Radionuclide Imaging – ABC CARDIOL

IJCS

Case Report

ECG's AVR ST elevation Analysis by Perfusion Scintilography in the Context of Myocardial Ischemia

Miriana Basso Gomes et al. Carolina Feijó Bombana Felipe C. Fuchs

Introduction

The presence of ST-segment elevation in two or more contiguous leads indicates a current subepicardial lesion that often requires early intervention, either by angioplasty or thrombolytic therapy.^, ST elevation, only in aVR, may also indicate the presence of an acute infarction. This finding was first made by Wellens et al. However, this is not always true, and physicians should be aware of the details surrounding changes in Right Vector amplification (aVR).

The medical literature has a wide range of articles reporting on the association between ST elevation in aVR during exercise testing and left main coronary artery injury.^– However, this concept began at a time when fewer imaging tests and catheterizations were performed. Altered stress tests are a common indication of myocardial scintigraphy, which is why the Nuclear Medicine laboratory is the perfect place to perform this type of analysis. There is now evidence that aVR elevation in this context may not indicate coronary lesions and may be present, for example, in patients with aortic stenosis, hypertrophy and hypoxia..^– Since these are stress tests, it is important to analyze the heart rate in which the aVR elevation occurs as well as the pattern of the other leads.

[…]

Ler artigo completo

IJCS

Original Article

Prevalence of Cardiac Amyloidosis in Elderly Patients With Aortic Stenosis

Ng Kin Key et al. Adelina Sanches de Melo Joberto Pinheiro Sena Adriano Dias Dourado … Julia Micheli Perez Jose Carlos Raimundo Brito Gilson Feitosa Gilson Soares Feitosa-Filho

Abstract

Background:

Aortic Stenosis (AS) is one of the most common valvular heart diseases in adults, especially the elderly. The persistence of heart failure symptoms and worse outcomes despite valve replacement treatment may be associated with the coexistence of Cardiac Amyloidosis (CA).

Objective:

To determine the prevalence of CA in patients with calcific AS.

Methods:

This was a cross-sectional study. Elderly patients with moderate to severe AS underwent cardiac scintigraphy with bone radiotracer for diagnosis of CA. Patients diagnosed with Transthyretin (TTR) amyloidosis by scintigraphy underwent genetic studies. Groups with altered and unaltered scintigraphy results for continuous variables were compared using an independent t-test for normally distributed variables and a Mann-Whitney test for those with asymmetric distribution. Statistical significance was set at p-value < 0.05

Results:

Forty-one patients with AS underwent pyrophosphate scintigraphy. The mean age of the cases was 79 ± 6 years, 23 (56%) were female, 23 (56%) had classic severe AS pattern, and 8 (19.5%) had low-flow low-gradient AS with reduced Ejection Fraction (EF). Carpal tunnel syndrome was present in 2 (4%) patients, 8 (19%) had polyneuropathy. A RAISE score ≥ 2 was found in 4 patients (9%). Four patients were diagnosed with TTR amyloidosis, one of whom had a Val122I genetic mutation. Three (75%) of the patients diagnosed with AE/AI were male. There were no statistically significant differences between the isolated AS and AS/CA groups.

Conclusion:

The prevalence of CA in patients with moderate to severe AS of probable calcified etiology in our sample was 10%.

Ler artigo completo

IJCS

Review Article

Pyrophosphate Scintigraphy: Use in the Diagnosis and Monitoring of Cardiac Amyloidosis

Claudio Tinoco Mesquita et al. Davi Shunji Yahiro José Felipe Ramos dos Santos Luís Eduardo Machado … Jose Gregorio Valero Rodriguez Giovane Leal de Azevedo Junior Marcus Simões

Abstract

Cardiac amyloidosis (CA) is a progressive condition marked by the accumulation of amyloid fibrils in cardiac tissue, resulting in cardiac dysfunction and, ultimately, heart failure. Pyrophosphate scintigraphy has emerged as a promising tool for the early detection and monitoring of CA, providing valuable insights into the disease’s extent and severity. This review examines the current use of pyrophosphate scintigraphy in distinguishing between different types of amyloidosis, assessing risk levels, and monitoring patients with CA. It underscores the clinical significance and prospects of this imaging technique.

Ler artigo completo

IJCS

Review Article

Multimodality Imaging of Chagas Heart Disease: Review and Case Presentation

Amalia Peix et al. Raul Araujo Veronica Gomez Aylen Perez Barreda … Maurizio Dondi Anita Brink Erika Minoshima Diana Paez

Abstract

Chagas disease (CD) is a neglected tropical disease (NTD) caused by Trypanosoma cruzi, a hemoflagellate protozoa. CD is diagnosed by epidemiologic history and two positive serological tests. The infection has two main clinical phases: acute, early after acquiring the infection, and chronic. The electrocardiogram (ECG) is the first tool to diagnose chronic Chagas heart disease after CD serological diagnosis. In addition, the different cardiac imaging modalities, including chest X-ray, echocardiography, single photon emission computed tomography (SPECT), computed tomography (CT), and magnetic resonance, play a crucial role in detecting the cardiac involvement, establishing the prognosis, stratifying patient risk, and addressing the management of CD patients. In this review of the current literature, we summarize the epidemiology, pathophysiology, and clinical presentation of CD. We also discuss the indications, advantages, and limitations of the different cardiac imaging modalities. We also present some case examples, where cardiac imaging proved helpful in cardiac CD (CCD). The early mortality and substantial disability caused by CD represents a health, social and economic burden, particularly in the Latin America. To harness the full potential of medical imaging for the effective management of patients with CD, a comprehensive approach is essential. This involves a concerted effort to invest in the education of medical providers and to facilitate widespread access to diagnostic tools. Accessible and timely diagnosis is crucial for initiating prompt and targeted interventions. Finally, continuous investment in research is vital to advance our understanding of CD and develop innovative solutions for improved patient care.

Ler artigo completo

ECG's AVR ST elevation Analysis by Perfusion Scintilography in the Context of Myocardial Ischemia

Introduction

Prevalence of Cardiac Amyloidosis in Elderly Patients With Aortic Stenosis

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

Pyrophosphate Scintigraphy: Use in the Diagnosis and Monitoring of Cardiac Amyloidosis

Abstract

Multimodality Imaging of Chagas Heart Disease: Review and Case Presentation

Abstract

Formato de Documento Eletrônico (Vancouver)

Formato de Documento Eletrônico (ABNT)

Formato de Documento Eletrônico (APA)

Formato de Documento Eletrônico (ISO)

Formato de Documento Eletrônico (Vancouver)

Formato de Documento Eletrônico (ABNT)

Formato de Documento Eletrônico (APA)

Formato de Documento Eletrônico (ISO)

Formato de Documento Eletrônico (Vancouver)

Formato de Documento Eletrônico (ABNT)

Formato de Documento Eletrônico (APA)

Formato de Documento Eletrônico (ISO)

Formato de Documento Eletrônico (Vancouver)

Formato de Documento Eletrônico (ABNT)

Formato de Documento Eletrônico (APA)

Formato de Documento Eletrônico (ISO)