871 results match your criteria Myocardial Ischemia - Nuclear Medicine and Risk Stratification

Recommendations for Multimodality Cardiovascular Imaging of Patients with Hypertrophic Cardiomyopathy: An Update from the American Society of Echocardiography, in Collaboration with the American Society of Nuclear Cardiology, the Society for Cardiovascular Magnetic Resonance, and the Society of Cardiovascular Computed Tomography.

J Am Soc Echocardiogr 2022 Jun;35(6):533-569

Toronto General Hospital, Toronto, Canada.

Hypertrophic cardiomyopathy (HCM) is defined by the presence of left ventricular hypertrophy in the absence of other potentially causative cardiac, systemic, syndromic, or metabolic diseases. Symptoms can be related to a range of pathophysiologic mechanisms including left ventricular outflow tract obstruction with or without significant mitral regurgitation, diastolic dysfunction with heart failure with preserved and heart failure with reduced ejection fraction, autonomic dysfunction, ischemia, and arrhythmias. Appropriate understanding and utilization of multimodality imaging is fundamental to accurate diagnosis as well as longitudinal care of patients with HCM. Read More

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Pericoronary Adipose Tissue Attenuation, Low-Attenuation Plaque Burden, and 5-Year Risk of Myocardial Infarction.

JACC Cardiovasc Imaging 2022 Jun 13;15(6):1078-1088. Epub 2022 Apr 13.

Departments of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. Electronic address:

Background: Pericoronary adipose tissue (PCAT) attenuation and low-attenuation noncalcified plaque (LAP) burden can both predict outcomes.

Objectives: This study sought to assess the relative and additive values of PCAT attenuation and LAP to predict future risk of myocardial infarction.

Methods: In a post hoc analysis of the multicenter SCOT-HEART (Scottish Computed Tomography of the Heart) trial, the authors investigated the relationships between the future risk of fatal or nonfatal myocardial infarction and PCAT attenuation measured from coronary computed tomography angiography (CTA) using multivariable Cox regression models including plaque burden, obstructive coronary disease, and cardiac risk score (incorporating age, sex, diabetes, smoking, hypertension, hyperlipidemia, and family history). Read More

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External validation of the CRAX2MACE model.

J Nucl Cardiol 2022 Apr 13. Epub 2022 Apr 13.

Department of Cardiac Sciences, University of Calgary, GAA08, 3230 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada.

Background: Single-photon emission computed tomography (SPECT) myocardial perfusion is frequently used to predict risk of major adverse cardiovascular events (MACE). We performed an external validation of the CRAX2MACE score, developed to estimate 2-year risk of MACE in patients with suspected coronary artery disease (CAD).

Methods: Patients who underwent clinically indicated SPECT with available follow-up for MACE were included (N = 2,985). Read More

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A Left Ventricular Mechanical Dyssynchrony-Based Nomogram for Predicting Major Adverse Cardiac Events Risk in Patients With Ischemia and No Obstructive Coronary Artery Disease.

Front Cardiovasc Med 2022 18;9:827231. Epub 2022 Mar 18.

Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

Background: The risk stratification of patients with ischemia and no obstructive coronary artery disease (INOCA) remains suboptimal. This study aims to establish a left ventricular mechanical dyssynchrony (LVMD)-based nomogram to improve the present situation.

Methods: Patients with suspected coronary artery disease (CAD) were retrospectively enrolled and divided into three groups: normal (stenosis <50%, without myocardial ischemia), INOCA (stenosis <50%, summed stress score >4, summed difference score ≥2), and obstructive CAD (stenosis ≥50%). Read More

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Lung Opacity and Coronary Artery Calcium Score: A Combined Tool for Risk Stratification and Outcome Prediction in COVID-19 Patients.

Acad Radiol 2022 06 28;29(6):861-870. Epub 2022 Feb 28.

Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.

Purpose: To assess and correlate pulmonary involvement and outcome of SARS-CoV-2 pneumonia with the degree of coronary plaque burden based on the CAC-DRS classification (Coronary Artery Calcium Data and Reporting System).

