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  1. Article ; Online: Comparative predictors of mortality among patients referred for stress single-photon emission computed tomography versus positron emission tomography myocardial perfusion imaging.

    Rozanski, Alan / Miller, Robert J H / Han, Donghee / Gransar, Heidi / Hayes, Sean W / Friedman, John D / Thomson, Louise E J / Berman, Daniel S

    Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

    2024  Volume 32, Page(s) 101811

    Abstract: Background: There is currently little information regarding the usage and comparative predictors of mortality among patients referred for single-photon emission computed tomography (SPECT) versus positron emission tomography (PET) myocardial perfusion ... ...

    Abstract Background: There is currently little information regarding the usage and comparative predictors of mortality among patients referred for single-photon emission computed tomography (SPECT) versus positron emission tomography (PET) myocardial perfusion imaging (MPI) within multimodality imaging laboratories.
    Methods: We compared the clinical characteristics and mortality outcomes among 15,718 patients referred for SPECT-MPI and 6202 patients referred for PET-MPI between 2008 and 2017.
    Results: Approximately two-thirds of MPI studies were performed using SPECT-MPI. The PET-MPI group was substantially older and included more patients with known coronary artery disease (CAD), hypertension, diabetes, and myocardial ischemia. The annualized mortality rate was also higher in the PET-MPI group, and this difference persisted after propensity matching 3615 SPECT-MPI and 3615 PET-MPI patients to have similar clinical profiles. Among the SPECT-MPI patients, the most potent predictor of mortality was exercise ability and performance, including consideration of patients' mode of stress testing and exercise duration. Among the PET-MPI patients, myocardial flow reserve (MFR) was the most potent predictor of mortality.
    Conclusions: In our real-world setting, PET-MPI was more commonly employed among older patients with more cardiac risk factors than SPECT-MPI patients. The most potent predictors of mortality in our SPECT and PET-MPI groups were variables exclusive to each test: exercise ability/capacity for SPECT-MPI patients and MFR for PET-MPI patients.
    MeSH term(s) Humans ; Myocardial Perfusion Imaging ; Positron-Emission Tomography ; Tomography, Emission-Computed, Single-Photon ; Coronary Artery Disease/diagnostic imaging ; Exercise
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1212505-2
    ISSN 1532-6551 ; 1071-3581
    ISSN (online) 1532-6551
    ISSN 1071-3581
    DOI 10.1016/j.nuclcard.2024.101811
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    Zs.A 4121: Show issues Location:
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  2. Article ; Online: Cardiac Computed Tomography for Quantification of Myocardial Extracellular Volume Fraction: A Systematic Review and Meta-Analysis.

    Han, Donghee / Lin, Andrew / Kuronuma, Keiichiro / Gransar, Heidi / Dey, Damini / Friedman, John D / Berman, Daniel S / Tamarappoo, Balaji K

    JACC. Cardiovascular imaging

    2023  Volume 16, Issue 10, Page(s) 1306–1317

    Abstract: Background: Extracellular volume (ECV) is a quantitative measure of extracellular compartment expansion, and an increase in ECV is a marker of myocardial fibrosis. Although cardiac magnetic resonance (CMR) is considered the standard imaging tool for ECV ...

