Background: More and more young people are being referred for evaluation or screening for coronary artery disease (CAD). However, the value of myocardial perfusion imaging (MPI) in this population is unclear, especially in the absence of symptoms.
Methods: The study sample included 1765 consecutive patients less than 51 years old who were referred to a major medical center for stress/rest MPI study. Clinical and MPI variables were compared between patients with and without known CAD, by gender.
Results: There were 1346 (76%) men and 419 (24%) women of mean age 44 +/- 6 years; 461 (26%) had known CAD. Stress-induced ischemia was detected in 321 patients (18.2%) and significant ischemia in 131 (7.4%); there was no difference in the rate or severity of ischemia by presence of symptoms. Among those without known CAD, the rate of stress-induced ischemia by MPI was significantly lower in women than men. On logistic regression analysis, the independent predictors of ischemia in men were high cholesterol, diabetes, angina during stress testing, ST depression, and smoking (P<.0001); and in women, the independent predictors were diabetes and high cholesterol.
Conclusion: Known CAD and stress-induced ischemia are significantly more prevalent in young men than in young women, irrespective of risk factors. The independent predictors of ischemia differ between men and women.
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http://dx.doi.org/10.1002/clc.20522 | DOI Listing |
The article presents a clinical case of secondary cardiomyopathy in an HIV patient with plasmablastic lymphoma due to the combined pathology (HIV infection with ongoing antiretroviral therapy in combination with antitumor therapy), in which the use of multimodal imaging contributed to establishing the correct diagnosis and excluding the unjustified use of invasive methods for diagnosing ischemic heart disease.
View Article and Find Full Text PDFDiscov Med (Cham)
January 2025
Institute of Biomedical Engineering, University of Toronto, Toronto, ON Canada.
Background: Microvascular dysfunction (MVD) is a recognized sign of disease in heart failure progression. Intact blood vessels exhibit abnormal vasoreactivity in early stage, subsequently deteriorating to rarefaction and reduced perfusion. In managing heart failure with preserved ejection fraction (HFpEF), earlier diagnosis is key to improving management.
View Article and Find Full Text PDFJTCVS Open
December 2024
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
Objective: To develop a model for preoperatively predicting postcardiotomy cardiogenic shock (PCCS) in patients with poor left ventricular (LV) function undergoing cardiac surgery.
Methods: From the Society of Thoracic Surgeons Adult Cardiac Database, 11,493 patients with LV ejection fraction ≤35% underwent isolated on-pump surgery from 2018 through 2019, of whom 3428 experienced PCCS. In total, 68 preoperative clinical variables were considered in machine-learning algorithms trained and optimized using scikit-learn software.
Cardiovasc Res
January 2025
State Key Laboratory of Cardiovascular Disease, Clinical Pharmacology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Aims: The therapeutic efficacy of coronary revascularization is compromised by myocardial ischemia-reperfusion (MI/R) injury. Higher levels of circulating arachidonic acid (AA) are reportedly associated with lower risk of cardiovascular disease. The cyclooxygenase (COX) pathway metabolizes AA into prostaglandins (PGs) and the platelet-activating thromboxane A2 (TXA2), which is inhibited by aspirin.
View Article and Find Full Text PDFNucl Med Commun
January 2025
Department of Radiological Sciences, Oncology and Anatomical Pathology, Nuclear Medicine Unit, 'Sapienza' University, Rome.
Purpose: Coronary artery disease (CAD) underestimation represents a major pitfall of single-photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI). Coronary artery calcium score (CACS) has emerged as a sensitive tool for the assessment of suspect CAD; however, the integration of SPECT-MPI with CACS has been seldom evaluated, so far, and was therefore the aim of the present study.
Methods: Patients undergoing SPECT-MPI with CACS and subsequent coronary angiography were included.
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