Myocardial Perfusion Imaging

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Ami E Iskandrian - One of the best experts on this subject based on the ideXlab platform.

  • Prevalence of abnormal SPECT Myocardial Perfusion Imaging during the COVID-19 pandemic
    European Journal of Nuclear Medicine and Molecular Imaging, 2021
    Co-Authors: Usman A. Hasnie, Pradeep Bhambhvani, Ami E Iskandrian, Fadi G Hage
    Abstract:

    Purpose The aim of this study is to evaluate the rate of abnormal Myocardial Perfusion Imaging (MPI) studies at a single medical center during the COVID-19 pandemic compared to prior to the pandemic. Methods We retrospectively studied stress single-photon emission computed tomography (SPECT)-MPI studies performed during the peak of COVID-19 restrictions at the University of Alabama Medical Center in comparison to the same time period in 2019. Results SPECT-MPI volume was reduced from 553 per month in 2019 to 105 per month in 2020. The proportion of abnormal SPECT-MPI for the 2020 cohort (61 ± 13 years, 48% men, 41% black) was not different from the 2019 cohort (62 ± 12 years, 48% men, 42% black) (31% vs. 27%, p  = 0.4). Similar proportion of patients in the 2 cohorts had abnormal Myocardial Perfusion, moderate-large Perfusion defects, Myocardial ischemia, Myocardial scar, and abnormal left ventricular ejection fraction. The proportion of abnormal SPECT-MPIs was not different based on whether patients were evaluated face-to-face or by telemedicine (28% vs. 27%, p  > 0.9) but was higher for cardiology providers (40% vs. 20%, p  

  • The prognostic value of Myocardial Perfusion Imaging in patients with type 2 Myocardial infarction
    Journal of Nuclear Cardiology, 2019
    Co-Authors: Chad M. Colon, Ami E Iskandrian, Ramey L. Marshell, Christopher P. Roth, Ayman A. Farag, Fadi G Hage
    Abstract:

    Objectives The aim of this retrospective study is to evaluate the prognostic role of Myocardial Perfusion Imaging (MPI) in patients with type 2 Myocardial infarction (T2MI). Background T2MI is an increasingly common diagnosis in clinical practice. The management of this condition is controversial and the prognostic value of MPI has not been established in this setting. Methods We retrospectively studied T2MI patients who underwent vasodilator gated MPI within 90 days of T2MI at a single tertiary care institution in 2013. Abnormal Myocardial Perfusion was defined as the Perfusion defect involving ≥ 5% of left ventricular (LV) myocardium. Abnormal LV ejection fraction (EF) was defined as 

  • detection and quantitation of right ventricular reversible Perfusion defects by stress spect Myocardial Perfusion Imaging a proof of principle study
    Journal of Nuclear Cardiology, 2019
    Co-Authors: Ayman A. Farag, Ami E Iskandrian, Guido Germano, Jack Heo, Lindsey Tauxe, Pradeep Bhambhvani, Paul B Kavanagh, Fadi G Hage
    Abstract:

    Background In patients with right dominant coronary circulation, the right ventricular (RV) myocardium and the inferior region of the left ventricular (LV) myocardium share a common source of blood flow. We hypothesized that stress/rest SPECT Myocardial Perfusion Imaging (MPI) could detect reversible Perfusion defects in the RV in some patients with LV inferior wall Perfusion abnormalities.

  • the prognostic value of regadenoson Myocardial Perfusion Imaging
    Journal of Nuclear Cardiology, 2015
    Co-Authors: Fadi G Hage, Gopal Ghimire, Davis Lester, Joshua Mckay, Steven Bleich, Stephanie Elhajj, Ami E Iskandrian
    Abstract:

    Background Regadenoson (REGA), a selective adenosine A2A receptor agonist, is the most widely used stress agent for SPECT Myocardial Perfusion Imaging (MPI) in the United States. The diagnostic accuracy of REGA MPI is comparable to Adenosine MPI, but its prognostic value is not well defined.

  • the prognostic value of left ventricular mechanical dyssynchrony using gated Myocardial Perfusion Imaging in patients with end stage renal disease
    Journal of Nuclear Cardiology, 2014
    Co-Authors: Himanshu Aggarwal, Ami E Iskandrian, Wael Aljaroudi, Shikha Mehta, Roslyn B Mannon, Fadi G Hage
    Abstract:

    Background Prior studies show that left ventricular mechanical dyssynchrony (LVD), measured by gated SPECT Myocardial Perfusion Imaging (MPI), identifies patients with end-stage renal disease (ESRD) at higher risk for all-cause mortality but these were in small number of patients. We sought to assess the interaction between LVD and LV Perfusion pattern in risk-stratification of a large sample size of patients with ESRD.

Gilles Baronerochette - One of the best experts on this subject based on the ideXlab platform.

Philipp A Kaufmann - One of the best experts on this subject based on the ideXlab platform.