    Abstract Background: Extracellular volume (ECV) is a quantitative measure of extracellular compartment expansion, and an increase in ECV is a marker of myocardial fibrosis. Although cardiac magnetic resonance (CMR) is considered the standard imaging tool for ECV quantification, cardiac computed tomography (CT) has also been used for ECV assessment.
    Objectives: The aim of this meta-analysis was to evaluate the correlation and agreement in the quantification of myocardial ECV by CT and CMR.
    Methods: PubMed and Web of Science were searched for relevant publications reporting on the use of CT for ECV quantification compared with CMR as the reference standard. The authors employed a meta-analysis using the restricted maximum-likelihood estimator with a random-effects method to estimate summary correlation and mean difference. A subgroup analysis was performed to compare the correlation and mean differences between single-energy CT (SECT) and dual-energy CT (DECT) techniques for the ECV quantification.
    Results: Of 435 papers, 13 studies comprising 383 patients were identified. The mean age range was 57.3 to 82 years, and 65% of patients were male. Overall, there was an excellent correlation between CT-derived ECV and CMR-derived ECV (mean: 0.90 [95% CI: 0.86-0.95]). The pooled mean difference between CT and CMR was 0.96% (95% CI: 0.14%-1.78%). Seven studies reported correlation values using SECT, and 4 studies reported those using DECT. The pooled correlation from studies utilizing DECT for ECV quantification was significantly higher compared with those with SECT (mean: 0.94 [95% CI: 0.91-0.98] vs 0.87 [95% CI: 0.80-0.94], respectively; P = 0.01). There was no significant difference in pooled mean differences between SECT vs DECT (P = 0.85).
    Conclusions: CT-derived ECV showed an excellent correlation and mean difference of <1% with CMR-derived ECV. However, the overall quality of the included studies was low, and larger, prospective studies are needed to examine the accuracy and diagnostic and prognostic utility of CT-derived ECV.
    MeSH term(s) Humans ; Male ; Middle Aged ; Aged ; Aged, 80 and over ; Female ; Predictive Value of Tests ; Myocardium/pathology ; Cardiomyopathies/pathology ; Heart ; Magnetic Resonance Imaging ; Fibrosis ; Contrast Media
    Chemical Substances Contrast Media
    Language English
    Publishing date 2023-05-31
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2491503-8
    ISSN 1876-7591 ; 1936-878X
    ISSN (online) 1876-7591
    ISSN 1936-878X
    DOI 10.1016/j.jcmg.2023.03.021
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    Zs.A 6846: Show issues Location:
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  3. Article ; Online: Is typical angina still prognostically important? The influence of "treatment bias" upon prognostic assessments.

    Rozanski, Alan / Han, Donghee / Miller, Robert J H / Gransar, Heidi / Hayes, Sean W / Friedman, John D / Thomson, Louise / Berman, Daniel S

    Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

    2023  Volume 31, Page(s) 101778

    Abstract: Background: Since typical angina has become less frequent, it is unclear if this symptom still has prognostic significance.: Methods: We evaluated 38,383 patients undergoing stress/rest SPECT myocardial perfusion imaging followed for a median of 10.9 ...

    Abstract Background: Since typical angina has become less frequent, it is unclear if this symptom still has prognostic significance.
    Methods: We evaluated 38,383 patients undergoing stress/rest SPECT myocardial perfusion imaging followed for a median of 10.9 years. After dividing patients by clinical symptoms, we evaluated the magnitude of myocardial ischemia and subsequent mortality among medically treated versus revascularized subgroups following testing.
    Results: Patients with typical angina had more frequent and greater ischemia than other symptom groups, but not higher mortality. Among typical angina patients, those who underwent early revascularization had substantially greater ischemia than the medically treated subgroup, including a far higher proportion with severe ischemia (44.9% vs 4.3%, P < 0.001) and transient ischemic dilation of the LV (31.3% vs 4.7%, P < 0.001). Nevertheless, the revascularized typical angina subgroup had a lower adjusted mortality risk than the medically treated subgroup (HR = 0.72, 95% CI: 0.57-0.92, P = 0.009) CONCLUSIONS: Typical angina is associated with substantially more ischemia than other clinical symptoms. However, the high referral of patients with typical angina patients with ischemia to early revascularization resulted in this group having a lower rather than higher mortality risk versus other symptom groups. These findings illustrate the need to account for "treatment bias" among prognostic studies.
    MeSH term(s) Humans ; Prognosis ; Angina Pectoris/diagnostic imaging ; Angina Pectoris/therapy ; Myocardial Ischemia ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/therapy ; Ischemia
    Language English
    Publishing date 2023-12-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1212505-2
    ISSN 1532-6551 ; 1071-3581
    ISSN (online) 1532-6551
    ISSN 1071-3581
    DOI 10.1016/j.nuclcard.2023.101778
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    Zs.A 4121: Show issues Location:
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  4. Article ; Online: 10-year experience of utilizing a stress-first SPECT myocardial perfusion imaging.

