Prognostic impact of reducing myocardial ischemia identified using ECG-gated myocardial perfusion SPECT in Japanese patients with coronary artery disease: J-ACCESS 4 study.

Aim: Whether myocardial ischemia identified using myocardial perfusion imaging (MPI) can be an alternative target of coronary revascularization to reduce the incidence of cardiac events remains unclear.

Methods And Results: This multicenter, prospective cohort study aimed to clarify the prognostic impact of reducing myocardial ischemia. Among 494 registered patients with possible or definite coronary artery disease (CAD), 298 underwent initial pharmacological stress Tc-tetrofosmin MPI before, and eight months after revascularization or medical therapy, and were followed up for at least one year.

Diagnostic accuracy of an artificial neural network compared with statistical quantitation of myocardial perfusion images: a Japanese multicenter study.

Purpose: Artificial neural networks (ANN) might help to diagnose coronary artery disease. This study aimed to determine whether the diagnostic accuracy of an ANN-based diagnostic system and conventional quantitation are comparable.

Methods: The ANN was trained to classify potentially abnormal areas as true or false based on the nuclear cardiology expert interpretation of 1001 gated stress/rest Tc-MIBI images at 12 hospitals.

Prognostic study of cardiac events in Japanese patients with chronic kidney disease using ECG-gated myocardial Perfusion imaging: Final 3-year report of the J-ACCESS 3 study.

Background: Myocardial perfusion imaging (MPI) is considered useful for risk stratification among patients with chronic kidney disease (CKD), without renal deterioration by contrast media.

Methods And Results: The Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS 3) is a multicenter, prospective cohort study investigating the ability of MPI to predict cardiac events in 529 CKD patients without a definitive coronary artery disease. All patients were assessed by stress and rest MPI with Tc-tetrofosmin and data were analyzed using a defect scoring method and QGS software.

Normal values and standardization of parameters in nuclear cardiology: Japanese Society of Nuclear Medicine working group database.

As a 2-year project of the Japanese Society of Nuclear Medicine working group activity, normal myocardial imaging databases were accumulated and summarized. Stress-rest with gated and non-gated image sets were accumulated for myocardial perfusion imaging and could be used for perfusion defect scoring and normal left ventricular (LV) function analysis. For single-photon emission computed tomography (SPECT) with multi-focal collimator design, databases of supine and prone positions and computed tomography (CT)-based attenuation correction were created.

Myocardial perfusion imaging for predicting cardiac events in Japanese patients with advanced chronic kidney disease: 1-year interim report of the J-ACCESS 3 investigation.

Purpose: Whether myocardial perfusion imaging (MPI) can predict cardiac events in patients with advanced conservative chronic kidney disease (CKD) remains unclear.

Methods: The present multicenter prospective cohort study aimed to clarify the ability of MPI to predict cardiac events in 529 patients with CKD and estimated glomerular filtration rates (eGFR) < 50 ml/min per 1.73(2) without a definitive diagnosis of coronary artery disease.

Prognostic study of cardiac and renal events in Japanese patients with chronic kidney disease and cardiovascular risk using myocardial perfusion SPECT: J-ACCESS 3 study design.

Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease. Recent studies have indicated that the incidence of cardiovascular disease increases inversely with estimated glomerular filtration rate. Although coronary angiography is considered the gold standard for detecting coronary artery disease, contrast-induced nephropathy or cholesterol microembolization remain serious problems; therefore, a method of detecting coronary artery disease without renal deterioration is desirable.

Clinical significance of B-type natriuretic Peptide in the assessment of untreated hypertension.

Background: Recent studies suggest that B-type natriuretic peptide (BNP) is an important predictor of cardiac events in hypertensive patients.

Methods And Results: The relationship between the plasma BNP level and various clinical parameters was examined in 154 untreated hypertensive patients without heart failure or atrial fibrillation (mean age: 58.0+/-10.

Pericarditis causing congestive heart failure as an initial manifestation of systemic lupus erythematosus.

Pericarditis is a common complication in systemic lupus erythematosus (SLE) patients, however, that causing congestive heart failure (CHF) is a rare initial manifestation of SLE. We treated a patient whose initial manifestation of SLE was pericardial effusion causing CHF, which improved following prednisolone therapy that led to a dramatic decrease in pericardial effusion and improvement in left ventricular diastolic dysfunction as shown in Doppler echocardiography findings. Further, the plasma brain natriuretic peptide level became normalized.

"W-shaped" volume curve with gated myocardial perfusion single photon emission computed tomography.

Objectives: Gating errors (GEs) with ECG gated myocardial SPECT (G-SPECT) may occur irrespective of the presence or absence of arrhythmias. We evaluated the impact of GEs on both reconstructed tomograms and left ventricular ejection fraction (LVEF) derived from G-SPECT, and searched for clues to identify these errors.

Methods: We studied 2 GE patients, 10 normal subjects (NLs), and 10 atrial fibrillation patients.

Compared with 3-dimensional analysis, 2-dimensional gated SPECT analysis overestimates left ventricular ejection fraction in patients with regional dyssynchrony.

Background: Left ventricular (LV) ejection fraction (EF) is a powerful prognostic predictor in patients with heart disease. However, LVEF calculated by 2-dimensional (2D) modalities such as echocardiography by use of the "modified" Simpson's rule may be incorrect in patients with regional dyssynchrony, presumably because regions of dyssynchrony are excluded from analysis.

Methods And Results: To elucidate the difference between 2D and 3-dimensional (3D) methods with regard to LVEF calculation in patients with regional dyssynchrony, we compared LVEF derived from 8-frame gated technetium 99m sestamibi stress perfusion tomograms using commercially available 2D single photon emission computed tomography (SPECTEF) software that uses the modified Simpson's rule, 3D QGS, and investigational 3D p-FAST software in 136 left bundle branch block patients.

Decreased septal wall thickening in patients with left bundle branch block.

Objectives: Septal wall motion abnormalities are frequently observed in patients with left bundle branch block (LBBB). However, septal wall thickening in LBBB patients has not been thoroughly evaluated.

Methods And Results: To investigate the relationship between septal wall motion and wall thickening, we studied 31 normal control subjects, 24 LBBB patients with normal wall motion (LBBB-NWM), and 24 LBBB patients with septal dyssynchrony (LBBB-SDS), all with a low likelihood (<15%) of coronary artery disease.

F-18 fluorodeoxyglucose uptake in atherosclerotic plaque in the mediastinum mimicking malignancy: another potential for error.

Atherosclerosis is an inflammatory process accumulating numerous inflammatory cells such as macrophages and lymphocytes. This cellular infiltrate has a high metabolic demand, which can be reflected on F-18 FDG positron emission tomographic (PET) imaging. The FDG uptake in atherosclerotic vessels is usually distinguishable as a result of its linear and continuous appearance and mild level of activity.