  • cadmium zinc telluride Myocardial Perfusion Imaging in obese patients
    The Journal of Nuclear Medicine, 2012
    Co-Authors: Michael Fiechter, Catherine Gebhard, Tobias A Fuchs, Jelena R Ghadri, Julia Stehli, Egle Kazakauskaite, Bernhard A Herzog, Aju P Pazhenkottil, Oliver Gaemperli, Philipp A Kaufmann
    Abstract:

    We have evaluated the impact of increased body mass on the quality of Myocardial Perfusion Imaging using a latest-generation γ-camera with cadmium-zinc-telluride semiconductor detectors in patients with high (≥40 kg/m2) or very high (≥45 kg/m2) body mass index (BMI). Methods: We enrolled 81 patients, including 18 with no obesity (BMI

  • cadmium zinc telluride Myocardial Perfusion Imaging in obese patients
    The Journal of Nuclear Medicine, 2012
    Co-Authors: Michael Fiechter, Catherine Gebhard, Tobias A Fuchs, Jelena R Ghadri, Julia Stehli, Egle Kazakauskaite, Bernhard A Herzog, Aju P Pazhenkottil, Oliver Gaemperli, Philipp A Kaufmann
    Abstract:

    UNLABELLED: We have evaluated the impact of increased body mass on the quality of Myocardial Perfusion Imaging using a latest-generation γ-camera with cadmium-zinc-telluride semiconductor detectors in patients with high (≥40 kg/m(2)) or very high (≥45 kg/m(2)) body mass index (BMI). METHODS: We enrolled 81 patients, including 18 with no obesity (BMI < 30 kg/m(2)), 17 in World Health Organization obese class I (BMI, 30-34.9 kg/m(2)), 15 in class II (BMI, 35-39.9 kg/m(2)), and 31 in class III (BMI ≥ 40 kg/m(2)), including 15 with BMI ≥ 45 kg/m(2). Image quality was scored as poor (1), moderate (2), good (3), or excellent (4). Patients with BMI ≥ 45 kg/m(2) and nondiagnostic image quality (≤2) were rescanned after repositioning to better center the heart in the field of view. Receiver-operating-curve analysis was applied to determine the BMI cutoff required to obtain diagnostic image quality (≥3). RESULTS: Receiver-operating-curve analysis resulted in a cutoff BMI of 39 kg/m(2) (P < 0.001) for diagnostic image quality. In patients with BMI ≥ 40 kg/m(2), image quality was nondiagnostic in 81%; after CT-based attenuation correction this decreased to 55%. Repositioning further improved image quality. Rescanning on a conventional SPECT camera resulted in diagnostic image quality in all patients with BMI ≥ 45 kg/m(2). CONCLUSION: Patients with BMI ≥ 40 kg/m(2) should be scheduled for Myocardial Perfusion Imaging on a conventional SPECT camera, as it is difficult to obtain diagnostic image quality on a cadmium-zinc-telluride camera.

  • nuclear Myocardial Perfusion Imaging with a novel cadmium zinc telluride detector spect ct device first validation versus invasive coronary angiography
    European Journal of Nuclear Medicine and Molecular Imaging, 2011
    Co-Authors: Michael Fiechter, Jelena R Ghadri, Aju P Pazhenkottil, Oliver Gaemperli, Rene Nkoulou, Mathias Wolfrum, Silke M Kuest, Robert Goetti, Philipp A Kaufmann
    Abstract:

    Purpose We evaluated the diagnostic accuracy of attenuation corrected nuclear Myocardial Perfusion Imaging (MPI) with a novel hybrid single photon emission computed tomography (SPECT)/CT device consisting of an ultrafast dedicated cardiac gamma camera with cadmium-zinc-telluride (CZT) solid-state semiconductor detectors integrated onto a multislice CT scanner to detect coronary artery disease (CAD). Invasive coronary angiography served as the standard of reference.

  • ultrafast assessment of left ventricular dyssynchrony from nuclear Myocardial Perfusion Imaging on a new high speed gamma camera
    European Journal of Nuclear Medicine and Molecular Imaging, 2010
    Co-Authors: Aju P Pazhenkottil, Bernhard A Herzog, Ronny R Buechel, Lars Husmann, Ines Valenta, Rene Nkoulou, Ursula Fehlmann, Jelenarima Ghadri, Mathias Wolfrum, Philipp A Kaufmann
    Abstract:

    Purpose To validate the ultrafast assessment of left ventricular (LV) dyssynchrony by phase analysis using high-speed nuclear Myocardial Perfusion Imaging (MPI) on a new gamma camera with cadmium-zinc-telluride (CZT) solid-state detector technology.

Jean Philippe Baguet - One of the best experts on this subject based on the ideXlab platform.

Rami Doukky - One of the best experts on this subject based on the ideXlab platform.