    Han, Donghee / Hyun, Mark C / Miller, Robert J H / Gransar, Heidi / Slomka, Piotr J / Dey, Damini / Hayes, Sean W / Friedman, John D / Thomson, Louise E J / Berman, Daniel S / Rozanski, Alan

    International journal of cardiology

    2024  Volume 401, Page(s) 131863

    Abstract: Background: Despite its potential benefits, the utilization of stress-only protocol in clinical practice has been limited. We report utilizing stress-first single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).: Methods! ...

    Abstract Background: Despite its potential benefits, the utilization of stress-only protocol in clinical practice has been limited. We report utilizing stress-first single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).
    Methods: We assessed 12,472 patients who were referred for SPECT-MPI between 2013 and 2020. The temporal changes in frequency of stress-only imaging were assessed according to risk factors, mode of stress, prior coronary artery disease (CAD) history, left ventricular function, and symptom status. The clinical endpoint was all-cause mortality.
    Results: In our lab, stress/rest SPECT-MPI in place of rest/stress SPECT-MPI was first introduced in November 2011 and was performed more commonly than rest/stress imaging after 2013. Stress-only SPECT-MPI scanning has been performed in 30-34% of our SPECT-MPI studies since 2013 (i.e.. 31.7% in 2013 and 33.6% in 2020). During the study period, we routinely used two-position imaging (additional prone or upright imaging) to reduce attenuation and motion artifact and introduced SPECT/CT scanner in 2018. The rate of stress-only study remained consistent before and after implementing the SPECT/CT scanner. The frequency of stress-only imaging was 43% among patients without a history of prior CAD and 19% among those with a prior CAD history. Among patients undergoing treadmill exercise, the frequency of stress-only imaging was 48%, while 32% among patients undergoing pharmacologic stress test. In multivariate Cox analysis, there was no significant difference in mortality risk between stress-only and stress/rest protocols in patients with normal SPECT-MPI results (p = 0.271).
    Conclusion: Implementation of a stress-first imaging protocol has consistently resulted in safe cancellation of 30% of rest SPECT-MPI studies.
    MeSH term(s) Humans ; Myocardial Perfusion Imaging/methods ; Tomography, Emission-Computed, Single-Photon/methods ; Coronary Artery Disease/diagnosis ; Risk Factors ; Exercise Test
    Language English
    Publishing date 2024-02-15
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2024.131863
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    Zs.A 1673: Show issues Location:
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  5. Article ; Online: Self-reported exercise activity influences the relationship between coronary computed tomography angiographic finding and mortality.

    Natanzon, Sharon Shalom / Han, Donghee / Kuronuma, Keiichiro / Gransar, Heidi / Miller, Robert J H / Slomka, Piotr J / Dey, Damini / Hayes, Sean W / Friedman, John D / Thomson, Louise E J / Berman, Daniel S / Rozanski, Alan

    Journal of cardiovascular computed tomography

    2024  

    Abstract: Aim: Recent studies suggest that the application of exercise activity questionnaires, including the use of a single-item exercise question, can be additive to the prognostic efficacy of imaging findings. This study aims to evaluate the prognostic ... ...

