nonsurgical cardiac events. Conclusions. Postoperative exercise radionuclide Cineangiography carried out soon after coronary artery bypass grafting had definite independent prognostic value and should be performed routinely to help decide treatment protocol.
Robert J Siegel - One of the best experts on this subject based on the ideXlab platform.
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correspondence of left ventricular ejection fraction determinations from two dimensional echocardiography radionuclide angiography and contrast Cineangiography
Journal of the American College of Cardiology, 1995Co-Authors: Manish M Naik, George A Diamond, Ariel Soffer, Robert J SiegelAbstract:Objectives. This study assessed the agreement of left ventricular ejection fraction determinations from two-dimensional echocardiography, radionuclide angiography and contrast Cineangiography. Background. Previously published reports suggest that twodimensional echocardiography, radionuclide angiography and contrast Cineangiography are equally acceptable methods of assessing left ventrieular ejection fraction on the basis of high coefficients of correlation. However, correlation of methods does not necessarily imply agreement. Methods. In a prospective analysis, 25 consecutive subjects all had two-dimensional echocardiography and radionuclide angiography performed within 10 days of each other in the cardiology department of a metropolitan community hospital. A retrospective computer search (Medline) revealed seven studies, using the coefficient of correlation (r), comparing two-dimensional echocardiographic left ventricular ejection fraction (n = 268) with radionuclide angiographic (n = 174) or contrast cineangiographic (n = 119) left ventricular ejection fractions. Results. The eight individual studies (n = 293) comparing two-dimensional echocardiography with either radionuclide angiography or contrast Cineangiography exhibited coefficients of correlation ranging from 0.78 to 0.93. Agreement analysis using the method of Bland and Altman was performed by averaging the results obtained from the two techniques and determining how disparate any single ejection fraction was (with 95% confidence limits) from the mean value. Agreement ranged from 23% to 42% around the mean ejection fraction. The average lack of agreement between the two methods for all studies involved was 17%, with an average r value of 0.86. Conclusions. Left ventricular ejection fraction determinations by means of two-dimensional echocardiography, radionuclide angiography and contrast Cineangiography exhibit high correlation and only moderate agreement. High correlation does not always imply high agreement. These results suggest that, when validated by agreement analysis, multiple studies may not be necessary in appropriate clinical situations, potentially reducing costs. (J Am Coil Cardiol 1995;25:937-42) Left ventricular ejection fraction is an important clinical variable with respect to diagnosis, prognosis and treatment in various clinical situations. Currently, there are three commonly used methods for determining left ventricular ejection fraction: 1) two-dimensional echocardiography, 2) radionuclide angiography, and 3) contrast Cineangiography. Because the clinical situation may dictate using one method versus another, it is important for the clinician to know whether the results of ejection fraction estimates are comparable among the three methods and if they can be used interchangeably. If the answer is yes, this could reduce the need for multiple tests and thereby reduce the cost of health care to the patient. Previously published reports (1-3) suggest that twodimensional echocardiography, radionuclide angiography and
Kunio Shirato - One of the best experts on this subject based on the ideXlab platform.
