Utility of myocardial perfusion imaging in patients with low-risk treadmill scores

Poornima, Indu; Miller, Todd D.; Christian, Timothy F.; Hodge, David O.; Bailey, Kent R.; Gibbons, Raymond J.

doi:10.1016/j.jacc.2003.09.029

Cited by 68 publications

(13 citation statements)

References 21 publications

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“…The five-point scoring used to grade each segment was as follows: 0, absent perfusion; 1, severe hypoperfusion; 2, moderate hypoperfusion; 3, mild hypoperfusion; 4, normal perfusion. The normal total score of LAD distribution areas is 28 (35).…”

Section: Methodsmentioning

confidence: 99%

Coexpression of VEGF and angiopoietin-1 promotes angiogenesis and cardiomyocyte proliferation reduces apoptosis in porcine myocardial infarction (MI) heart

Zeng

Chen

Tan

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

158

103

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VEGF and angiopoietin-1 (Ang1) are two major angiogenic factors being investigated for the treatment of myocardial infarction (MI). Targeting VEGF and Ang1 expression in the ischemic myocardium can increase their local therapeutic effects and reduce possible adverse effects. Adeno-associated viral vectors (AAVs) expressing cardiac-specific and hypoxia-inducible VEGF [AAV-myosin light chain-2v (MLC)VEGF] and Ang1 (AAV-MLCAng1) were coinjected (VEGF/Ang1 group) into six different sites of the porcine myocardium at the peri-infarct zone immediately after ligating the left descending coronary artery. An identical dose of AAV-Cytomegalovirus (CMV)LacZ or saline was injected into control animals. AAV genomes were detected in the liver in addition to the heart. RT-PCR, Western blotting, and ELISA analyses showed that VEGF and Ang1 were predominantly expressed in the myocardium in the infarct core and border of the infarct heart. Gated single-photon emission computed tomography analyses showed that the VEGF/Ang1 group had better cardiac function and myocardial perfusion at 8 wk than at 2 wk after vector injection. Compared with the saline and LacZ controls, the VEGF/Ang1 group expressed higher phosphorylated Akt and Bcl-xL, less Caspase-3 and Bad, and had higher vascular density, more proliferating cardiomyocytes, and less apoptotic cells in the infarct and peri-infarct zones. Thus, cardiac-specific and hypoxia-induced coexpression of VEGF and Ang1 improves the perfusion and function of porcine MI heart through the induction of angiogenesis and cardiomyocyte proliferation, activation of prosurvival pathways, and reduction of cell apoptosis.

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Section: Methodsmentioning

confidence: 99%

Coexpression of VEGF and angiopoietin-1 promotes angiogenesis and cardiomyocyte proliferation reduces apoptosis in porcine myocardial infarction (MI) heart

Zeng

Chen

Tan

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

158

103

View full text Add to dashboard Cite

show abstract

“…Furthermore, nuclear perfusion imaging is the only technique that allows reliable evaluation of myocardial perfusion during dynamic exercise. Although the value of pharmacological stress testing is undeniable, the importance of exercise-related parameters for risk stratification cannot be exaggerated [144,145]. Multi-slice computed tomography is also emerging as an alternative non-invasive approach for coronary artery disease diagnosis [146].…”

Section: Gated Spect Versus Other Imaging Modalitiesmentioning

confidence: 99%

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Sciagrà

2007

Eur J Nucl Med Mol Imaging

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Background Gating of single-photon emission computed tomography (SPECT) has significantly improved the reliability and diagnostic accuracy of myocardial perfusion imaging. The functional parameters derived from this technique, mainly left ventricular volumes and ejection fraction, have been demonstrated to be accurate and reproducible. They are able to increase the detection of severe and extensive coronary artery disease and show a significant incremental prognostic power over perfusion abnormalities. Therefore, the importance given to gated SPECT functional data has progressively grown. Discussion This circumstance has further expanded the indications for myocardial perfusion imaging and strengthened its position among the different imaging modalities. Moreover, several studies show that the evaluation of ventricular function may have a leading part in justifying the execution of perfusion scintigraphy in various clinical conditions. Aim Aim of this review is to describe this evolution of gated SPECT functional assessment from a supporting rank with respect to perfusion, to a main actor position in the field of cardiac imaging.

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“…Aunque nuestra casuística es limitada por el tipo de pacientes, la tasa de eventos mayores fue más alta (1,7%) que la descrita 16 . En otro estudio con Tl 201 -SPECT en pacientes sin EC e índices de Duke alto y bajo, con seguimiento a 7 años, se observó que sólo en alto riesgo el SPECT tuvo valor pronóstico independiente para mortalidad cardiaca 23 . Sin embargo, la experiencia reciente en pacientes con edad marcadamente superior a la nuestra, de los cuales 28% realizó PE, el alcanzar < 7 METs y el aumento del volumen de fin de sístole predijeron mortalidad; las variables del SPECT fueron incapaces de proveer estratificación del riesgo 24 .…”

Section: Discussionunclassified

Seguimiento clínico en pacientes con buena capacidad metabólica en la prueba de esfuerzo con SPECT miocárdico

et al. 2015

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10% left ventricular extension) in 56.6%. Only seven cases had coronary events after the SPECT. Two major (myocardial infarction and emergency coronary revascularization) and 5 minor events (elective revascularization) ere observed in the follow-up. In a multivariate analysis, SPECT ischemia was the only statistically significant parameter that increased the probability of having a major or minor event. Conclusions: Nearly a quarter of our patients with good exercise capacity demonstrated reversible defects in their myocardial perfusion SPECT. In the intermediate-term follow-up, a low rate of cardiac events was observed, being the isotopic ischemia the only significant predictive parameter.]]>

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Utility of myocardial perfusion imaging in patients with low-risk treadmill scores

Cited by 68 publications

References 21 publications

Coexpression of VEGF and angiopoietin-1 promotes angiogenesis and cardiomyocyte proliferation reduces apoptosis in porcine myocardial infarction (MI) heart

Coexpression of VEGF and angiopoietin-1 promotes angiogenesis and cardiomyocyte proliferation reduces apoptosis in porcine myocardial infarction (MI) heart

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Seguimiento clínico en pacientes con buena capacidad metabólica en la prueba de esfuerzo con SPECT miocárdico

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