    Abstract Aim: Recent studies suggest that the application of exercise activity questionnaires, including the use of a single-item exercise question, can be additive to the prognostic efficacy of imaging findings. This study aims to evaluate the prognostic efficacy of exercise activity in patients undergoing coronary computed tomography angiography (CCTA).
    Methods and results: We assessed 9772 patients who underwent CCTA at a single center between 2007 and 2020. Patients were divided into 4 groups of physical activity as no exercise (n ​= ​1643, 17%), mild exercise (n ​= ​3156, 32%), moderate exercise (n ​= ​3542, 36%), and high exercise (n ​= ​1431,15%), based on a single-item self-reported questionnaire. Coronary stenosis was categorized as no (0%), non-obstructive (1-49%), borderline (50-69%), and obstructive (≥70%). During a median follow-up of 4.64 (IQR 1.53-7.89) years, 490 (7.6%) died. There was a stepwise inverse relationship between exercise activity and mortality (p ​< ​0.001). Compared with the high activity group, the no activity group had a 3-fold higher mortality risk (HR: 3.3, 95%CI (1.94-5.63), p ​< ​0.001) after adjustment for age, clinical risk factors, symptoms, and statin use. For any level of CCTA stenosis, mortality rates were inversely associated with the degree of patients' exercise activity. The risk of all-cause mortality was similar among the patients with obstructive stenosis with high exercise versus those with no coronary stenosis but no exercise activity (p ​= ​0.912).
    Conclusion: Physical activity as assessed by a single-item self-reported questionnaire is a strong stepwise inverse predictor of mortality risk among patients undergoing CCTA.
    Language English
    Publishing date 2024-04-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2394360-9
    ISSN 1876-861X ; 1934-5925
    ISSN (online) 1876-861X
    ISSN 1934-5925
    DOI 10.1016/j.jcct.2024.03.011
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    Zs.A 6761: Show issues Location:
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  6. Article ; Online: Downward myocardial creep during stress PET imaging is inversely associated with mortality.

    Kuronuma, Keiichiro / Miller, Robert J H / Wei, Chih-Chun / Singh, Ananya / Lemley, Mark H / Van Kriekinge, Serge D / Kavanagh, Paul B / Gransar, Heidi / Han, Donghee / Hayes, Sean W / Thomson, Louise / Dey, Damini / Friedman, John D / Berman, Daniel S / Slomka, Piotr J

    European journal of nuclear medicine and molecular imaging

    2024  Volume 51, Issue 6, Page(s) 1622–1631

    Abstract: Purpose: The myocardial creep is a phenomenon in which the heart moves from its original position during stress-dynamic PET myocardial perfusion imaging (MPI) that can confound myocardial blood flow measurements. Therefore, myocardial motion correction ... ...

    Abstract Purpose: The myocardial creep is a phenomenon in which the heart moves from its original position during stress-dynamic PET myocardial perfusion imaging (MPI) that can confound myocardial blood flow measurements. Therefore, myocardial motion correction is important to obtain reliable myocardial flow quantification. However, the clinical importance of the magnitude of myocardial creep has not been explored. We aimed to explore the prognostic value of myocardial creep quantified by an automated motion correction algorithm beyond traditional PET-MPI imaging variables.
    Methods: Consecutive patients undergoing regadenoson rest-stress [
    Results: A total of 4,276 patients (median age 71 years; 60% male) were analyzed, and 1,007 ACM events were documented during a 5-year median follow-up. Processing time for automatic motion correction was < 12 s per patient. Myocardial creep in the superior to inferior (downward) direction was greater than the other directions (median, 4.2 mm vs. 1.3-1.7 mm). Annual mortality rates adjusted for age and sex were reduced with a larger downward creep, with a 4.2-fold ratio between the first (0 mm motion) and 10th decile (11 mm motion) (mortality, 7.9% vs. 1.9%/year). Downward creep was associated with lower ACM after full adjustment for clinical and imaging parameters (adjusted hazard ratio, 0.93; 95%CI, 0.91-0.95; p < 0.001). Adding downward creep to the standard PET-MPI imaging model significantly improved ACM prediction (area under the receiver operating characteristics curve, 0.790 vs. 0.775; p < 0.001), but other directions did not (p > 0.5).
    Conclusions: Downward myocardial creep during regadenoson stress carries additional information for the prediction of ACM beyond conventional flow and perfusion PET-MPI. This novel imaging biomarker is quantified automatically and rapidly from stress dynamic PET-MPI.
    MeSH term(s) Humans ; Male ; Female ; Aged ; Myocardial Perfusion Imaging/methods ; Positron-Emission Tomography ; Heart/diagnostic imaging ; Middle Aged ; Myocardium/pathology ; Rubidium Radioisotopes ; Stress, Physiological ; Prognosis
    Chemical Substances Rubidium Radioisotopes
    Language English
    Publishing date 2024-01-23
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 8236-3
    ISSN 1619-7089 ; 0340-6997 ; 1619-7070
    ISSN (online) 1619-7089
    ISSN 0340-6997 ; 1619-7070
    DOI 10.1007/s00259-024-06611-2
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    Zs.A 1227: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  7. Article ; Online: Mortality risk among patients undergoing exercise versus pharmacologic myocardial perfusion imaging: A propensity-based comparison.

