Blog
About

  • Record: found
  • Abstract: found
  • Article: found
Is Open Access

Coronary-to-pulmonary artery fistula in adults: Evaluation with thallium-201 myocardial perfusion SPECT

Read this article at

Bookmark
      There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

      Abstract

      ObjectivesWith the increasing use of multi-detector CT, the number of detected cases with coronary-to-pulmonary artery fistula (CPAF) has increased. Several previous studies reported severe cases of angina, but no appropriate tests to evaluate myocardial perfusion for patients with CPAF have been established. We evaluated the hemodynamic characteristics of CPAF using thallium-201 (Tl-201) single photon emission computed tomography (SPECT).Materials and methodsTl-201 SPECT was performed in 17 patients with CPAF, but without evidence of coronary artery disease on coronary computed tomography angiography (CCTA) (age, 58.5±13.3 years; 8 men). Quantitative analysis of scintigraphic data was performed. Additionally, perfusion abnormalities were compared with CCTA findings. Medical records were obtained to define clinical data, diagnostic findings, symptoms, management, follow-up data, and major adverse cardiac events (MACE).ResultsSix patients (35.2%) showed perfusion abnormalities on SPECT studies and could be classified as follows: 3 patients, no reversible ischemia (3/17, 17.6%); 1 patient, mild ischemia (1/17, 5.8%); and 2 patients, moderate ischemia (2/17, 11.7%). During the follow-up, ten patients (58.8%) improved under medical management and 5 patients (29.4%) underwent surgical ligation for CPAF with symptomatic improvement in 4 patients. Seven patients performed follow-up myocardial perfusion SPECT, and symptomatic improvement correlated well with scintigraphic perfusion improvement in 6 patients No MACE was observed.Clinical significanceTl-201 myocardial perfusion SPECT might be useful for determining the hemodynamic status and for risk stratification in patients with CPAF.

      Related collections

      Most cited references 37

      • Record: found
      • Abstract: found
      • Article: not found

      General cardiovascular risk profile for use in primary care: the Framingham Heart Study.

      Separate multivariable risk algorithms are commonly used to assess risk of specific atherosclerotic cardiovascular disease (CVD) events, ie, coronary heart disease, cerebrovascular disease, peripheral vascular disease, and heart failure. The present report presents a single multivariable risk function that predicts risk of developing all CVD and of its constituents. We used Cox proportional-hazards regression to evaluate the risk of developing a first CVD event in 8491 Framingham study participants (mean age, 49 years; 4522 women) who attended a routine examination between 30 and 74 years of age and were free of CVD. Sex-specific multivariable risk functions ("general CVD" algorithms) were derived that incorporated age, total and high-density lipoprotein cholesterol, systolic blood pressure, treatment for hypertension, smoking, and diabetes status. We assessed the performance of the general CVD algorithms for predicting individual CVD events (coronary heart disease, stroke, peripheral artery disease, or heart failure). Over 12 years of follow-up, 1174 participants (456 women) developed a first CVD event. All traditional risk factors evaluated predicted CVD risk (multivariable-adjusted P<0.0001). The general CVD algorithm demonstrated good discrimination (C statistic, 0.763 [men] and 0.793 [women]) and calibration. Simple adjustments to the general CVD risk algorithms allowed estimation of the risks of each CVD component. Two simple risk scores are presented, 1 based on all traditional risk factors and the other based on non-laboratory-based predictors. A sex-specific multivariable risk factor algorithm can be conveniently used to assess general CVD risk and risk of individual CVD events (coronary, cerebrovascular, and peripheral arterial disease and heart failure). The estimated absolute CVD event rates can be used to quantify risk and to guide preventive care.
        Bookmark
        • Record: found
        • Abstract: found
        • Article: not found

        Use of multiple biomarkers to improve the prediction of death from cardiovascular causes.

