Publications by authors named "Vitola J"
Article Synopsis
- The study evaluates the recovery of cardiac diagnostic procedures in Italy one year after the COVID-19 outbreak, focusing on procedure volumes, practices, and staff well-being.
- A global survey revealed a 72% drop in cardiac diagnostic procedures in April 2020 compared to March 2019, with only a slight recovery (3% increase) by April 2021, though some specific tests showed increased volumes.
- Many healthcare centers adopted measures like physical distancing and COVID-19 screening, but 25% of physicians reported high psychological stress levels, highlighting ongoing challenges within the healthcare system.
Temporal trends in the contribution of modifiable cardiovascular risk factors to cardiovascular and all-cause mortality in patients undergoing myocardial perfusion imaging in a large city in Brazil.
Int J Cardiol
August 2024
Background: Most cardiovascular (CV) events stem from modifiable risk factors, but it remains uncertain whether their impact on mortality has decreased in recent years as a result of treatment, particularly in low- and middle-income countries. We evaluated the temporal trends in the population attributable fraction (PAF) of modifiable risk factors to CV mortality in patients undergoing myocardial perfusion imaging (MPI) for suspected coronary artery disease in a large city in Brazil.
Methods: The cohort comprised 25,127 patients without established CV disease undergoing MPI in a referral center in Curitiba, Brazil, from 2010 to 2018.
Background: In this substudy of the Value of Gated-SPECT MPI for Ischemia- Guided PCI of non-culprit vessels in STEMI Patients with Multi vessel Disease after primary PCI trial after primary PCI we aim to assess if infarct size affects conventional measures of dyssynchrony at rest. Additionally, we explore if there is an independent correlation of stress-inducible ischemia with dyssynchrony at rest.
Methods: The 48 patients with imaging at randomization were analyzed.
Article Synopsis
- - The COVID-19 pandemic significantly disrupted cardiovascular testing in Latin America (LATAM), with a study finding a 21% decrease in procedure volumes from pre-pandemic levels in April 2021, contrasting with zero change in the rest of the world.
- - Central America and Mexico experienced the largest reductions in procedures (47%), while healthcare centers in LATAM reported more staff layoffs and salary cuts than those in other regions.
- - The study highlighted the lasting effects of the pandemic on cardiovascular care and emphasized the need for mental health support for healthcare workers in LATAM, as nearly 50% reported excessive psychological stress.
Introduction: Ivabradine reduces heart rate (HR), episodes of angina, and nitrate consumption, and increases exercise capacity in patients with chronic angina (CA). In this exploratory study, myocardial perfusion scintigraphy (MPS) was used to evaluate changes in the percentage of myocardial ischemia after ivabradine therapy in patients with CA.
Methods: This prospective, open-label, single-arm study included patients with CA receiving maximum tolerated doses of beta blockers, who had a resting HR ≥ 70 bpm and had experienced ischemia according to MPS during an exercise test at baseline.
Article Synopsis
- The study aimed to evaluate the recovery of cardiac diagnostic procedure volumes in Oceania during the COVID-19 pandemic by comparing data from March 2019, April 2020, and April 2021 across various health facilities.
- Results showed that 11,902 procedures were performed in April 2021, slightly below pre-pandemic levels, while the rest of the world had similar recovery rates, indicating a small decline in both regions.
- Although there were no significant differences in overall recovery rates, anatomical coronary testing in Oceania demonstrated poorer recovery compared to the rest of the world, raising concerns about specific diagnostic procedures.
Article Synopsis
- The COVID-19 pandemic significantly disrupted cardiovascular care, particularly affecting noninvasive testing for coronary artery disease (CAD), with unclear trends across different income levels.
- A global survey by the International Atomic Energy Agency included data from 669 centers in 107 countries, revealing that traditional tests decreased by 14%, while advanced tests increased by 15% from 2019 to 2021.
- The rise in advanced testing mainly occurred in high- and upper middle-income countries, highlighting a growing disparity in CAD diagnostic practices between wealthier and lower-income nations.
Background: Association of Income Level and Ischemic Heart Disease: Potential Role of Walkability Association of ischemic heart disease (adjusted for traditional risk factors and socioeconomics variables) and income level (A), and walkability z-score (B), and association of walkability z-score and income level (C).
Background: Socioeconomic status has been linked to ischemic heart disease (IHD). High-income neighborhoods may expose individuals to a walking-promoting built environment for daily activities (walkability).
Article Synopsis
- The study aimed to assess how diagnostic cardiovascular procedure volumes rebounded in the U.S. and abroad during the year after COVID-19 hit, relying on data from 669 facilities worldwide.
- In the early pandemic (April 2020), procedure volumes dropped significantly but showed a better recovery in U.S. facilities by April 2021 compared to non-U.S. facilities, although high-income non-U.S. countries showed similar recovery rates as the U.S.
- Regional variations within the U.S. were noted, with the Midwest having the highest recovery rate, but no specific factors were found to predict recovery levels from the initial drop in procedure volumes.
Background: Whether initial invasive management in older vs younger adults with chronic coronary disease and moderate or severe ischemia improves health status or clinical outcomes is unknown.
Objectives: The goal of this study was to examine the impact of age on health status and clinical outcomes with invasive vs conservative management in the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial.
Methods: One-year angina-specific health status was assessed with the 7-item Seattle Angina Questionnaire (SAQ) (score range 0-100; higher scores indicate better health status).
Background: The prospective, multicentre EURECA registry assessed the use of imaging and adoption of the European Society of Cardiology (ESC) Guidelines (GL) in patients with chronic coronary syndromes (CCS).
Methods: Between May 2019 and March 2020, 5156 patients were recruited in 73 centres from 24 ESC member countries. The adoption of GL recommendations was evaluated according to clinical presentation and pre-test probability (PTP) of obstructive coronary artery disease (CAD).