    Rozanski, Alan / Gransar, Heidi / Hayes, Sean W / Friedman, John D / Thomson, Louise / Berman, Daniel S

    Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

    2020  Volume 29, Issue 2, Page(s) 840–852

    Abstract: Background: The increased risk associated with pharmacologic versus exercise testing is obscured by the higher prevalence of clinical risk factors among pharmacologic patients. Thus, we assessed comparative mortality in a large risk factor-matched group ...

    Abstract Background: The increased risk associated with pharmacologic versus exercise testing is obscured by the higher prevalence of clinical risk factors among pharmacologic patients. Thus, we assessed comparative mortality in a large risk factor-matched group of exercise versus pharmacologic patients undergoing stress/rest SPECT myocardial perfusion imaging (MPI).
    Methods: 39,179 patients undergoing stress/rest SPECT-MPI were followed for 13.3 ± 5.0 years for all-cause mortality (ACM). We applied propensity-matching to create pharmacologic and exercise groups with similar risk profiles.
    Results: In comparison to exercise patients, pharmacologic patients had an increased risk-adjusted hazard ratio for ACM for each level of ischemia: increased by 3.8-fold (95%CI 3.5-4.1) among nonischemic patients, 2.5-fold (95%CI 2.0-3.2) among mildly ischemic patients, and 2.6-fold (95%CI 2.1-3.3) among moderate/severe ischemic patients. Similar findings were observed among a propensity-matched cohort of 10,113 exercise and 10,113 pharmacologic patients as well as in an additional cohort that also excluded patients with noncardiac co-morbidities.
    Conclusions: Patients requiring pharmacologic stress testing manifest substantially heightened clinical risk at each level of myocardial ischemia and even when myocardial ischemia is absent. These findings suggest the need to study the pathophysiological drivers of increased risk in association with pharmacologic testing and to convey this risk in clinical reports.
    MeSH term(s) Coronary Artery Disease/complications ; Exercise Test/methods ; Humans ; Myocardial Ischemia/complications ; Myocardial Ischemia/diagnostic imaging ; Myocardial Perfusion Imaging/methods ; Perfusion ; Tomography, Emission-Computed, Single-Photon/methods
    Language English
    Publishing date 2020-10-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1212505-2
    ISSN 1532-6551 ; 1071-3581
    ISSN (online) 1532-6551
    ISSN 1071-3581
    DOI 10.1007/s12350-020-02294-y
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    Zs.A 4121: Show issues Location:
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  8. Article ; Online: Decline in typical angina among patients referred for cardiac stress testing.

    Rozanski, Alan / Han, Donghee / Miller, Robert J H / Gransar, Heidi / Slomka, Piotr J / Hayes, Sean W / Friedman, John D / Thomson, Louise E J / Berman, Daniel S

    Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

    2023  Volume 30, Issue 4, Page(s) 1309–1320

    Abstract: Objective: To evaluate temporal trends in the prevalence of typical angina and its clinical correlates among patients referred for stress/rest SPECT myocardial perfusion imaging (MPI).: Patients and methods: We evaluated the prevalence of chest pain ... ...