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Right Ventricular Ejection Function Assessed by Cineangiography
Circulation, 2002Co-Authors: Masahito Sakuma, Hidehiko Ishigaki, Kohtaroh Komaki, Yoshichika Oikawa, Atsushi Katoh, Makoto Nakagawa, Hidenari Hozawa, Yoshito Yamamoto, Tohru Takahashi, Kunio ShiratoAbstract:The right ventricular ejection fraction (RVEF) can be shown theoretically as a mathematical function of the percent shortening in the 3 axial dimensions of the right ventricular cavity (the septum - free wall dimension (SF), the anterior - posterior dimension (AP), and the tricuspid valve - apex dimension (TA) or the long axis dimension (LA)). There is a need to decide which mechanism is the most important for the RVEF in cases with neither obvious regional wall motion abnormalities of the left ventricle nor right ventricular overload. Forty-four consecutive subjects (34 males/10 females) were enrolled: 16 had normal hemodynamic parameters without significant coronary artery stenosis, 15 had hypertrophic cardiomyopathy and 13 had dilated cardiomyopathy. Biplane right ventricular Cineangiography was performed and the percent shortening of the SF, AP, and TA or LA were measured. The percent shortening in the SF (34.8±14.7%) was larger than that of the AP, TA, and LA (23.2±8.5, 21.0±8.3 and 18.3±7.0, respectively; all p
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right ventricular ejection function assessed by Cineangiography
Circulation, 2002Co-Authors: Masahito Sakuma, Hidehiko Ishigaki, Kohtaroh Komaki, Yoshichika Oikawa, Atsushi Katoh, Makoto Nakagawa, Hidenari Hozawa, Yoshito Yamamoto, Tohru Takahashi, Kunio ShiratoAbstract:The right ventricular ejection fraction (RVEF) can be shown theoretically as a mathematical function of the percent shortening in the 3 axial dimensions of the right ventricular cavity (the septum - free wall dimension (SF), the anterior - posterior dimension (AP), and the tricuspid valve - apex dimension (TA) or the long axis dimension (LA)). There is a need to decide which mechanism is the most important for the RVEF in cases with neither obvious regional wall motion abnormalities of the left ventricle nor right ventricular overload. Forty-four consecutive subjects (34 males/10 females) were enrolled: 16 had normal hemodynamic parameters without significant coronary artery stenosis, 15 had hypertrophic cardiomyopathy and 13 had dilated cardiomyopathy. Biplane right ventricular Cineangiography was performed and the percent shortening of the SF, AP, and TA or LA were measured. The percent shortening in the SF (34.8±14.7%) was larger than that of the AP, TA, and LA (23.2±8.5, 21.0±8.3 and 18.3±7.0, respectively; all p<0.001). There was a linear correlation between the percent shortening of each dimension and the RVEF. The 95% confidence interval of the regression equation from the percent shortening of the SF and RVEF was located above those from the other percent shortenings, except for a lower RVEF. These results indicate that systolic shortening of the SF (ie, bellows action) plays an important role in the RVEF except for a lower ejection fraction. (Circ J 2002; 66: 605 - 609)
James B Wallis - One of the best experts on this subject based on the ideXlab platform.
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risk stratification in the elderly patient after coronary artery bypass grafting the prognostic value of radionuclide Cineangiography
Journal of Nuclear Cardiology, 1994Co-Authors: Phyllis G Supino, James B Wallis, Gregory Chlouverakis, Jeffrey S. BorerAbstract:Background Recent data have shown that assessment of left ventricular function by radionuclide Cineangiography (RNCA) predicts survival and cardiac events among non-age-selected patients who have previously undergone coronary artery bypass grafting (CABG). However, the prognostic value of this noninvasive approach is not known for elderly patients who now undergo CABG with progressively increasing frequency and who survive longer because of operation. Such easily applied prognostic indexes may be useful to determine whether survival benefits are likely to be maintained or additional therapy should be considered.
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identification of surgical coronary anatomy by exercise radionuclide Cineangiography
American Journal of Cardiology, 1991Co-Authors: James B Wallis, Jeffrey S. BorerAbstract:Abstract Radionuclide Cineangiography with exercise has been used to identify patients with coronary arteriographic patterns for which bypass grafting has been shown to prolong life. However, patients with severe prior myocardial damage were included in these studies, although the randomized medicine versus surgery trials recognized an effect of resting ejection fraction on operative risk and excluded patients with severely compromised function. Moreover, continuing reports from trials of surgery and from an ancillary evaluation of angioplasty have refined the set of coronary anatomic patterns for which mechanical therapy prolongs life, although stenosis severity criteria varied (50 vs 70 to 75%) between these trials. In this study, we have focused on patients who would have been eligible for the randomized trials of surgical therapy, and included only those with at least moderately preserved ventricular function at rest (ejection fraction ≥30%). In such patients, exercise parameters were significantly more accurate than rest variables in identifying all anatomic patterns appropriately treated mechanically; logistic regression selected ejection fraction change with exercise, followed by systolic blood pressure change with exercise, as the 2 most powerful independent covariates among patients with “surgical” coronary anatomy defined by a 70% stenosis criterion; absolute exercise ejection fraction contributed no significant independent information. When defined at a 50% stenosis severity level, blood pressure change and angina class were more powerful than absolute exercise ejection fraction, but a crude, noninvasively determined analog of stroke work, incorporating change in both ejection fraction and blood pressure, was most accurate. Coronary anatomic patterns appropriately managed mechanically are identifiable by results of radionuclide Cineangiography with exercise most efficiently by use of change in ejection fraction and blood pressure induced by exercise.