Cardiac Imaging in Women: Use of Radionuclide Myocardial Perfusion Imaging and Echocardiography for Acute Chest Pain

Mobasseri, Sara; Hendel, Robert C.

doi:10.1097/00045415-200205000-00003

Cited by 10 publications

(7 citation statements)

References 59 publications

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“…The meta-analysis published by Metz et al (1) highlights the high-quality evidence base for Echo and MPI largely developed within the cardiovascular community. Although earlier studies report differential prognostic findings for Echo and MPI (23)(24)(25)(26)(27), as larger sample sizes were accrued we have observed a convergence of outcome evidence. The low event rate in patients with normal exercise Echo and MPI supports similar post-test management strategies for patients with low-risk findings.…”

Section: See Page 227supporting

confidence: 42%

Assessing Mature Technology

Shaw

Polk

Merz

2007

Journal of the American College of Cardiology

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Section: See Page 227supporting

confidence: 42%

Assessing Mature Technology

Shaw

Polk

Merz

2007

Journal of the American College of Cardiology

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“…[8][9][10][11][12] However, dual-isotope myocardial scintigraphy takes time, is somewhat expensive, and uses radiation. 20 Echocardiography is normally used for the evaluation of wall motion recovery and LV functional evolution, but is techniciandependent and imaging may be subject to unavoidable operator-dependent error. Another disadvantage of echocardiography is the variable acoustic windows in patients with underlying lung diseases, which technically limits the studies because of poor definition of the heart.…”

Section: Discussionmentioning

confidence: 99%

“…Another disadvantage of echocardiography is the variable acoustic windows in patients with underlying lung diseases, which technically limits the studies because of poor definition of the heart. 20 Electrocardiography, which is less expensive, very convenient, and the most available and widespread modality, is useful in diagnosing acute MI in patients having acute chest pain. Regeneration of the R-waves instead of disappearance of the Q-waves has often been reported after acute MI, 1-7 but the exact mechanism in relation to the time course of such ECG changes or the clinical relevance of this phenomenon has not been well characterized.…”

Section: Discussionmentioning

confidence: 99%

Increase in Electrocardiographic R-Waves After Revascularization in Patients With Acute Myocardial Infarction

Isobe

Takada

Ando

et al. 2006

Circ J

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spontaneous increase in the electrocardiographic (ECG) R-wave voltage after acute myocardial infarction (MI) is a unique phenomenon, and regeneration of R-waves or disappearance of Q-waves after acute ischemic events has been reported. [1][2][3][4][5][6][7] With the prevalence of interventional therapy, it is thought that this phenomenon is increasing, but little is known regarding the physiological mechanism involved.Patients with acute MI always undergo echocardiography in order to evaluate changes in wall motion, left ventricular (LV) cavity, and LV function over time. Myocardial scintigraphy provides important information about myocardial perfusion and/or metabolism. Specifically, a combined study of myocardial metabolic tracer with perfusion tracer provides clues about the myocardial status in the healing stage of MI. [8][9][10] Perfusion -metabolism mismatch of the Circulation Journal Vol. 70, November 2006 perfusion/metabolic dual-tracers represents impaired but viable myocardium in the risk area, which is involved in functional recovery after revascularization in patients with acute MI. 11-13 Therefore, both examinations are cardinal diagnostic modalities for patients after acute MI.In this study, we performed dual-isotope scintigraphy and echocardiography, and compared the findings with ECG results to determine the physiological mechanism of the increase in ECG R-wave voltage during the acute to the subacute phase after revascularization in patients with acute MI. Methods PopulationOne hundred and seventy-one consecutive patients with first onset of acute MI who underwent emergency coronary revascularization, dual-isotope scintigraphy, and echocardiography between January 1998 and March 2004 were retrospectively examined. Acute MI was diagnosed by typical chest pain for >30 min, ECG ST-elevation of ≥0.1 mV (1 mm) in at least 2 contiguous leads, and a characteristic rise in plasma creatine kinase-MB activity. All patients underwent emergency coronary angiography (CAG) immediately after the ECG diagnosis and subsequent coronary revascularization. In the emergency CAG, antegrade flow was characterized using the Thrombolysis In Myocardial Background The physiological mechanism of the increase in the electrocardiographic (ECG) R-wave voltage after revascularization in patients with acute myocardial infarction (MI) needs to be elucidated. Methods and ResultsOne hundred and thirty-eight MI patients (83: anterior MI, 45: inferior MI, 10: lateral MI) underwent ECG and echocardiography in both the acute and subacute phases after emergency revascularization, as well as a resting thallium-201/iodine-123 15-p-iodophenyl-3-(R,S)-methyl pentadecanoic acid myocardial scintigraphy in the acute phase. The total sum of the R-wave voltage (∑R) was calculated over multiple leads on ECG for each infarcted lesion. Scintigraphic defect on each tracer was expressed as the percentage (%) defect of the total left ventricular (LV) myocardium. The % defect-discordance on both images in the acute phase and the % increase in ∑R an...

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“…In the current day world for the patients with coronary artery disease echocardiography is normally used for the evaluation of wall motion recovery and LV functional evolution, but may be subject to unavoidable operatordependent error [45]. For that region we were intended to use different parameters of this relatively convenient and most available approach to assess global LV dysfunction on subsequent follow up of AMI with the reference of combined BMIPP-TF scan.…”

Section: Discussionmentioning

confidence: 99%