        The incremental usefulness of adding multiple biomarkers from different disease pathways for predicting the risk of death from cardiovascular causes has not, to our knowledge, been evaluated among the elderly. We used data from the Uppsala Longitudinal Study of Adult Men (ULSAM), a community-based cohort of elderly men, to investigate whether a combination of biomarkers that reflect myocardial cell damage, left ventricular dysfunction, renal failure, and inflammation (troponin I, N-terminal pro-brain natriuretic peptide, cystatin C, and C-reactive protein, respectively) improved the risk stratification of a person beyond an assessment that was based on the established risk factors for cardiovascular disease (age, systolic blood pressure, use or nonuse of antihypertensive treatment, total cholesterol, high-density lipoprotein cholesterol, use or nonuse of lipid-lowering treatment, presence or absence of diabetes, smoking status, and body-mass index). During follow-up (median, 10.0 years), 315 of the 1135 participants in our study (mean age, 71 years at baseline) died; 136 deaths were the result of cardiovascular disease. In Cox proportional-hazards models adjusted for established risk factors, all of the biomarkers significantly predicted the risk of death from cardiovascular causes. The C statistic increased significantly when the four biomarkers were incorporated into a model with established risk factors, both in the whole cohort (C statistic with biomarkers vs. without biomarkers, 0.766 vs. 0.664; P<0.001) and in the group of 661 participants who did not have cardiovascular disease at baseline (0.748 vs. 0.688, P=0.03). The improvement in risk assessment remained strong when it was estimated by other statistical measures of model discrimination, calibration, and global fit. Our data suggest that in elderly men with or without prevalent cardiovascular disease, the simultaneous addition of several biomarkers of cardiovascular and renal abnormalities substantially improves the risk stratification for death from cardiovascular causes beyond that of a model that is based only on established risk factors. Copyright 2008 Massachusetts Medical Society.
          Bookmark
          • Record: found
          • Abstract: not found
          • Article: not found

          SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography.

            Bookmark

            Author and article information

            Affiliations
            [1 ] Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
            [2 ] Department of Nuclear Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
            [3 ] Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
            [4 ] Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
            Ziekenhuisgroep Twente, NETHERLANDS
            Author notes

            Competing Interests: The authors have declared that no competing interests exist.

            [¤]

            Current address: Department of Radiology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.

            Contributors
            Role: Data curation, Role: Formal analysis, Role: Investigation, Role: Methodology, Role: Writing – original draft
            Role: Conceptualization, Role: Formal analysis, Role: Supervision, Role: Writing – review & editing
            Role: Formal analysis, Role: Investigation, Role: Software, Role: Writing – review & editing
            Role: Investigation, Role: Resources, Role: Visualization
            Role: Investigation, Role: Resources, Role: Visualization
            Role: Editor
            Journal
            PLoS One
            PLoS ONE
            plos
            plosone
            PLoS ONE
            Public Library of Science (San Francisco, CA USA )
            1932-6203
            7 December 2017
            2017
            : 12
            : 12
            29216309
            5720796
            10.1371/journal.pone.0189269
            PONE-D-16-42394
            (Editor)
            © 2017 Lee et al

            This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

            Counts
            Figures: 2, Tables: 4, Pages: 13
            Product
            Funding
            The authors received no specific funding for this work.
            Categories
            Research Article
            Research and Analysis Methods
            Imaging Techniques
            Neuroimaging
            Single Photon Emission Computed Tomography
            Biology and Life Sciences
            Neuroscience
            Neuroimaging
            Single Photon Emission Computed Tomography
            Medicine and Health Sciences
            Diagnostic Medicine
            Diagnostic Radiology
            Tomography
            Single Photon Emission Computed Tomography
            Research and Analysis Methods
            Imaging Techniques
            Diagnostic Radiology
            Tomography
            Single Photon Emission Computed Tomography
            Medicine and Health Sciences
            Radiology and Imaging
            Diagnostic Radiology
            Tomography
            Single Photon Emission Computed Tomography
            Medicine and Health Sciences
            Vascular Medicine
            Coronary Heart Disease
            Medicine and Health Sciences
            Cardiology
            Coronary Heart Disease
            Medicine and Health Sciences
            Diagnostic Medicine
            Signs and Symptoms
            Fistulas
            Medicine and Health Sciences
            Pathology and Laboratory Medicine
            Signs and Symptoms
            Fistulas
            Medicine and Health Sciences
            Vascular Medicine
            Ischemia
            Medicine and Health Sciences
            Surgical and Invasive Medical Procedures
            Medicine and Health Sciences
            Vascular Medicine
            Vascular Diseases
            Aneurysms
            Medicine and Health Sciences
            Diagnostic Medicine
            Biology and Life Sciences
            Anatomy
            Cardiovascular Anatomy
            Blood Vessels
            Arteries
            Coronary Arteries
            Medicine and Health Sciences
            Anatomy
            Cardiovascular Anatomy
            Blood Vessels
            Arteries
            Coronary Arteries
            Custom metadata
            All relevant data are within the paper and its Supporting Information files.

            Uncategorized

            Comments

            Comment on this article