1
|
Zhang M, Sun Y, Zhang L, Xu Y, Liu Y, Li K. The application of mass defect percentage in the evaluation of acute coronary syndrome. Nucl Med Commun 2024:00006231-990000000-00348. [PMID: 39363632 DOI: 10.1097/mnm.0000000000001907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
OBJECTIVES White blood cells, neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio (NLR) distribution patterns in patients with anatomic coronary disease have previously been associated with cardiac events such as myocardial infarct size, complications, and prognosis. However, it remains unknown whether myocardial perfusion mass defect percentage (MDP) obtained from gated myocardial perfusion imaging (G-MPI) correlates with these hematological parameters. Therefore, our research aimed to investigate the application of MDP in the evaluation of acute coronary syndrome (ACS). METHODS Thirty-six patients with ACS underwent single-photon emission computed tomography/computed tomography using retrospective electrocardiography gating during the resting state. The primary outcome was the percentage of left ventricular mass with abnormal myocardial perfusion (i.e. MDP) in G-MPI. Furthermore, the correlation between myocardial perfusion MDP and lymphocyte count, neutrophil count, white blood cell count, and NLR was calculated. In addition, we explored the relationship of myocardial perfusion MDP with other cardiac function parameters obtained from G-MPI, such as summed rest score, left ventricular ejection fraction, end-systolic volume, and end-diastolic volume. RESULTS Myocardial perfusion MDP significantly correlated with white blood cell count, neutrophil count, and NLR (P < 0.01). Furthermore, these hematological parameters were significantly different between low and high MDP groups. Additionally, myocardial perfusion MDP negatively correlated with end-systolic volume (r = -0.615) and left ventricular ejection fraction (r = -0.657). CONCLUSION Myocardial perfusion MDP has a high correlation with inflammatory cell counts and cardiac function parameters obtained from G-MPI in ACS; this may be of help in the evaluation and treatment of these patients.
Collapse
Affiliation(s)
- Man Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, 250014, China
| | | | | | | | | | | |
Collapse
|
2
|
Yan X, Zhang J, Hao J, Xie J, Sun Y, Ma Z. Severe stress cardiomyopathy following spinal corrective surgery for scoliosis complicated with pectus excavatum: a case report. BMC Anesthesiol 2024; 24:333. [PMID: 39294612 PMCID: PMC11409605 DOI: 10.1186/s12871-024-02713-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 09/02/2024] [Indexed: 09/20/2024] Open
Abstract
BACKGROUND Stress cardiomyopathy (SCM) is an acute heart failure syndrome characterized by transient, usually reversible left ventricular systolic dysfunction with normal or enhanced basal compensatory wall motion abnormalities involving the left ventricular anterior septum and apex, resulting in a "ballooning" appearance. However, it has rarely been reported in patients undergoing spinal surgery. CASE PRESENTATION We report a case of severe stress cardiomyopathy in a scoliosis patient with pectus excavatum who underwent spinal corrective surgery. During the wake-up period, circulatory collapse occurred. After multidisciplinary consultation, the patient was diagnosed with stress cardiomyopathy. At last, she had a good prognosis after a series of treatments including ECMO. CONCLUSION Stress cardiomyopathy is a reversible but uncommon condition. It can cause death if it is not diagnosed in time. Consequently, this report should improve the awareness of orthopedists and anesthesiologists for timely identification and management. For patients with potential risk factors, timely preoperative intervention should be performed to reduce the occurrence of stress cardiomyopathy.
Collapse
Affiliation(s)
- Xuhong Yan
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, China
| | - Juan Zhang
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The affiliated hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Jing Hao
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The affiliated hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Jun Xie
- Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, 210008, China
| | - Yue Sun
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, China.
| | - Zhengliang Ma
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, China.