Methods: This retrospective study included 142 patients with confirmed SARS-CoV-2 pneumonia (58 ± 16 years; 57 women) who underwent non-contrast CT between January 2020 and August 2021 and were followed up for 129 ± 72 days. One experienced blinded radiologist analyzed CT series for the presence and extent of calcified plaque burden according to the visual and quantitative HU-based CAC-DRS Score. Read More

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Non-invasive Multimodality Imaging of Coronary Vulnerable Patient.

Front Cardiovasc Med 2022 24;9:836473. Epub 2022 Feb 24.

Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France.

Atherosclerotic plaque rupture or erosion remain the primary mechanism responsible for myocardial infarction and the major challenge of cardiovascular researchers is to develop non-invasive methods of accurate risk prediction to identify vulnerable plaques before the event occurs. Multimodal imaging, by CT-TEP or CT-SPECT, provides both morphological and activity information about the plaque and cumulates the advantages of anatomic and molecular imaging to identify vulnerability features among coronary plaques. However, the rate of acute coronary syndromes remains low and the mechanisms leading to adverse events are clearly more complex than initially assumed. Read More

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February 2022

Updates in the Impact of Chronic Systemic Inflammation on Vascular Inflammation by Positron Emission Tomography (PET).

Curr Cardiol Rep 2022 04 16;24(4):317-326. Epub 2022 Feb 16.

Inflammation and Cardiometabolic Diseases, Clinical Research Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, USA.

Purpose Of Review: In this review, we focus on the clinical and epidemiological studies pertaining to systemic and vascular inflammation by positron emission tomography (PET) in patients with chronic inflammatory conditions such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), and psoriasis to highlight the importance of chronic systemic inflammation on vascular inflammation by PET in these disease states.

Recent Findings: Recent clinical and translation advancements have demonstrated the durable relationship between chronic systemic inflammation and cardiovascular disease (CVD). In chronic inflammatory states, this relationship is robustly evident in the form of increased vascular inflammation, yet traditional risk estimates often underestimate the subclinical cardiovascular risk conferred by chronic inflammation. Read More

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Role of cardiac CT in the diagnostic evaluation and risk stratification of patients with myocardial infarction and non-obstructive coronary arteries (MINOCA): rationale and design of the MINOCA-GR study.

BMJ Open 2022 Feb 2;12(2):e054698. Epub 2022 Feb 2.

First Department of Cardiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece

Introduction: Myocardial infarction with non-obstructive coronary arteries (MINOCA) occurs in 5%-15% of all patients with acute myocardial infarction. Cardiac MR (CMR) and optical coherence tomography have been used to identify the underlying pathophysiological mechanism in MINOCA. The role of cardiac CT angiography (CCTA) in patients with MINOCA, however, has not been well studied so far. Read More

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February 2022

Prognostic indicators for the onset of ischaemic versus haemorrhagic stroke in stable coronary artery disease.

Medicine (Baltimore) 2021 Dec;100(48):e27973

Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, R.O.C.

Abstract: The incidence of stroke may be increased in patients with coronary artery disease (CAD). We aimed to investigate the specific risk factors for the development of ischaemic and haemorrhagic stroke in stable CAD patients.Patients with stable CAD were prospectively enrolled for future cardiovascular events in Taiwan. Read More

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December 2021

Innovative Approaches to Assess Intermediate Cardiovascular Risk Subjects: A Review From Clinical to Metabolomics Strategies.

Front Cardiovasc Med 2021 22;8:788062. Epub 2021 Dec 22.

School of Medicine, University of Brasilia, Brasilia, Brazil.

Current risk stratification strategies for coronary artery disease (CAD) have low predictive value in asymptomatic subjects classified as intermediate cardiovascular risk. This is relevant because not all coronary events occur in individuals with traditional multiple risk factors. Most importantly, the first manifestation of the disease may be either sudden cardiac death or acute coronary syndrome, after rupture and thrombosis of an unstable non-obstructive atherosclerotic plaque, which was previously silent. Read More

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December 2021

Association between de Quervain syndrome and herpes zoster: a population-based cohort study.

BMJ Open 2021 12 23;11(12):e046891. Epub 2021 Dec 23.

Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan

Objective: Both physical diseases such as infection and chronic pain and psychological disorders such as depression have been associated with herpes zoster (HZ) reactivation. However, the relationship between de Quervain syndrome (DQS), a painful tenosynovitis and HZ remains unclear. We investigated whether DQS increases the risk of HZ reactivation. Read More

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December 2021

Association between T wave morphology parameters and abnormal cardiac SPECT imaging.

J Electrocardiol 2022 Jan-Feb;70:65-69. Epub 2021 Dec 11.

Department of Cardiology, Meir Medical Center, Kfar Sava, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. Electronic address:

Background: T-wave morphology dispersion (TMD) described the electrocardiographic T-wave heterogeneity during a single cardiac cycle. Total cosine R-to-T (TCRT) is the average of the cosines of the angles between the QRS and T vectors on the ECG. We examine the predictive value of TMD and TCRT calculation to assess abnormal myocardial perfusion. Read More

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The association between heart rate reserve and impaired coronary flow velocity reserve: a study based on adenosine stress echocardiography.

Int J Cardiovasc Imaging 2021 Dec 17. Epub 2021 Dec 17.

Department of Cardiac Function, People's Hospital of Liaoning Province, Building 1, No.33, Wenyi Road, Shenhe District, Shenyang, 110000, China.

This study was to explore the correlation between heart rate reserve (HRR) to coronary flow velocity reserve (CFVR), using adenosine stress echocardiography (SE), in patients with angina and no obstructive coronary artery disease (ANOCA). 111 ANOCA patients underwent adenosine SE were enrolled, which were divided into two groups, impaired CFVR group (CFVR < 2) and control groups (CFVR ≥ 2). The relationships between HRR and impaired CFVR were explored in total and subgroup to sex. Read More

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December 2021

[Clinical value of TDI combined with 2D-STI on evaluating the microcirculation dysfunction and left ventricular dysfunction in patients with non-obstructive coronary angina].

Zhonghua Xin Xue Guan Bing Za Zhi 2021 Dec;49(12):1191-1197

Department of Cardiac Function, People's Hospital of Liaoning Province, Shenyang 110000, China.

To explore the value of tissue Doppler imaging (TDI) combined with two-dimensional speckle tracking imaging (2D-STI) at rest on evaluating microcirculation dysfunction and left ventricular dysfunction in patients with angina and no obstructive coronary artery disease(ANOCA). This retrospective study recruited 78 ANOCA patients, who hospitalized in the People's Hospital of Liaoning Province from August 2019 to July 2021. These patients underwent conventional echocardiography examination, including TDI and 2D-STI, to evaluate the left ventricular dysfunction, and adenosine stress echocardiography (SE) to evaluate the coronary flow velocity reserve (CFVR). Read More

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December 2021

Comparison of diabetes to other prognostic predictors among patients referred for cardiac stress testing: A contemporary analysis from the REFINE SPECT Registry.

J Nucl Cardiol 2021 Nov 10. Epub 2021 Nov 10.

Departments of Medicine (Division of Artificial Intelligence), Imaging, and Biomedical Sciences, Cedars-Sinai, Los Angeles, CA, USA.

Background: Diabetes mellitus (DM) is increasingly prevalent among contemporary populations referred for cardiac stress testing, but its potency as a predictor for major adverse cardiovascular events (MACE) vs other clinical variables is not well delineated.

Methods And Results: From 19,658 patients who underwent SPECT-MPI, we identified 3122 patients with DM without known coronary artery disease (CAD) (DM+/CAD-) and 3564 without DM with known CAD (DM-/CAD+). Propensity score matching was used to control for the differences in characteristics between DM+/CAD- and DM-/CAD+ groups. Read More

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November 2021

Arterial calcification at different sites and prediction of atherosclerotic cardiovascular disease among women and men.

Atherosclerosis 2021 Oct 19;337:27-34. Epub 2021 Oct 19.

Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. Electronic address:

Background And Aims: The sex-specific contributions of arterial calcification to atherosclerotic cardiovascular disease (ASCVD) risk prediction and stratification in the light of recent modifications by cardiovascular prevention guidelines remain unclear. We assessed the sex-specific value of calcification in different arteries, beyond the Pooled Cohort Equations (PCE) risk factors, for 10-year ASCVD risk prediction.

