T. Murata, T. Toyama, S. Kasama, H. Hoshizaki, M. Kurabayashi
Background : Myocardial perfusion imaging (MPI) by single photon emission computed tomography is widely performed in patients with coronary artery disease (CAD). These days, the relation between MPI findings and the prognosis of CAD has been reported. Methods : A total of 188 consecutive patients with stable CAD were retrospectively enrolled. They all had ischemic findings in the initial stress/resting MPI and underwent a repeat stress/resting MPI within one year of the initial test. We evaluated the summed stress score, summed rest score, and summed difference score (SDS). We defined %residual ischemia as the percent SDS on repeat MPI relative to that on initial MPI (post SDS × 100/pre SDS). We followed the patients until occurrence of an adverse event or for at least one year after repeat MPI to assess adverse events including cardiac death, nonfatal myocardial infarction, hospitalization for heart failure, revascularization by percutaneous coronary intervention or coronary artery bypass grafting, stroke, and non-cardiac death. Results : Fifty-four patients (28.7%) experienced adverse events. According to multivariate Cox proportional hazards regression analysis of adverse event rates, more extensive %residual ischemia was associated with a higher incidence of adverse events (HR 1.025, p = 0.018). According to Kaplan-Meier analysis, patients with significant %residual ischemia had a higher risk of adverse events than those with mild %residual ischemia (p = 0.001, log rank test). Conclusion : In patients with CAD, significant residual ischemia on repeat MPI may predict a worse prognosis for CAD patients receiving optimal medical therapy with or without coronary revascularization.
{"title":"Significant Residual Ischemia on Myocardial Perfusion Imaging after Optimal Medical Therapy with or without Coronary Revascularization Predicts a Worse Prognosis","authors":"T. Murata, T. Toyama, S. Kasama, H. Hoshizaki, M. Kurabayashi","doi":"10.17996/ANC.19-00086","DOIUrl":"https://doi.org/10.17996/ANC.19-00086","url":null,"abstract":"Background : Myocardial perfusion imaging (MPI) by single photon emission computed tomography is widely performed in patients with coronary artery disease (CAD). These days, the relation between MPI findings and the prognosis of CAD has been reported. Methods : A total of 188 consecutive patients with stable CAD were retrospectively enrolled. They all had ischemic findings in the initial stress/resting MPI and underwent a repeat stress/resting MPI within one year of the initial test. We evaluated the summed stress score, summed rest score, and summed difference score (SDS). We defined %residual ischemia as the percent SDS on repeat MPI relative to that on initial MPI (post SDS × 100/pre SDS). We followed the patients until occurrence of an adverse event or for at least one year after repeat MPI to assess adverse events including cardiac death, nonfatal myocardial infarction, hospitalization for heart failure, revascularization by percutaneous coronary intervention or coronary artery bypass grafting, stroke, and non-cardiac death. Results : Fifty-four patients (28.7%) experienced adverse events. According to multivariate Cox proportional hazards regression analysis of adverse event rates, more extensive %residual ischemia was associated with a higher incidence of adverse events (HR 1.025, p = 0.018). According to Kaplan-Meier analysis, patients with significant %residual ischemia had a higher risk of adverse events than those with mild %residual ischemia (p = 0.001, log rank test). Conclusion : In patients with CAD, significant residual ischemia on repeat MPI may predict a worse prognosis for CAD patients receiving optimal medical therapy with or without coronary revascularization.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82280137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Hirano, M. Higashi, Hideyuki Miyauchi, A. Takagi, Y. Ikeda, Y. Nakano, T. Amano
{"title":"Increased Washout of 123I-BMIPP in Triglyceride Deposit Cardiomyovasculopathy (TGCV) with Severe Coronary Stenosis","authors":"K. Hirano, M. Higashi, Hideyuki Miyauchi, A. Takagi, Y. Ikeda, Y. Nakano, T. Amano","doi":"10.17996/anc.19-00106","DOIUrl":"https://doi.org/10.17996/anc.19-00106","url":null,"abstract":"","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76616700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Interpreting medical scans acquired with nuclear imaging equipment requires testing the equipment to assure that the best results achievable are routinely and reliably produced. Strict adherence to predetermined schedules for testing and recording the results for gamma cameras will facilitate the efficient operation of a Nuclear Cardiology laboratory, satisfy regulatory and accreditation requirements, and instill confidence in the readings obtained by interpreting the collected patient scans, for the ultimate benefit of the patients being evaluated.
