Dynamic Cardiac SPECT Imaging
The investigators propose a 4 year prospective, observational study of 40 patients yearly, comparing conventional clinically indicated SPECT and PET perfusion with dynamic rest/stress MPI studies with coronary angiography, in some cases performed with quantitative coronary anatomy and flow as well as quantitative 13N-ammonia PET MPI. Methods will also be assessed for their ability to determine myocardial viability by comparing regional wall motion (WM) on clinically indicated serial ventriculography, echocardiography or gated SPECT MPI in those protocol patients with WM abnormalities who subsequently undergo revascularization. Patient studies will begin in the first study year based on those methods already developed and integrate new advances as they become evident.
Coronary Artery Disease
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Dynamic Cardiac SPECT Imaging|
- Coronary Flow Reserve [ Time Frame: Length of procedure- 90 min ] [ Designated as safety issue: No ]The coronary flow reserve will be measured by comparing the rest and stress exams on the dynamic SPECT scans using developed algorithms. The accuracy will be compared with clinical PET, coronary angiography, and clinical SPECT.
|Study Start Date:||March 2012|
|Estimated Primary Completion Date:||September 2015 (Final data collection date for primary outcome measure)|
Patients scheduled to have clinically indicated stress MPI with low pre-test likelihood (0-15%) of coronary disease based on criteria of Diamond and Forrester. And those who have already had a clinical indicated stress MPI in the last three years with a low likelihood of having active coronary disease with no significantly narrowed coronary arteries.
Patients in Group II who will have the dynamic imaging protocol studies after SCA, patients will be selected for protocol enlistment only if the decision is made by the patient's physician, based totally on clinical and social factors, that any considered revascularization intervention would not be performed on the day of diagnostic selective coronary angiography (SCA) and will be performed electively, at least 4 to 7 days later. Viability will be assessed in these patients only in the presence of WM abnormalities, and with serial analysis of WM, as described above. Patients will be followed for death or infarction or other events more than 3 months after study, for up to 3 years following participation in the protocol.
Patients found at SCA to have lesions of "borderline" clinical significance, preferably in the absence of other associated lesions.
Patients who were diagnosed with advanced heart failure including patients who had or will have cardiac resynchonization therapy (CRT) or a heart transplant.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01934985
|Contact: Elias Botvinick, MDfirstname.lastname@example.org|
|United States, California|
|University of California, San Francisco Imaging Center||Recruiting|
|San Francisco, California, United States, 94107|
|Principal Investigator:||Elias Botvinick, MD||University of California, San Francisco|