  • The prognostic value of regadenoson SPECT Myocardial Perfusion Imaging: The largest cohort to date
    Journal of Nuclear Cardiology, 2020
    Co-Authors: Ajoe John Kattoor, Ahmed A. Kolkailah, Fady Iskander, Mina Iskander, Lisa Diep, Rozi Khan, Rami Doukky
    Abstract:

    Background Data on the prognostic value of regadenoson SPECT Myocardial Perfusion Imaging (MPI) is limited and based on small cohorts. Methods and Results We conducted a single-center, retrospective cohort study of 10,275 consecutive patients who underwent regadenoson SPECT-MPI. Among the study subjects, 28.7% had abnormal MPI and 25.5% had Myocardial ischemia. Patients were followed for a mean of 2.4 ± 2.2 years for major adverse cardiac events (MACE), defined as cardiac death or Myocardial infarction. There was a significant stepwise increase in MACE with an increasing burden of Perfusion abnormality ( P  

  • Prognostic value of regadenoson stress Myocardial Perfusion Imaging in patients with left bundle branch block or ventricular paced rhythm
    Journal of Nuclear Cardiology, 2019
    Co-Authors: Fady Iskander, Mina Iskander, Javier Gomez, Rami Doukky
    Abstract:

    Background Vasodilator stress Myocardial Perfusion Imaging (MPI) is the provocative test of choice in patients with left bundle branch block (LBBB) or ventricular paced (V-paced) rhythm. The prognostic value of regadenoson SPECT Myocardial Perfusion Imaging (MPI) in these patients has not been studied. Methods and Results We conducted a retrospective cohort study of 562 patients [mean age, 69 ± 11 years; men, 53.3%] with LBBB (50.7%) or V-paced rhythm (49.3%) who underwent regadenoson stress SPECT-MPI. There were 321 (57.1%) subjects with abnormal MPI and 192 (34.2%) with Myocardial ischemia. During a mean follow-up of 2.5 ± 1.9 years, 39 (6.9%) patients had a major adverse cardiac event (MACE), defined as cardiac death or Myocardial infarction. The annualized MACE rate in patients with normal MPI was 0.9% (LBBB, 0.8%; V-paced, 1.0%). There was a significant stepwise increase in MACE rates with increasing burdens of Perfusion abnormality ( P   0.05). Conclusion In patients with LBBB and V-paced rhythm, regadenoson stress SPECT-MPI provides independent and incremental prognostic value in predicting adverse cardiac events.

  • prognostic value of regadenoson stress Myocardial Perfusion Imaging in patients with left bundle branch block or ventricular paced rhythm
    Journal of Nuclear Cardiology, 2019
    Co-Authors: Fady Iskande, Mina Iskande, Javie Gomez, Rami Doukky
    Abstract:

    Vasodilator stress Myocardial Perfusion Imaging (MPI) is the provocative test of choice in patients with left bundle branch block (LBBB) or ventricular paced (V-paced) rhythm. The prognostic value of regadenoson SPECT Myocardial Perfusion Imaging (MPI) in these patients has not been studied. We conducted a retrospective cohort study of 562 patients [mean age, 69 ± 11 years; men, 53.3%] with LBBB (50.7%) or V-paced rhythm (49.3%) who underwent regadenoson stress SPECT-MPI. There were 321 (57.1%) subjects with abnormal MPI and 192 (34.2%) with Myocardial ischemia. During a mean follow-up of 2.5 ± 1.9 years, 39 (6.9%) patients had a major adverse cardiac event (MACE), defined as cardiac death or Myocardial infarction. The annualized MACE rate in patients with normal MPI was 0.9% (LBBB, 0.8%; V-paced, 1.0%). There was a significant stepwise increase in MACE rates with increasing burdens of Perfusion abnormality (P   0.05). In patients with LBBB and V-paced rhythm, regadenoson stress SPECT-MPI provides independent and incremental prognostic value in predicting adverse cardiac events.

  • Stress SPECT Myocardial Perfusion Imaging in End-Stage Renal Disease
    Current Cardiovascular Imaging Reports, 2017
    Co-Authors: Yasmeen Golzar, Rami Doukky
    Abstract:

    Purpose of Review Patients with end-stage renal disease (ESRD) have an increased risk of cardiovascular morbidity and mortality. Cardiac risk assessment, though challenging, is critical in these high-risk patients, particularly in the pre-transplant population. In this review, we discuss the burden of coronary artery disease in the ESRD population and review the literature on the diagnostic and prognostic performance, clinical value, and future directions of single-photon emission computed tomography (SPECT) Myocardial Perfusion Imaging (MPI) in ESRD patients. Recent Findings Stress Myocardial Perfusion Imaging provides incremental prognostic value to clinical data. The American Heart Association/American College of Cardiology Foundation consensus statement on the cardiac assessment of kidney transplant candidates provides some guidance on the selection of asymptomatic patients for further non-invasive risk stratification. Additionally, the novel selective A_2A receptor-agonist vasodilator stress agent, regadenoson, is safe and effective in ESRD and has recently been approved by the Food and Drug Administration for use in this population. Ancillary stress MPI findings, namely heart rate response to vasodilator stress, can provide incremental risk stratification. Summary While Myocardial Perfusion Imaging is widely used as a risk assessment tool, its utilization and clinical implications in the ESRD population are controversial. Though stress SPECT-MPI has imperfect diagnostic accuracy in this specific patient population, it is still a valuable non-invasive modality in cardiovascular risk assessment.

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