{"title":"Gamma Camera Testing Schedules for Nuclear Cardiology Facilities","authors":"K. Nichols, A. Tosh","doi":"10.17996/anc.19-00104","DOIUrl":"https://doi.org/10.17996/anc.19-00104","url":null,"abstract":"Interpreting medical scans acquired with nuclear imaging equipment requires testing the equipment to assure that the best results achievable are routinely and reliably produced. Strict adherence to predetermined schedules for testing and recording the results for gamma cameras will facilitate the efficient operation of a Nuclear Cardiology laboratory, satisfy regulatory and accreditation requirements, and instill confidence in the readings obtained by interpreting the collected patient scans, for the ultimate benefit of the patients being evaluated.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81899221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I n this issue of the Annals of Nuclear Cardiology, there are two review articles related to myocardial blood flow assessment (MBF; ml/g-myocardium/min). One is using dynamic perfusion CT by Manabe et al., and the other is using dynamic perfusion MR by Ichikawa et al. (1, 2). MBF measurement has been mainly performed by dynamic positron emission tomography (PET) imaging with 13 N-NH3, 15 O-H2O, and 82 Rb (3, 4). PET MBF assessment is a gold standard for non-invasive quantification of MBF, however, there are limited number of facilities where dynamic perfusion PET can be available in the clinical settings. Recently, there are trials to quantify MBF using semi-conductor detector single photon emission computed tomography (SPECT) (5) and the PET MBF quantification methodology using 99m Tc-MIBI, 99m Tctetrofosmin or 201 Tl-TlCl. In addition to the limited number of facilities where semi-conductor or high sensitivity SPECT systems are installed, there are limitations of SPECT MBF quantification such as underestimation and accuracy when using 99m Tc-agents, and low counts or noisy data. If non-invasive MBF assessment is available with widely used modalities such as CT and MR, it would be of beneficial for many coronary artery disease (CAD) patients in the clinical setting.
{"title":"Current Status of Myocardial Blood Flow Quantification by CT and MR","authors":"T. Mochizuki","doi":"10.17996/anc.19-00109","DOIUrl":"https://doi.org/10.17996/anc.19-00109","url":null,"abstract":"I n this issue of the Annals of Nuclear Cardiology, there are two review articles related to myocardial blood flow assessment (MBF; ml/g-myocardium/min). One is using dynamic perfusion CT by Manabe et al., and the other is using dynamic perfusion MR by Ichikawa et al. (1, 2). MBF measurement has been mainly performed by dynamic positron emission tomography (PET) imaging with 13 N-NH3, 15 O-H2O, and 82 Rb (3, 4). PET MBF assessment is a gold standard for non-invasive quantification of MBF, however, there are limited number of facilities where dynamic perfusion PET can be available in the clinical settings. Recently, there are trials to quantify MBF using semi-conductor detector single photon emission computed tomography (SPECT) (5) and the PET MBF quantification methodology using 99m Tc-MIBI, 99m Tctetrofosmin or 201 Tl-TlCl. In addition to the limited number of facilities where semi-conductor or high sensitivity SPECT systems are installed, there are limitations of SPECT MBF quantification such as underestimation and accuracy when using 99m Tc-agents, and low counts or noisy data. If non-invasive MBF assessment is available with widely used modalities such as CT and MR, it would be of beneficial for many coronary artery disease (CAD) patients in the clinical setting.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80631110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Editor-in Chief of the Journal of Nuclear Cardiology created in 2014 the “Mentorship at Distance Committee” to provide editorial assistance to foreign authors. The chair of the committee discusses in the present communication his 3-year experience with mentoring manuscripts. He addresses the selection of manuscripts, the process of mentoring and common problems encountered and resolved. The mentoring process required the full commitment by both the mentor and the author, because of necessary intensive and frequent communications by email. The average time involved from start to finish averaged about 9 weeks. Eight of 11 mentored manuscripts could be sufficiently revised and were accepted for publication. ・
{"title":"Medical Writing by Non-native English-speaking Authors","authors":"F. Wackers","doi":"10.17996/ANC.19-00095","DOIUrl":"https://doi.org/10.17996/ANC.19-00095","url":null,"abstract":"The Editor-in Chief of the Journal of Nuclear Cardiology created in 2014 the “Mentorship at Distance Committee” to provide editorial assistance to foreign authors. The chair of the committee discusses in the present communication his 3-year experience with mentoring manuscripts. He addresses the selection of manuscripts, the process of mentoring and common problems encountered and resolved. The mentoring process required the full commitment by both the mentor and the author, because of necessary intensive and frequent communications by email. The average time involved from start to finish averaged about 9 weeks. Eight of 11 mentored manuscripts could be sufficiently revised and were accepted for publication. ・","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89665868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"JSNC 2020 in Aichi","authors":"J. Hashimoto","doi":"10.17996/anc.19-002","DOIUrl":"https://doi.org/10.17996/anc.19-002","url":null,"abstract":"","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85879348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rubidium-82 is the most well-established cardiac PET flow tracer with over 6 decades of literature. Due to its robust supply, short physical half-life, ease of use, low radiation dose and favorable kinetics it can deliver comprehensive clinical information with minimal risk and maximum convenience to patients and clinical staff. Optimized 82 Rb protocols can deliver high quality myocardial perfusion imaging, functional cardiac images and absolute myocardial blood flow and flow reserve from a single session 30 minutes clinical protocol‒benefiting patient convenience and clinical throughput. In a high volume setting the cost of 82 Rb PET can be dramatically lower than that of alternative PET flow tracers. These factors compound toward 82 Rb as the best PET flow tracer for high-throughput clinics.
