Beneficial Effect of Coronary Artery Bypass Grafting as Assessed by Quantitative Gated Single-Photon Emission Computed Tomography

Hida, Satoshi; Chikamori, Taishiro; Hirayama, T; Usui, Yasuhiro; Yanagisawa, Hidefumi; Morishima, Takayuki; Ishimaru, Shin; Yamashina, Akira

doi:10.1253/circj.67.499

Cited by 18 publications

(18 citation statements)

References 22 publications

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“…Image acquisition was commenced 30 min after the last exercise session. In the remaining 56 patients, adenosine triphosphate disodium (0.16 mg · kg -1 · min -1 ) was administered intravenously for 6 min, 15 and 3 min later, 99m Tc-sestamibi (259 MBq) was given intravenously with image acquisition beginning 30 min later. On the same day, the patients were given 99m Tc-sestamibi (777 MBq) while at rest and 30 min later, quantitative gated myocardial SPECT images were acquired.…”

Section: Stress Myocardial Perfusion Imagingmentioning

confidence: 99%

Diagnostic Value of Simultaneous Brachial and Ankle Blood Pressure Measurements for the Extent and Severity of Coronary Artery Disease as Assessed by Myocardial Perfusion Imaging

Igarashi

Chikamori

Tomiyama

et al. 2005

Circ J

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Section: Stress Myocardial Perfusion Imagingmentioning

confidence: 99%

Diagnostic Value of Simultaneous Brachial and Ankle Blood Pressure Measurements for the Extent and Severity of Coronary Artery Disease as Assessed by Myocardial Perfusion Imaging

Igarashi

Chikamori

Tomiyama

et al. 2005

Circ J

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“…According to a method reported elsewhere, 20 each SPECT image was divided into 20 segments, with segments 1-3, 7-9, 13-14 and 19-20 corresponding to the areas perfused by the left anterior descending coronary artery, segments 4, 10 and 15-16 corresponding to the areas perfused by the right coronary artery, and segments 5-6, 11-12 and 17-18 corresponding to the areas perfused by the left circumflex coronary artery (Fig 1). The accumulation of radioisotope in the myocardium was visually evaluated by 2 cardiologists using a 5-grade scale: 0 (normal), 1 (slight reduction of uptake), 2 (moderate reduction of uptake), 3 (severe reduction of uptake) or 4 (absent of radioactive uptake).…”

Section: Stress Myocardial Scintigraphymentioning

confidence: 99%

Value of Pharmacologic Stress Myocardial Perfusion Imaging for Preoperative Risk Stratification for Aortic Surgery

Harafuji

Chikamori

Kawaguchi

et al. 2005

Circ J

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valuating the risk of perioperative cardiac events related to noncardiac surgery is important. [1][2][3][4][5][6][7][8][9] Preoperative myocardial perfusion imaging is useful for further stratification of the risk in moderate-and highrisk patients 3,4 because the redistribution findings can be used as predictive factors for cardiac events, and the technique has a high negative predictive value. [5][6][7][8] Moreover, recent studies suggest that the likelihood of cardiac events increases with the severity of the defect score on images evaluated semi-quantitatively 4,6-9 and guidelines for the perioperative cardiovascular evaluation of noncardiac surgery patients were recently published by the ACC/AHA, providing a framework for weighting the cardiac risk of noncardiac surgery based on patients' risk profiles and the type of operation. 10 Of the procedures, aortic surgery is claimed to be high-risk (the reported cardiac risk is often ≥5%), not only because it is highly invasiveness surgery but also because of the high prevalence of coronary artery disease in patients with aortic diseases. 10-12 However, there are few studies regarding preoperative risk stratification in Japanese patients who undergo aortic surgery. 13,14 Thus, the present study evaluated whether perioperative cardiac events related to aortic surgery can be predicted by preoperative pharmacologic stress myocardial perfusion imaging. Methods SubjectsThe subjects of this study were 302 consecutive patients who underwent elective aortic surgery after pharmacologic stress single-photon emission computed tomography (SPECT) between January 1998 and August 2003. SPECT study was performed in all patients unless contraindications such as bronchial asthma and advanced heart block were present. There were 261 men and 41 women, aged 71±10 years (35-86 years); 128 of them (42%) were aged 75 years or older. Medical history of angina pectoris was noted in 19 patients, myocardial infarction (MI) in 26, and heart failure in 5; 19 of them had undergone coronary revascularization. Hypertension was found in 217 patients, hypercholesterolemia in 73, diabetes mellitus (DM) in 55, and renal insufficiency defined as serum creatinine level ≥2.0 mg/dl in 20.The etiologies of the aortic diseases were type B aortic dissection in 56 patients, thoracic aortic aneurysm in 124, and abdominal aortic aneurysm in 122. The indication for aortic surgery was decided by cardiovascular surgeons based on the anatomical and pathological indications. [15][16][17][18] The type of surgery was conventional open surgery in 75 patients and endovascular surgery with stent -graft placement in 227. Aortic surgery including stent -graft placement was performed under general anesthesia. Approval to perform the endovascular surgery was obtained from the Ethical Committee of Tokyo Medical University. Written informed consent was obtained from all of the patients. Stress Myocardial ScintigraphyPharmacologic stress SPECT was performed ≥15 h after Background Aortic surgery is an invasive, high-risk noncard...

