Predictive Value of Tests

IJCS

Editorial

Myocardial Perfusion Imaging: Always Evolving

Myocardial perfusion assessed by nuclear medicine began to be used in clinical practice in the 1970s with the radiotracer 201-thallium chloride in two-dimensional images.

Advances in the development of equipment, from the possibility of three-dimensional images by single-photon emission computed tomography (SPECT), and new tracers, such as those linked to 99-technetium, have allowed the consolidation of nuclear cardiology as a non-invasive tool with high diagnostic accuracy in the context of coronary artery disease.

[…]

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IJCS

Original Article

Early Use of Handgrip Exercise Associated with Dobutamine Stress Echocardiography in Women

Isabela de Andrade Lindner et al. Patricia Sens de Oliveira Caroline de Oliveira Fischer Bacca Josie Budag Matsuda … Franciani Rodrigues da Rocha Jeancarlo Visentainer Luiz Eduardo Bacca

Abstract

Background

Coronary artery disease (CAD) is an important cause of morbidity and mortality in women and requires early diagnosis for defining the appropriate treatment.

Objective

To identify the positive predictive value (PPV) and safety of the early use of handgrip exercise in pharmacological stress echocardiography using dobutamine (early-ECHO) in women.

Methods

Positive ischemic early-ECHO records from 111 women were evaluated from January 2012 to March 2018. Subsequently, the hospital medical records were verified to locate patients who underwent conventional coronary angiography (CCA), and we analyzed the medical conduct adopted for these patients. Statistical analyses were performed using SPSS employing one-way analysis of variance (ANOVA), Fisher’s exact test, or Pearson’s chi-square test. The level of statistical significance was set at p < 0.05 for all analyses.

Results

Four patients (4.4%) presented serious complications during the examination. Out of 90 patients who underwent CCA, 71 (78.9%) had CAD. Among these 71 patients, 58 (81.7%) had severe lesions and 13 (18.3%) presented moderate CAD. Moreover, CCA did not demonstrate relevant coronary lesions in 19 of the 90 patients (21.1%). Among patients with severe CAD, 16 (27.6%) underwent myocardial revascularization surgery; 34 (58.6%) underwent percutaneous coronary angioplasty; and 08 (13.7%) had their clinical treatments intensified. The PPV for early-ECHO was 78.9%.

Conclusions

Early-ECHO showed a high PPV for diagnosing myocardial ischemia in women. It presented a low complication rate and provided rapid disease identification, allowing the early treatment of injuries and potentially preventing CAD complications.

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IJCS

Original Article

Analysis of Conduction Intervals in Normal Electrophysiological Studies: Establishment of Reference Values the Brazilian Population

Tiago Luiz Luz Leiria et al. Catarine Benta Lopes dos Santos Roberto Tofani Sant'anna Julia Santana Trombetta … Gabriela Osterkamp Marcelo Lapa Kruse Leonardo Martins Pires Gustavo Glotz Lima

Abstract

Background

In the investigation of cardiac rhythm disorders, a normal electrophysiological (EPS) study is associated with a favorable prognosis. One of the normality criteria is established by conduction intervals within expected range.

Objective

To establish reference values in EPS for the intracavitary conduction intervals (PA, AH and HV) in a Brazilian population.

Methods

A retrospective cohort study of the first 1,500 patients submitted to EPS ablation was performed at Instituto de Cardiologia do Rio Grande do Sul, Brazil. The EPS was considered normal if the test was performed for diagnostic purpose; absence of induced arrhythmias; and conduction intervals within the expected range. The REDCap software was used for data collection and management, and the SPSS Statistics 22.0 used for data analysis. Continuous variables were compared with Student’s t-test for independent samples and categorical variables with the chi-square test (X ² ). Values of p ≤ 0.05 were considered significant.

Results

A total of 124 (8.3%) with EPS considered normal were included; mean age was 52 ± 21 years, and 63 were male. The mean values in milliseconds of PA, AH and HV were 23 ± 9, 88 ± 25 and 44 ± 7, respectively. The PA, AH, and HV percentile ranges were 13 – 25, 81-107 and 40 – 52, respectively. When the patients were divided into three age groups (1 to 18 years, 19 to 64 years and 65 or more), we observed that the group of older patients had significantly higher values of PA, AH and HV compared with younger patients.

Conclusion

This study showed that intracavitary conduction intervals in a sample of the Brazilian population were similar to previously published studies. Elderly patients tend to have higher values of intracavitary conduction intervals in EPS. Future studies including broader age ranges could enable the acquisition of more reliable and reproducible reference values. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

Ler artigo completo

Myocardial Perfusion Imaging: Always Evolving

Early Use of Handgrip Exercise Associated with Dobutamine Stress Echocardiography in Women

Abstract

Background

Objective

Methods

Results

Conclusions

Analysis of Conduction Intervals in Normal Electrophysiological Studies: Establishment of Reference Values the Brazilian Population

Abstract

Background

Objective

Methods

Results

Conclusion

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