Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

68 patients with a history of angina pectoris (AP) and/or myocardial infarction, 35 patients with atypical chest pain and 27 healthy volunteers underwent 201Tl myocardial perfusion imaging (201Tl-MPI). In a preselected group of 71 patients with coronary arteriograms, sensitivity was 98.3% and specificity 71%. In patients with AP and positive exercise ECG, 201 Tl-MPI only serves to confirm the diagnosis of coronary artery disease (CAD) (46 pathological 201Tl-MPI of 47 patients). Perfusion defects are a useful adjunct for the diagnosis of CAD in patients with AP and normal or uninterpretable exercise ECG (20 of 21 patients), and in those with atypical chest pain and positive or uninterpretable exercise ECG (25 of 39 patients). A negative 201Tl-MPI virtually rules out CAD.
 ...
PMID:[1 year's experiences with the 201 thallium myocardial scintigraphy for the evaluation of coronary circulation disorders]. 91 19

Angina is a common symptom in patients with AS with or without accompanying CAD. When due to the valvular obstruction alone, the pathophysiology involves mismatch between reduced diastolic coronary flow and increased LV mass, or impaired coronary vasodilator reserve. When CAD is present, the severity of angina correlates with the extent of CAD, which tends to be inversely related to the degree of valvular obstruction at presentation. It is important to make a correct diagnosis of CAD in AS patients pre-operatively, since this factor significantly influences peri-operative morbidity and long-term survival. Whether MPI in AS patients can completely exclude CAD and eliminate the need for coronary angiography is a difficult question. Approximately 350 AS patients having had MPI have been reported. The studies differ in terms of scintigraphic technique (planar versus SPECT), stress modality, isotopes used, and definitions of an abnormal scan and what constitutes hemodynamically significant coronary stenosis. The 'best case' diagnostic data showed sensitivity of 87%, specificity 72%, positive predictive value of 81%, and negative predictive value of 86%. These figures indicate a high degree of accuracy and are comparable to the results of MPI in patients without AS. However, the data suggest that the diagnosis of coronary disease is missed by MPI in 14% of AS patients with CAD. Review of the referenced series indicates that in many cases, the stenoses were hemodynamically significant, and were important to identify pre-operatively to avoid operative morbidity and improve long-term prognosis. Thus, in conclusion, although MPI is highly accurate in AS patients, a normal study cannot totally exclude the diagnosis of CAD. Coronary angiography should continue to be performed, particularly in patients with angina, or who are at risk for CAD because of their risk factor profile.
 ...
PMID:The value of myocardial perfusion imaging for diagnosing coronary artery disease in patients with aortic valve stenosis. 1206 Sep 24

This was an observational study carried out in the department of cardiology. Bangabandhu Shikh Mujib Medical University (BSMMU), Dhaka in collaboration with Institute of Nuclear Medicine (INM), Shabag, Dhaka during the period October 2002-March 2003. A total of 54 patients presenting with Canadian Cardiovascular Society (CCS) class I-II severity of chest pain with mean +/-SD age 49.88 +/- 8.44 yrs and having male to female ratio 5.75:1 were included in the study. The main objective of the study was to predict severity of myocardial ischemia by Exercise Tolerance Test (ETT) determined by Duke Treadmill Score (DTS) and by perfusion pattern observed following Single-Photon Emission Computed Tomography myocardial perfusion imaging (SPECT-MPI). All patients underwent ETT and then SPECT-MPI scan using Tc-99m-tetrofosmin in one-day stress and rest protocol. Coronary angiogram (CAG) was done with in six months of the perfusion study. After performing ETT, patients were categorized by DTS and myocardial perfusion studies were also stratified according to severity of perfusion defect. The formula used to calculate the score was: Exercise time- (5 x ST segment deviation)-(4 X Treadmill angina index). The angiographic findings (significant >50% stenosis) and perfusion defects in MPI were compared with the severity of DTS. There were 31 patients who had CAG proven (>50% luminal diameter narrowing) CAD and 23 patients free of CAD. After ETT patients were categorized by Duke Treadmill Score into high DTS 12 (22.22%) patients, intermediate DTS 20 (37.03%) patients low DTS 22 (40.74%) patients. In high DTS group 91.66% patients had perfusion defect, whereas in intermediate and low risk group it was 60% and 40.9% respectively. In high DTS group 91.66% of patients had angiographicaly proven CAD, 58.33% of them had triple vessel disease (TVD) while in intermediate and low risk groups angiographically proven CAD were 65% and 22.72% of whom TVD only in 15% & 0% respectively. The results of ETT using DTS score were satisfactorily correlated with SPECT-MPI scanning in high DTS subsets of patients only. It is therefore, suggested that patient of high risk DTS do not need for myocardial perfusion imaging study and should undergo CAG for further evaluation. But the intermediate and low risk groups were needed myocardial perfusion imaging study to guide for further evaluation.
 ...
PMID:Role of exercise tolerance test (ETT) and gated single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) in predicting severity of ischemia in patients with chest pain. 1668 38