Methods: From 2003 to 2006, participants from the population-based Rotterdam Study (n = 2167) underwent CT to quantify coronary artery calcification (CAC), aortic arch calcification (AAC), extracranial (ECAC) and intracranial carotid artery calcification (ICAC). Read More

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October 2021

Biomarkers of subclinical atherosclerosis in patients with psoriasis.

Sci Rep 2021 11 2;11(1):21438. Epub 2021 Nov 2.

Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.

Psoriasis is linked with increased risk of cardiovascular disease (CVD) that is underestimated by traditional risk stratification. We conducted a large-scale plasma proteomic analysis by use of a proximity extension assay in 85 patients with a history of moderate-to-severe psoriasis with or without established atherosclerotic CVD. Differentially expressed proteins associated with CVD were correlated with subclinical atherosclerotic markers including vascular inflammation determined by F-fluorodeoxyglucose positron emission tomography/computed tomography, carotid intima-media thickness (CIMT), carotid artery plaques, and coronary artery calcium score (CCS) in the patients without CVD and statin treatment. Read More

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November 2021

Cardiovascular event risk estimated by myocardial perfusion SPECT combined with clinical data.

J Cardiol 2022 07 30;80(1):64-71. Epub 2021 Oct 30.

Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Myocardial scintigraphy plays important roles in the diagnosis of coronary artery disease, prognostic risk stratification, and determination of the treatment policy. Recently, several large-scale clinical trials reported that coronary intervention was not necessarily advantageous for preventing future cardiac events in patients with stable angina. This review summarizes how we can estimate cardiac event risks based on Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS), and describes that the combination of scintigraphy and other clinical features leads to more accurate stratification of prognosis and the determination of subsequent treatment policy. Read More

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Long-term prognostic value of computed tomography-based attenuation correction on thallium-201 myocardial perfusion imaging: A cohort study.

PLoS One 2021 26;16(10):e0258983. Epub 2021 Oct 26.

Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Background: Myocardial perfusion imaging (MPI) is a well-established diagnostic tool to evaluate coronary artery disease (CAD) and also an effective prognostic tool for patients with CAD. However, few studies investigated the prognostic value of attenuation correction (AC) in MPI, and the results were controversial.

Objectives: To investigate the prognostic value of computed tomography (CT)-based AC thallium-201 (Tl-201) MPI. Read More

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December 2021

Detection of subclinical atherosclerosis from PET-CT in patients with breast cancer.

J Cardiovasc Comput Tomogr 2022 Mar-Apr;16(2):189-190. Epub 2021 Sep 29.

Cardiovascular Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA. Electronic address:

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Stress Cardiac Magnetic Resonance Myocardial Perfusion Imaging: JACC Review Topic of the Week.

J Am Coll Cardiol 2021 10;78(16):1655-1668

Cardiovascular Division, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA; Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA.

Stress cardiovascular magnetic resonance imaging (CMR) is a cost-effective, noninvasive test that accurately assesses myocardial ischemia, myocardial viability, and cardiac function without the need for ionizing radiation. There is a large body of literature, including randomized controlled trials, validating its diagnostic performance, risk stratification capabilities, and ability to guide appropriate use of coronary intervention. Specifically, stress CMR has shown higher diagnostic sensitivity than single-photon emission computed tomography imaging in detecting angiographically significant coronary artery disease. Read More

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October 2021

Artificial Intelligence Based Multimodality Imaging: A New Frontier in Coronary Artery Disease Management.

Front Cardiovasc Med 2021 22;8:736223. Epub 2021 Sep 22.

Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy.

Coronary artery disease (CAD) represents one of the most important causes of death around the world. Multimodality imaging plays a fundamental role in both diagnosis and risk stratification of acute and chronic CAD. For example, the role of Coronary Computed Tomography Angiography (CCTA) has become increasingly important to rule out CAD according to the latest guidelines. Read More

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September 2021

Amiodarone attenuates cardiac Rubidium-82 in consecutive PET/CT scans in a rodent model.