    Abstract Objective: To evaluate temporal trends in the prevalence of typical angina and its clinical correlates among patients referred for stress/rest SPECT myocardial perfusion imaging (MPI).
    Patients and methods: We evaluated the prevalence of chest pain symptoms and their relationship to inducible myocardial ischemia among 61,717 patients undergoing stress/rest SPECT-MPI between January 2, 1991 and December 31, 2017. We also assessed the relationship between chest pain symptom and angiographic findings among 6,579 patients undergoing coronary CT angiography between 2011 and 2017.
    Results: The prevalence of typical angina among SPECT-MPI patients declined from 16.2% between 1991 and 1997 to 3.1% between 2011 and 2017, while the prevalence of dyspnea without any chest pain increased from 5.9 to 14.5% over the same period. The frequency of inducible myocardial ischemia declined over time within all symptom groups, but its frequency among current patients (2011-2017) with typical angina was approximately three-fold higher versus other symptom groups (28.4% versus 8.6%, p < 0.001). Overall, patients with typical angina had a higher prevalence of obstructive CAD on CCTA than those with other clinical symptoms, but 33.3% of typical angina patients had no coronary stenoses, 31.1% had 1-49% stenoses, and 35.4% had ≥ 50% stenoses.
    Conclusions: The prevalence of typical angina has declined to a very low level among contemporary patients referred for noninvasive cardiac tests. The angiographic findings among current typical angina patients are now quite heterogeneous, with one-third of such patients having normal coronary angiograms. However, typical angina remains associated with a substantially higher frequency of inducible myocardial ischemia compared to patients with other cardiac symptoms.
    MeSH term(s) Humans ; Constriction, Pathologic ; Angina Pectoris/diagnostic imaging ; Angina Pectoris/epidemiology ; Coronary Stenosis ; Coronary Angiography/methods ; Chest Pain/diagnostic imaging ; Chest Pain/epidemiology ; Tomography, Emission-Computed, Single-Photon ; Myocardial Perfusion Imaging/methods ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology
    Language English
    Publishing date 2023-07-06
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1212505-2
    ISSN 1532-6551 ; 1071-3581
    ISSN (online) 1532-6551
    ISSN 1071-3581
    DOI 10.1007/s12350-023-03305-4
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  9. Article ; Online: Comparison of coronary artery calcium scores among patients referred for cardiac imaging tests.

    Rozanski, Alan / Han, Donghee / Miller, Robert J H / Gransar, Heidi / Slomka, Piotr / Hayes, Sean W / Friedman, John D / Thomson, Louise E J / Berman, Daniel S

    Progress in cardiovascular diseases

    2023  Volume 81, Page(s) 24–32

    Abstract: Background: While coronary artery calcium (CAC) can now be evaluated by multiple imaging modalities, there is presently scant study regarding how CAC scores may vary among populations of varying clinical risk.: Methods: We evaluated the distribution ... ...