RESCUE is a phase III, randomized, controlled, multicenter, comparative efficacy study, designed to compare two diagnostic imaging/treatment paradigms that use coronary computed tomography angiography (CCTA) or single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) for assisting in the diagnosis of ischemic heart disease in patients with stable angina symptoms, and guiding subsequent treatment. The study is based on the hypothesis that CCTA as a diagnostic tool is associated with no increase in cardiac risk, decreased cost, and reduced radiation exposure compared with SPECT MPI. The RESCUE trial was funded by the Agency for Healthcare Research and Quality (AHRQ) and the American College of Radiology Imaging Network (ACRIN) Fund for Imaging Innovation, began in 2011, and completed in 2014.
...
PMID:Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial. 2759 76

Coronary stent restenosis rate following implantation is considerably high. The adenosine stress gated myocardial perfusion imaging (G-MPI) method has been widely used in the diagnosis, risk stratification and prognosis evaluation of coronary heart disease; however, the high cost of adenosine limits its clinical application. The aim of the present study was to investigate the efficacy of adenosine triphosphate (ATP) stress 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) G-MPI for diagnosis in-stent restenosis following coronary stent implantation. Data from 66 patients with typical angina pectoris symptoms who had undergone percutaneous coronary stent implantation >3 months prior to participation in the study were analyzed. All the patients underwent ATP stress 99mTc-MIBI G-MPI and coronary artery angiography as the criterion diagnostic standard within 1 month. The sensitivity, specificity, and accuracy of ATP stress 99mTc-MIBI G-MPI in the assessment of in-stent restenosis were calculated. In addition, Fisher's exact probability methods were used to compare differences between experimental groups. Among 66 patients with a total of 99 implanted coronary arterial branches, 39 patients (59%) with 45 coronary arteries (45%) presented in-stent restenosis. The diagnostic sensitivity, specificity, accuracy, positive predictive and negative predictive value of ATP stress 99mTc-MIBI G-MPI for assessing stent restenosis in all patients were 85, 89, 86, 92 and 80%, respectively. Similarly, these values in patients with myocardial infarction were 79, 88, 83, 88 and 78%, respectively, while in patients without myocardial infarction the values were 90, 91, 90, 95 and 83%, respectively. Therefore, the diagnostic efficacy of ATP stress 99mTc-MIBI G-MPI in patients without myocardial infarction was higher compared with those with myocardial infarction; however, no significant difference was observed between the two groups. Furthermore, the sensitivity, specificity and accuracy for diagnosing LAD stent restenosis were higher compared with LCX and RCA stent restenosis, but with no significant differences observed (P>0.05). The present results indicated that ATP stress 99mTc-MIBI G-MPI had a high clinical application value for diagnosing in-stent restenosis following coronary stent implantation as a non-invasive examination tool, with the advantages of safety and low cost.
 ...
PMID:Adenosine triphosphate stress 99mTc-methoxyisobutylisonitrile gated myocardial perfusion imaging efficacy in diagnosing stent restenosis following coronary stent implantation. 2810 Nov 72