Background: In patients with multi-vessel disease presenting with ST elevation myocardial infarction (STEMI), the efficacy and safety of ischemia-guided, vs routine non-culprit vessel angioplasty has not been adequately studied.
Methods: We conducted an international, randomized, non-inferiority trial comparing ischemia-guided non-culprit vessel angioplasty to routine non-culprit vessel angioplasty, following primary PCI for STEMI. The primary outcome was the between-group difference in percent ischemic myocardium at follow-up stress MPI.
Introduction: AIM: Myocardial perfusion imaging (MPI) is a key tool for the identification and risk stratification of patients with coronary artery disease. The use of a coronary calcium score further adds to prognostic data above MPI alone. In this study, our aim was to evaluate the extent to which the use of a coronary artery calcium (CAC) score, when co-reported with MPI, impacts changes in clinical management in patients without a history of coronary artery disease (CAD) undergoing functional imaging.
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- The study investigates how the COVID-19 pandemic affected cardiac diagnostic services globally, examining changes in testing practices and provider stress levels.
- Researchers conducted a survey from 669 centers across 107 countries and found a 64% reduction in cardiac procedure volumes during the pandemic, with recovery varying significantly between high-income and lower-income countries.
- Results indicated a shift from traditional stress testing to advanced imaging techniques, alongside widespread psychological stress among healthcare providers, which hindered the recovery of cardiac testing services, especially in lower-income regions.
Article Synopsis
- The COVID-19 pandemic significantly disrupted cardiac diagnostic procedures in Latin America, with volumes dropping by 36% in March 2020 and 82% by April 2020 compared to the previous year.
- Key tests like echocardiograms and exercise treadmill tests saw the most dramatic declines, with reductions of up to 91%.
- The study found that changes in social distancing were more closely linked to these volume reductions than the actual incidence of COVID-19 cases, highlighting the need for better management of healthcare access during pandemics.
Article Synopsis
- The COVID-19 pandemic led to a significant decline in cardiovascular diagnostic procedures in Asia, with procedure volumes dropping by 47% from March 2019 to March 2020, and even more in low-income countries where reductions reached 81%.
- A worldwide survey by the International Atomic Energy Agency highlighted that recovery began in some regions like Eastern Asia, especially China, between March and April 2020.
- Changes in practices included the implementation of physical distancing and restricting visitors; however, COVID testing was infrequently conducted, despite being more common in one-third of Eastern Asian facilities.
Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards.
View Article and Find Full Text PDFObjectives: We aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe.
Methods: The online survey organised by the International Atomic Energy Agency Division of Human Health collected information on changes in cardiac imaging procedural volumes between March 2019 and March/April 2020. Data were collected from 909 centres in 108 countries.
Impact of COVID-19 on Cardiovascular Testing in the United States Versus the Rest of the World.
JACC Cardiovasc Imaging
September 2021
Article Synopsis
- This study analyzed the impact of the COVID-19 pandemic on cardiovascular procedure volumes in the U.S. compared to non-U.S. institutions, finding significant declines across both areas.
- In April 2020, U.S. facilities experienced a 68% reduction in procedures, similar to the 63% decline in non-U.S. locations, but U.S. invasive coronary angiography procedures dropped more steeply (69% vs. 53%).
- The study also noted more U.S. facilities adopted telehealth and patient screening measures, with volume reductions varying by region—most significantly in the Northeast and Midwest.
Article Synopsis
- The INCAPS COVID Oceania study investigated how the COVID-19 pandemic affected the volume of cardiac procedures in the Oceania region by comparing data from March 2019 to April 2020.
- A significant reduction of 52.2% in cardiac diagnostic procedures was noted in Oceania, which was less severe than the global reduction of 75.9%.
- The decrease varied by procedure type, with transthoracic echocardiography down 51.6% and transoesophageal echocardiography decreased by 74%; overall, recommendations to limit COVID-19 spread likely influenced these drops.
Objectives: This study sought to describe worldwide variations in the use of myocardial perfusion imaging hardware, software, and imaging protocols and their impact on radiation effective dose (ED).
Background: Concerns about long-term effects of ionizing radiation have prompted efforts to identify strategies for dose optimization in myocardial perfusion scintigraphy. Studies have increasingly shown opportunities for dose reduction using newer technologies and optimized protocols.
Article Synopsis
- The COVID-19 pandemic significantly disrupted the diagnosis and treatment of cardiovascular diseases, which are the leading cause of death worldwide, leading to a drastic reduction in procedural volumes globally.* -
- A global survey revealed that cardiovascular diagnostic procedures decreased by around 42% in March 2020 and 64% by April 2020 compared to the same months in the previous year, with non-invasive tests like echocardiography and stress tests experiencing even steeper declines.* -
- The impact was more pronounced in countries with lower GDP, where facilities experienced 22% more reduction in procedures and had less access to personal protective equipment and telehealth options, highlighting the unequal effects of the pandemic on healthcare services.*
The purpose of this study was to compare F-FDG PET/CT and CT performance in guiding percutaneous biopsies with histologic confirmation of lung lesions. We prospectively evaluated 341 patients, of whom 216 underwent F-FDG PET/CT-guided biopsy and 125 underwent CT-guided biopsy. The pathology results, lesion size, complications, and rebiopsy rate in the 2 groups were evaluated.
View Article and Find Full Text PDFObjectives: This study sought to establish worldwide and regional diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).
Background: Reference levels serve as radiation dose benchmarks to compare individual laboratories against aggregated data, helping to identify sites in greatest need of dose reduction interventions. DRLs for SPECT MPI have previously been derived from national or regional registries.