    Abstract Background: While coronary artery calcium (CAC) can now be evaluated by multiple imaging modalities, there is presently scant study regarding how CAC scores may vary among populations of varying clinical risk.
    Methods: We evaluated the distribution of CAC scores among three patient groups: 18,941 referred for CAC scanning, 5101 referred for diagnostic coronary CT angiography (CCTA), and 3307 referred for diagnostic positron emission tomography (PET) myocardial perfusion imaging (MPI). We assessed the relationship between CAC score and myocardial ischemia, obstructive coronary artery disease (CAD), and all-cause mortality across imaging modalities.
    Results: Within each age group, the frequency of CAC abnormalities were relatively similar across testing modalities, despite an annualized mortality rate which varied from 0.5%/year among CAC patients to 3.8%/year among PET-MPI patients (p < 0.001). Among CCTA and PET-MPI patients, a zero CAC score was common, occurring in ~70% of patients <50 years, ~40% of patients 50-59 years, and ~ 25% of patients 60-69 years. Among CCTA patients, zero CAC was associated with a normal coronary angiogram with high frequency, ranging from 92.2% among patients <50 years to 87.9% among patients ≥70 years. Among PET-MPI patients, zero CAC was associated with a very low frequency of inducible ischemia across all age groups, ranging from 1.5% among patients <50 years to 0.9% among patients ≥70 years.
    Conclusions: In our study, relatively similar CAC scores were noted among patients varying markedly in mortality risk. Clinically, zero CAC scores predicted both a low likelihood of obstructive CAD and inducible myocardial ischemia in all age groups and were observed with high frequency across diagnostic testing modalities.
    MeSH term(s) Humans ; Middle Aged ; Calcium ; Coronary Artery Disease/diagnostic imaging ; Myocardial Ischemia/complications ; Coronary Angiography/methods ; Myocardial Perfusion Imaging/methods
    Chemical Substances Calcium (SY7Q814VUP)
    Language English
    Publishing date 2023-10-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 209312-1
    ISSN 1873-1740 ; 1532-8643 ; 0033-0620
    ISSN (online) 1873-1740 ; 1532-8643
    ISSN 0033-0620
    DOI 10.1016/j.pcad.2023.10.005
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  10. Article ; Online: Increasing frequency of dyspnea among patients referred for cardiac stress testing.

    Rozanski, Alan / Gransar, Heidi / Sakul, Sakul / Miller, Robert J H / Han, Donghee / Hayes, Sean W / Friedman, John D / Thomson, Louise E J / Berman, Daniel S

    Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

    2023  Volume 30, Issue 6, Page(s) 2303–2313

    Abstract: Objective: To assess the frequency, change in prevalence, and prognostic significance of dyspnea among contemporary patients referred for cardiac stress testing.: Patients and methods: We evaluated the prevalence of dyspnea and its relationship to ... ...

    Abstract Objective: To assess the frequency, change in prevalence, and prognostic significance of dyspnea among contemporary patients referred for cardiac stress testing.
    Patients and methods: We evaluated the prevalence of dyspnea and its relationship to all-cause mortality among 33,564 patients undergoing stress/rest SPECT-MPI between January 1, 2002 and December 31, 2017. Dyspnea was assessed as a single-item question. Patients were divided into three temporal groups.
    Results: The overall prevalence of dyspnea in our cohort was 30.2%. However, there was a stepwise increase in the temporal prevalence of dyspnea, which was present in 25.6% of patients studied between 2002 and 2006, 30.5% of patients studied between 2007 and 2011, and 38.7% of patients studied between 2012 and 2017. There was a temporal increase in the prevalence of dyspnea in each age, symptom, and risk factor subgroup. The adjusted hazard ratio for mortality was higher among patients with dyspnea vs those without dyspnea both among all patients, and within each chest pain subgroup.
    Conclusions: Dyspnea has become increasingly prevalent among patients referred for cardiac stress testing and is now present among nearly two-fifths of contemporary cohorts referred for stress-rest SPECT-MPI. Prospective study is needed to standardize the assessment of dyspnea and evaluate the reasons for its increasing prevalence.
    MeSH term(s) Humans ; Exercise Test/adverse effects ; Chest Pain/diagnosis ; Prognosis ; Tomography, Emission-Computed, Single-Photon/adverse effects ; Dyspnea/diagnosis ; Dyspnea/etiology ; Myocardial Perfusion Imaging/adverse effects ; Coronary Artery Disease/complications
    Language English
    Publishing date 2023-10-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1212505-2
    ISSN 1532-6551 ; 1071-3581
    ISSN (online) 1532-6551
    ISSN 1071-3581
    DOI 10.1007/s12350-023-03375-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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