{"title":"82Rb is the Best Flow Tracer for High-volume Sites","authors":"R. Klein, R. deKemp","doi":"10.17996/anc.19-00105","DOIUrl":"https://doi.org/10.17996/anc.19-00105","url":null,"abstract":"Rubidium-82 is the most well-established cardiac PET flow tracer with over 6 decades of literature. Due to its robust supply, short physical half-life, ease of use, low radiation dose and favorable kinetics it can deliver comprehensive clinical information with minimal risk and maximum convenience to patients and clinical staff. Optimized 82 Rb protocols can deliver high quality myocardial perfusion imaging, functional cardiac images and absolute myocardial blood flow and flow reserve from a single session 30 minutes clinical protocol‒benefiting patient convenience and clinical throughput. In a high volume setting the cost of 82 Rb PET can be dramatically lower than that of alternative PET flow tracers. These factors compound toward 82 Rb as the best PET flow tracer for high-throughput clinics.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76015160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Epicardial coronary artery disease has been highly noticed in the traditional clinical examination, while myocardial microcirculation function has been neglected for a long time, which plays a nonnegligible role in quite a few patients’ clinical manifestations and prognosis. Non-invasive quantitative PET myocardial perfusion imaging has become a unique and gold standard of evaluating myocardial microcirculation function. Its clinical applications in diagnosis, risk stratification, prognosis evaluation, efficacy evaluation and treatment guidance of cardiovascular diseases are given, together with its development status in China.
{"title":"Clinical Application of Quantitative Myocardial Blood Flow Accessment Using Positron Emission Tomography","authors":"Ping Wu, Sijin Li, Xiaoshan Guo, Ruonan Wang","doi":"10.17996/ANC.19-00091","DOIUrl":"https://doi.org/10.17996/ANC.19-00091","url":null,"abstract":"Epicardial coronary artery disease has been highly noticed in the traditional clinical examination, while myocardial microcirculation function has been neglected for a long time, which plays a nonnegligible role in quite a few patients’ clinical manifestations and prognosis. Non-invasive quantitative PET myocardial perfusion imaging has become a unique and gold standard of evaluating myocardial microcirculation function. Its clinical applications in diagnosis, risk stratification, prognosis evaluation, efficacy evaluation and treatment guidance of cardiovascular diseases are given, together with its development status in China.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81191041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Muramatsu, S. Nishimura, Y. Takeishi, T. Nishimura
Background : The relationship between myocardial perfusion imaging (MPI) and aortic calcification (AoC) in chronic kidney disease (CKD) patients remains unclear. Methods : The Japanese Assessment of Cardiac Events and Survival Study by quantitative gated single-photon emission computed tomography (J-ACCESS 3) is a multicenter, prospective cohort study investigating the ability of MPI to predict cardiac events in 529 CKD patients. In J-ACCESS 3, the sum of myocardial perfusion defect score at stress (SSS) was a useful predictor of cardiac major events in CKD patients. However, aortic calcification was not examined. We examined the prognosis of patients with CKD according to the presence or absence of AoC using data from the J-ACCESS 3 cohort. Results : There were 60 major cardiac events (three cardiac deaths, six sudden deaths, five non-fatal myocardial infarctions, 46 hospitalization cases for heart failure). In the univariate analysis, patients with AoC had a higher left ventricular (LV) ejection fraction, smaller LV volume, and lower SSS by MPI. Kaplan ‒ Meier curves showed a significantly higher incidence of major cardiac events in the AoC group (P = 0.0041). Patients were categorized into the following four groups: Group A (non-AoC and SSS < 4; normal score of 0 ‒ 3); Group B (AoC and SSS < 4); Group C (non-AoC and SSS ≧ 4); Group D (AoC and SSS ≧ 4). Kaplan ‒ Meier curves showed that the major cardiac events rates were A < B < C < D (P = 0.002). The difference was most pronounced between the AoC and no-AoC groups with SSS < 4. Conclusions : The combination of SSS using MPI and AoC is a useful predictor of cardiac major events in CKD patients.