| |
Collapse
|
3
|
Wu P, Zhao Y, Guo X, Liu X, Hu Y, Xiao Y, Xu L, Huang N, Li Y, Wang Y, Ren T, Wu Q, Wang R, Zhang X, Wu Z, Li S. Prognostic Value of Resting Left Ventricular Sphericity Indexes in Coronary Artery Disease With Preserved Ejection Fraction. J Am Heart Assoc 2024; 13:e032169. [PMID: 39189479 DOI: 10.1161/jaha.123.032169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 07/02/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Adverse left ventricular remodeling is a significant cardiovascular predictor for patients with coronary artery disease and preserved left ventricular ejection fraction (LVEF). However, the remodeling indexes reflecting left ventricular spherization by myocardial perfusion imaging are underexplored. METHODS AND RESULTS 727 patients (mean age 59.8±13.5 years, 329 women) diagnosed or suspected coronary artery disease with preserved LVEF who underwent resting myocardial perfusion imaging were retrospectively enrolled. The myocardial perfusion imaging findings including the total perfusion deficit and sphericity indexes (shape index (SI) and eccentricity index (EI) obtained from gated (QGS) and non-gated (QPS) images) were collected. Major adverse cardiovascular events (MACE) were followed up for 45.1±22.0 months. All patients were divided into 4 subgroups based on total perfusion deficit at 10% and LVEF at 65%. Univariable comparative analyses were performed in 5 cohorts (all patients and 4 subgroups). Patients who experienced MACE displayed higher SI and/or lower EI (all P<0.05). Kaplan-Meier survival analyses suggested significant differences for SIQPS in all 5 cohorts, for EIQPS and EIQGS in 4 cohorts, and for end-systolic and end-diastolic SIQGS in 3 cohorts (all P<0.05). Multivariate Cox analysis showed that abnormal SI and EI remained statistically significant predictors for MACE after adjusting for total perfusion deficit, LVEF, and other confounding factors. CONCLUSIONS For patients diagnosed or suspected of coronary artery disease with preserved or supra-normal LVEF, resting sphericity indexes by myocardial perfusion imaging displayed incremental long-term prognostic value. Among these indicators, SIQPS is particularly promising across different perfusion or preserved functional conditions.
Collapse
Affiliation(s)
- Ping Wu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine Shanxi Medical University Taiyuan China
| | - Yuting Zhao
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
| | - Xiaoshan Guo
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine Shanxi Medical University Taiyuan China
| | - Xia Liu
- Department of Radiology Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University Taiyuan China
| | - Yingqi Hu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Yuxin Xiao
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Li Xu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Nan Huang
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
| | - Yuanyuan Li
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Yanhui Wang
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Tailin Ren
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Qiuyan Wu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Ruonan Wang
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Xiaoli Zhang
- Laboratory for Molecular Imaging, Department of Nuclear Medicine Beijing Anzhen Hospital, Capital Medical University Beijing China
| | - Zhifang Wu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine Shanxi Medical University Taiyuan China
| | - Sijin Li
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine Shanxi Medical University Taiyuan China
| |
Collapse
|
4
|
Jose A, Zhou C, Baker R, Walker J, Kurek N, O'Donnell RE, Elwing JM, Gerson M. Predictive value of incidental right ventricular abnormalities identified on SPECT for mortality and pulmonary hypertension. J Nucl Cardiol 2022; 29:1903-1914. [PMID: 33851355 PMCID: PMC8043660 DOI: 10.1007/s12350-021-02612-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The clinical significance of incidentally found RV abnormalities on low-risk SPECT studies is not well-defined. The objective of this study was to determine the predictive value of incidental right ventricular (RV) abnormalities identified on single photon emission computed tomography (SPECT) scans for mortality and pulmonary hypertension (PH). METHODS We retrospectively analyzed all low-risk SPECT studies in patients without known coronary artery or pulmonary vascular disease, performed at our institution, from 2007-2020. Adjusted Cox proportional hazards models were used to evaluate the association between incidental RV abnormalities on low-risk SPECT studies and outcomes. RESULTS Of the 4761 patients included in the analysis, mortality events were present in 494, and echocardiographic PH was present in 619. Incidental RV abnormalities on low-risk SPECT studies were significantly and independently associated with all-cause mortality (HR = 1.41, CI [1.07-1.86], P = 0.0152) and echocardiographic PH (HR = 2.06, CI [1.64-2.60], P < 0.0001). CONCLUSIONS These data suggest incidental RV abnormalities found on low-risk SPECT imaging studies are significantly and independently associated with increased mortality and risk of developing echocardiographic PH, and could identify high-risk patients for closer monitoring and additional diagnostic testing.
Collapse
Affiliation(s)
- Arun Jose
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Cincinnati College of Medicine, 6352-A, Medical Sciences Building, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA.