J Nucl Cardiol 2021 Oct 5. Epub 2021 Oct 5.

Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen, Denmark.

Background: Risk stratification and diagnosis using Rubidium-82 (Rb) positron emission tomography (PET) is a routine clinical approach in coronary artery disease (CAD). Various drugs are used to treat CAD; however, whether any of them change the uptake of Rb in the heart has not been investigated. The aim of this study is to determine whether drugs used in treatment of CAD affect the uptake of Rb in the heart in healthy rats. Read More

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October 2021

Diagnostic strategies in suspected chronic coronary syndrome - The case for a hybrid approach.

J Cardiovasc Comput Tomogr 2022 Jan-Feb;16(1):41-42. Epub 2021 Sep 20.

Cardiac Imaging, Department of Nuclear Medicine, University and University Hospital Zurich, Zurich, Switzerland. Electronic address:

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February 2022

Optimizing diagnosis and risk stratification of ischemic heart disease by myocardial perfusion imaging: The incremental values of non-perfusion variables during vasodilator stress.

Guang-Uei Hung

J Nucl Cardiol 2022 Jun 13;29(3):934-937. Epub 2021 Sep 13.

Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.

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Prognostic value of myocardial perfusion imaging after first-line coronary computed tomography angiography: A multi-center cohort study.

J Cardiovasc Comput Tomogr 2022 Jan-Feb;16(1):34-40. Epub 2021 Aug 27.

Department of Cardiology, Hospital Unit West, Herning, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark. Electronic address:

Purpose: Further diagnostic testing may be required after a coronary computed tomography angiography (CTA) showing suspected coronary stenosis. Whether myocardial perfusion imaging (MPI) provides further prognostic information post-CTA remains debated. We evaluated the prognosis for patients completing CTA stratified for post-CTA diagnostic work-up using real-world data. Read More

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January 2022

Development and Piloting of a Patient-Centered Report Design for Stress Myocardial Perfusion Imaging Results.

JAMA Netw Open 2021 08 2;4(8):e2121011. Epub 2021 Aug 2.

Saint Luke's Mid America Heart Institute, Kansas City, Missouri.

Importance: The management of coronary disease epitomizes the call to better engage patients in shared medical decision-making. Myocardial perfusion imaging (MPI) is the foundation of diagnosis, risk stratification, and subsequent therapy; however, MPI reports are currently interpretable by specialists but not patients.

Objective: To design and test a patient-centered report for stress MPI test results. Read More

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Patterns of [18F]FDG myocardial uptake in oncology patients as a predictor of myocardial ischaemia on stress myocardial perfusion imaging.

Nucl Med Rev Cent East Eur 2021 ;24(2):51-57

King Faisal Hospital, Riyadh, Saudi Arabia.

Background: There is variable cardiac uptake observed on oncological ¹⁸F-fludeoxyglucose ([¹⁸F]FDG) positron emission/computed tomography (PET/CT). The main purpose of this study is to evaluate patterns of overnight fasting myocardial [¹⁸F]FDG uptake in oncological PET/CT and analyse the relationship between myocardial [¹⁸F]FDG uptake and myocardial ischaemia on stress single-photon emission CT (SPECT) myocardial perfusion imaging (MPI).

Material And Methods: A total of 362 subjects underwent both oncological PET/CT and stress SPECT MPI within 3 months of each other. Read More

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October 2021

Does quantification of [C]meta-hydroxyephedrine and [N]ammonia kinetics improve risk stratification in ischemic cardiomyopathy.

J Nucl Cardiol 2022 04 2;29(2):413-425. Epub 2021 Aug 2.

Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.

Background: In ischemic cardiomyopathy patients, cardiac sympathetic nervous system dysfunction is a predictor of sudden cardiac arrest (SCA). This study compared abnormal innervation and perfusion measured by [C]meta-hydroxyephedrine (HED) vs [N]ammonia (NH), conventional uptake vs parametric tracer analysis, and their SCA risk discrimination.

Methods: This is a sub-study analysis of the prospective PAREPET trial, which followed ischemic cardiomyopathy patients with reduced left ventricular ejection fraction (LVEF ≤ 35%) for events of SCA. Read More

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