背景:慢性肾脏疾病(CKD)患者心肌灌注成像(MPI)与主动脉钙化(AoC)之间的关系尚不清楚。方法:日本通过定量门控单光子发射计算机断层扫描评估心脏事件和生存研究(J-ACCESS 3)是一项多中心、前瞻性队列研究，旨在调查529名CKD患者MPI预测心脏事件的能力。在J-ACCESS 3中，应激时心肌灌注缺陷评分(SSS)的总和是CKD患者心脏主要事件的有效预测因子。然而，没有检查主动脉钙化。我们使用J-ACCESS 3队列的数据，根据AoC的存在与否来检查CKD患者的预后。结果:主要心脏事件60例(心源性死亡3例，猝死6例，非致死性心肌梗死5例，心力衰竭住院46例)。在单因素分析中，AoC患者具有较高的左室射血分数，较小的左室容积和较低的MPI SSS。Kaplan - Meier曲线显示AoC组的主要心脏事件发生率显著升高(P = 0.0041)。将患者分为四组:A组(非aoc且SSS < 4);正常得分0 - 3);B组(AoC、SSS < 4);C组(非aoc及SSS≧4);D组(AoC和SSS≧4)。Kaplan - Meier曲线显示主要心脏事件发生率A < B < C < D (P = 0.002)。当SSS < 4时，AoC组与无AoC组的差异最为明显。结论:SSS联合MPI和AoC是CKD患者心脏重大事件的有效预测指标。
{"title":"Prognostic Risk Stratification of Cardiac Events Evaluated by Aortic Calcification in Elderly Patients with Chronic Kidney Disease","authors":"T. Muramatsu, S. Nishimura, Y. Takeishi, T. Nishimura","doi":"10.17996/ANC.19-00090","DOIUrl":"https://doi.org/10.17996/ANC.19-00090","url":null,"abstract":"Background : The relationship between myocardial perfusion imaging (MPI) and aortic calcification (AoC) in chronic kidney disease (CKD) patients remains unclear. Methods : The Japanese Assessment of Cardiac Events and Survival Study by quantitative gated single-photon emission computed tomography (J-ACCESS 3) is a multicenter, prospective cohort study investigating the ability of MPI to predict cardiac events in 529 CKD patients. In J-ACCESS 3, the sum of myocardial perfusion defect score at stress (SSS) was a useful predictor of cardiac major events in CKD patients. However, aortic calcification was not examined. We examined the prognosis of patients with CKD according to the presence or absence of AoC using data from the J-ACCESS 3 cohort. Results : There were 60 major cardiac events (three cardiac deaths, six sudden deaths, five non-fatal myocardial infarctions, 46 hospitalization cases for heart failure). In the univariate analysis, patients with AoC had a higher left ventricular (LV) ejection fraction, smaller LV volume, and lower SSS by MPI. Kaplan ‒ Meier curves showed a significantly higher incidence of major cardiac events in the AoC group (P = 0.0041). Patients were categorized into the following four groups: Group A (non-AoC and SSS < 4; normal score of 0 ‒ 3); Group B (AoC and SSS < 4); Group C (non-AoC and SSS ≧ 4); Group D (AoC and SSS ≧ 4). Kaplan ‒ Meier curves showed that the major cardiac events rates were A < B < C < D (P = 0.002). The difference was most pronounced between the AoC and no-AoC groups with SSS < 4. Conclusions : The combination of SSS using MPI and AoC is a useful predictor of cardiac major events in CKD patients.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74795571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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