| | - Christine Zhou
- Division of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Rachel Baker
- Undergraduate Studies, University of Cincinnati College of Arts and Sciences, Cincinnati, OH, USA
| | - Jackson Walker
- Division of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Nicholas Kurek
- Division of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Robert E O'Donnell
- Division of Cardiovascular Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jean M Elwing
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Cincinnati College of Medicine, 6352-A, Medical Sciences Building, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA
| | - Myron Gerson
- Division of Cardiovascular Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
5
|
Liu B, Yu W, Wang J, Shao X, Zhang F, Zhou M, Shi Y, Wang B, Xu Y, Wang Y. A model combining rest-only ECG-gated SPECT myocardial perfusion imaging and cardiovascular risk factors can effectively predict obstructive coronary artery disease. BMC Cardiovasc Disord 2022; 22:268. [PMID: 35705898 PMCID: PMC9202088 DOI: 10.1186/s12872-022-02712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/06/2022] [Indexed: 11/20/2022] Open
Abstract
Objective The rest-only single photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) had low sensitivity in diagnosing obstructive coronary artery disease (CAD). Improving the efficacy of resting MPI in diagnosing CAD has important clinical significance for patients with contraindications to stress. The purpose of this study was to develop and validate a model predicting obstructive CAD in suspected CAD patients, based on rest-only MPI and cardiovascular risk factors. Methods A consecutive retrospective cohort of 260 suspected CAD patients who underwent rest-only gated SPECT MPI and coronary angiography was constructed. All enrolled patients had stress MPI contraindications. Clinical data such as age and gender were collected. Automated quantitative analysis software QPS and QGS were used to evaluate myocardial perfusion and function parameters. The least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression were used to select the variables and build the prediction model. Results Among the enrolled 260 patients with suspected CAD, there were 95 (36.5%, 95/260) patients with obstructive CAD. The prediction model was presented in the form of a nomogram and developed based on selected predictors, including age, sex, SRS ≥ 4, SMS ≥ 2, STS ≥ 2, hypertension, diabetes, and hyperlipidemia. The AUC of the prediction model was 0.795 (95% CI: 0.741–0.843), which was better than the traditional models. The AUC calculated by enhanced bootstrapping validation (500 bootstrap resamples) was 0.785. Subsequently, the calibration curve (intercept = − 0.106; slope = 0.843) showed a good calibration of the model. The decision curve analysis (DCA) shows that the constructed clinical prediction model had good clinical applications. Conclusions In patients with suspected CAD and contraindications to stress MPI, a prediction model based on rest-only ECG-gated SPECT MPI and cardiovascular risk factors have been developed and validated to predict obstructive CAD effectively.
Collapse
Affiliation(s)
- Bao Liu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Wenji Yu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Jianfeng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Xiaoliang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Feifei Zhang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Mingge Zhou
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Yunmei Shi
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Bing Wang
- The Nuclear Medicine and Molecular Imaging Clinical Translation Institute of Soochow University, Changzhou, Jiangsu Province, China
| | - Yiduo Xu
- The Nuclear Medicine and Molecular Imaging Clinical Translation Institute of Soochow University, Changzhou, Jiangsu Province, China
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China.
| |
Collapse
|
6
|
Liu B, Yu W, Wang J, Shao X, Zhang F, Yang M, Yang X, Wu Z, Li S, Shi Y, Wang B, Xu Y, Wang Y. Incremental value of regional wall motion abnormalities for detecting obstructive coronary artery disease by rest-only electrocardiogram-gated single-photon emission computerized tomography myocardial perfusion imaging in suspected coronary artery disease patients. Nucl Med Commun 2021; 42:276-283. [PMID: 33252509 DOI: 10.1097/mnm.0000000000001335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether regional wall motion (WM) abnormalities by rest-only 99mtechnetium-sestamibi (99mTc-MIBI) electrocardiogram (ECG)-gated single-photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) had incremental diagnostic value for detecting obstructive coronary artery disease (CAD) in suspected CAD patients. METHODS This study retrospectively studied 255 consecutive suspected CAD patients who underwent rest-only ECG-gated SPECT MPI and were performed coronary angiography within 3 months. Obstructive CAD was defined as ≥70% narrowing of the inner diameter of the left anterior descending coronary artery, left circumflex coronary artery and right coronary artery or their main branches and ≥50% narrowing of the left main coronary artery. QPS and QGS were used to assess rest perfusion and WM. Summed rest score ≥4 and summed motion score ≥2 exhibited in two consecutive segments in one territory was considered abnormal. RESULTS The sensitivity of the combination of perfusion and regional WM abnormalities was significantly higher than perfusion alone for detecting obstructive CAD (46.8% vs. 30.9%; P < 0.001), with similar specificity (91.9% vs. 95.0; P = 0.063). The global chi-square value of combination of perfusion and WM increased from 31.40 to 50.71 (P < 0.001) compared to perfusion. The sensitivity of combination of perfusion and WM for detecting obstructive CAD in patients with multivessel disease was higher than single-vessel disease (56.1% vs. 25.0%; P < 0.001), with similar specificity. CONCLUSION Regional WM abnormalities at rest, as shown by rest-only 99mTc-MIBI ECG-gated SPECT MPI, have additional diagnostic value over perfusion alone for detecting obstructive CAD in suspected CAD patients.
Collapse
Affiliation(s)
- Bao Liu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province
| | - Wenji Yu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province
| | - Jianfeng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province
| | - Xiaoliang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province
| | - Feifei Zhang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province
| | - Minfu Yang
- Department of Nuclear Medicine, Affiliated Beijing Chaoyang Hospital of Capital Medical University, Beijing
| | - Xiaoyu Yang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province
| | - Zhifang Wu
- Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Sijin Li
- Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Yunmei Shi
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province
| | - Bing Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province
| | - Yiduo Xu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province
| |
Collapse
|