Deciding Wisely: A Case for an Effective Use of Myocardial Perfusion Imaging

Overview

Journal J Nucl Cardiol

Specialty Cardiology & Vascular Diseases

Date 2017 Dec 1

PMID 29188433

Citations 1

Authors

Rami Doukky

Affiliations

Soon will be listed here.

Abstract

There is a vast body of literature supporting the use of stress myocardial perfusion imaging (MPI) in patients with known or suspected coronary artery disease. When applied in the appropriate clinical setting, MPI can aid, not only in diagnosis and risk stratification, but also in decision-making. In a case of a 58-year-old man with suspected coronary artery disease, we highlight how the appropriate use of stress MPI can leverage the diagnostic and prognostic utility of MPI in an effective, evidence-based decision-making aimed to achieve the best patient outcome.

Citing Articles

Case Presentation Commentary on "Deciding wisely: A case for an effective use of myocardial perfusion imaging".

Phillips L J Nucl Cardiol. 2017; 25(1):62.

PMID: 29218643 DOI: 10.1007/s12350-017-1138-y.

References

Shaw L, Berman D, Maron D, Mancini G, Hayes S, Hartigan P . Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy. Circulation. 2008; 117(10):1283-91. DOI: 10.1161/CIRCULATIONAHA.107.743963. View

Mark D, Federspiel J, Cowper P, Anstrom K, Hoffmann U, Patel M . Economic Outcomes With Anatomical Versus Functional Diagnostic Testing for Coronary Artery Disease. Ann Intern Med. 2016; 165(2):94-102. PMC: 5046832. DOI: 10.7326/M15-2639. View

Mohr F, Morice M, Kappetein A, Feldman T, Stahle E, Colombo A . Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet. 2013; 381(9867):629-38. DOI: 10.1016/S0140-6736(13)60141-5. View

Diamond G, Forrester J . Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979; 300(24):1350-8. DOI: 10.1056/NEJM197906143002402. View

Gould K, Johnson N, Bateman T, Beanlands R, Bengel F, Bober R . Anatomic versus physiologic assessment of coronary artery disease. Role of coronary flow reserve, fractional flow reserve, and positron emission tomography imaging in revascularization decision-making. J Am Coll Cardiol. 2013; 62(18):1639-1653. DOI: 10.1016/j.jacc.2013.07.076. View

Alexander K, Shaw L, Shaw L, DeLong E, Mark D, Peterson E . Value of exercise treadmill testing in women. J Am Coll Cardiol. 1998; 32(6):1657-64. DOI: 10.1016/s0735-1097(98)00451-3. View

Fihn S, Blankenship J, Alexander K, Bittl J, Byrne J, Fletcher B . 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice.... J Am Coll Cardiol. 2014; 64(18):1929-49. DOI: 10.1016/j.jacc.2014.07.017. View

Balady G, Bricker J, Chaitman B, Fletcher G, Froelicher V, Mark D . ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). J Am Coll Cardiol. 2002; 40(8):1531-40. DOI: 10.1016/s0735-1097(02)02164-2. View

Johnson L, Verdesca S, Aude W, Xavier R, Nott L, Campanella M . Postischemic stunning can affect left ventricular ejection fraction and regional wall motion on post-stress gated sestamibi tomograms. J Am Coll Cardiol. 1997; 30(7):1641-8. DOI: 10.1016/s0735-1097(97)00388-4. View

10.

Ward R, Gundeck E, Lang R, Spencer K, Williams K . Overestimation of postischemic myocardial stunning on gated SPECT imaging: correlation with echocardiography. J Nucl Cardiol. 2006; 13(4):514-20. DOI: 10.1016/j.nuclcard.2006.03.009. View

11.

Frye R, August P, Brooks M, Hardison R, Kelsey S, MacGregor J . A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009; 360(24):2503-15. PMC: 2863990. DOI: 10.1056/NEJMoa0805796. View

12.

Emmett L, Iwanochko R, Freeman M, Barolet A, Lee D, Husain M . Reversible regional wall motion abnormalities on exercise technetium-99m-gated cardiac single photon emission computed tomography predict high-grade angiographic stenoses. J Am Coll Cardiol. 2002; 39(6):991-8. DOI: 10.1016/s0735-1097(02)01707-2. View

13.

Park S, Ahn J, Kim Y, Park D, Yun S, Lee J . Trial of everolimus-eluting stents or bypass surgery for coronary disease. N Engl J Med. 2015; 372(13):1204-12. DOI: 10.1056/NEJMoa1415447. View

14.

Doukky R, Hayes K, Frogge N, Balakrishnan G, Dontaraju V, Rangel M . Impact of appropriate use on the prognostic value of single-photon emission computed tomography myocardial perfusion imaging. Circulation. 2013; 128(15):1634-43. DOI: 10.1161/CIRCULATIONAHA.113.002744. View

15.

Alama M, Labos C, Emery H, Iwanochko R, Freeman M, Husain M . Diagnostic and prognostic significance of transient ischemic dilation (TID) in myocardial perfusion imaging: A systematic review and meta-analysis. J Nucl Cardiol. 2017; 25(3):724-737. PMC: 5966496. DOI: 10.1007/s12350-017-1040-7. View

16.

Hachamovitch R, Hayes S, Friedman J, Cohen I, Berman D . Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation. 2003; 107(23):2900-7. DOI: 10.1161/01.CIR.0000072790.23090.41. View

17.

Hachamovitch R, Berman D, Kiat H, Cohen I, Cabico J, Friedman J . Exercise myocardial perfusion SPECT in patients without known coronary artery disease: incremental prognostic value and use in risk stratification. Circulation. 1996; 93(5):905-14. DOI: 10.1161/01.cir.93.5.905. View

18.

Shaw L, Mieres J, Hendel R, Boden W, Gulati M, Veledar E . Comparative effectiveness of exercise electrocardiography with or without myocardial perfusion single photon emission computed tomography in women with suspected coronary artery disease: results from the What Is the Optimal Method for Ischemia.... Circulation. 2011; 124(11):1239-49. DOI: 10.1161/CIRCULATIONAHA.111.029660. View

19.

Xu Y, Arsanjani R, Clond M, Hyun M, Lemley Jr M, Fish M . Transient ischemic dilation for coronary artery disease in quantitative analysis of same-day sestamibi myocardial perfusion SPECT. J Nucl Cardiol. 2012; 19(3):465-73. PMC: 3377488. DOI: 10.1007/s12350-012-9527-8. View

20.

Gomez J, Golzar Y, Fughhi I, Olusanya A, Doukky R . The significance of post-stress decrease in left ventricular ejection fraction in patients undergoing regadenoson stress gated SPECT myocardial perfusion imaging. J Nucl Cardiol. 2017; 25(4):1313-1323. DOI: 10.1007/s12350-017-0802-6. View