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“…Several studies have shown that the %WT is an important parameter in assessment of myocardial viability. 13,[30][31][32] We used QGS because this algorithm Comparison of the 2 visual wall motion scores (gated PET and LVG) and regional NH3 uptake. The wall motion scores were classified as: 1= normal, 2= mildly reduced, 3= severely reduced and 4= akinesis or dyskinesis.…”

Section: Study Limitationsmentioning

confidence: 99%

“…is widely used around the world and many reports have been validating this algorithm for evaluating LV function in gated SPECT [5][6][7][8][30][31][32] and also in gated PET. 12,15,16 We would like to apply the other algorithms such as pFAST 10 or Emory Cardiac Toolbox (ECT) 11 for 13 N-NH3 gated PET to measure LVEF and LV volumes and compare them with QGS.…”

Section: Circulation Journal Vol69 February 2005mentioning

confidence: 99%

Assessment of Global and Regional Left Ventricular Function by Electrocardiographic Gated N-13 Ammonia Positron Emission Tomography in Patients With Coronary Artery Disease

Kanayama

Matsunari²,

Hirayama

et al. 2005

Circ J

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he assessment of left ventricular (LV) function and volumes, together with myocardial perfusion, is important for prognostic stratification of patients with coronary artery disease (CAD). [1][2][3][4][5] The electrocardiographic (ECG) -gated acquisition technique with perfusion tracers for single-photon emission computed tomography (SPECT) has been established to assess global and regional LV function, and several automated quantitative algorithms, such as the Cedars-Sinai quantitative gated SPECT (QGS), have been developed for this purpose. 6-11 Several recent studies have applied these algorithms to positron emission tomography (PET), 12-16 which has several advantages over SPECT in that it produces high-quality imaging and has the capability of quantitative analysis of perfusion or metabolism. Nitrogen-13-ammonia ( 13 N-NH3) has been widely used for quantification of myocardial blood flow Circulation Journal Vol.69, February 2005 (MBF) in PET studies. [17][18][19][20] Although MBF and LV function should usually be closely related, they may disagree in some circumstances, such as myocardial stunning. Therefore, the integration of MBF and LV function is important for understanding of the pathophysiology of various disease conditions. In this regard, ECG-gated 13 N-NH3 PET is attractive because it enables simultaneous assessment of MBF and LV function, but this promising technique has not been systematically validated in a large patient cohort. Furthermore, the feasibility of assessing regional function has not been previously addressed. The aim of this study was to evaluate the feasibility of ECG-gated 13 N-NH3 PET to assess global and regional LV function in a relatively large cohort of patients with CAD in comparison with conventional left ventriculography (LVG) as the reference technique. Methods Study PopulationThe study group consisted of 54 consecutive patients (51 men, 3 women; age range: 30-85 years, mean age: 62.6± 12.4 years) with CAD documented by coronary angiography. Of these 54 patients, 34 had a previous myocardial infarction. All patients underwent both LVG and gated 13 N-NH3 PET at rest within 2 weeks of each other (mean duration 7.2 days). All patients had normal sinus rhythm, and Methods and ResultsFifty-four patients with CAD underwent gated 13 N-ammonia PET and LVG. The LV end-diastolic and end-systolic volumes (LVEDV, LVESV) and ejection fraction (LVEF) by gated 13 N-ammonia PET were calculated using Cedars-Sinai automated quantitative gated single photon emission computed tomography (QGS) and compared with those obtained by LVG. The regional wall motion (RWM) was visually scored, and compared with that on LVG. There were good correlations between the 2 methods for LVEF, LVEDV and LVESV (R=0.828, R=0.821 and R=0.874 respectively). The RWM assessed by gated 13 N-ammonia PET also agreed well with that by LVG (complete agreement was 70.4%, =0.58). Conclusions Gated 13 N-ammonia PET combined with QGS works reasonably well for the assessment of both global and regional LV function in CAD p...

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Beneficial Effect of Coronary Artery Bypass Grafting as Assessed by Quantitative Gated Single-Photon Emission Computed Tomography

Cited by 18 publications

References 22 publications

Diagnostic Value of Simultaneous Brachial and Ankle Blood Pressure Measurements for the Extent and Severity of Coronary Artery Disease as Assessed by Myocardial Perfusion Imaging

Diagnostic Value of Simultaneous Brachial and Ankle Blood Pressure Measurements for the Extent and Severity of Coronary Artery Disease as Assessed by Myocardial Perfusion Imaging

Value of Pharmacologic Stress Myocardial Perfusion Imaging for Preoperative Risk Stratification for Aortic Surgery

Assessment of Global and Regional Left Ventricular Function by Electrocardiographic Gated N-13 Ammonia Positron Emission Tomography in Patients With Coronary Artery Disease

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