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Trial record 30 of 38 for:    alternans

Gated SPECT Abnormality With J Point Elevation

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ClinicalTrials.gov Identifier: NCT03472898
Recruitment Status : Completed
First Posted : March 21, 2018
Last Update Posted : March 22, 2018
Sponsor:
Information provided by (Responsible Party):
Aylin AKBULUT, Ankara Education and Research Hospital

Brief Summary:
The investigators present an interesting co-incidence of Gated wall abnormality in the inferolateral wall in normal sestamibi myocardial perfusion images with J wave in the inferior derivations of the ECG in a patient. The subsequent coronary angiography demonstrated 80% mid right coronary artery (RCA) stenosis, which was intervened with a drug-eluting stent. The investigators conclude that even though the myocardial perfusion is normal, the association of gated wall abnormality with J wave presentation within the same location should be further evaluated.

Condition or disease
Cardiovascular Diseases Electrocardiogram: Electrical Alternans Myocardial Ischemia Early Repolarization Syndrome Left Ventricular Hypokinesia

Detailed Description:

The isolated J-point elevation considered as a type of "early repolarization" pattern (ER), is commonly been regarded as a benign finding. However, ER associations with arrhythmic sudden death from CAD or sudden cardiac death due to either idiopathic ventricular fibrillation have been shown. A recent study reported that ER especially in inferior leads, was related to worse cardiac outcomes in patients with CAD and they argue that ER in patients with CAD seems to be associated with the myocardial scar in the absence of pathologic Q waves.

Likewise, it is rare to detect clinically important gated SPECT abnormalities in normal myocardial perfusion studies with normal transient ischemic dilatation (TID) score and without any right ventricular uptake or any pulmonary uptake. Normal myocardial perfusion findings with wall motion abnormalities are frequently encountered in the interventricular septum of the patients who have previous bypass surgery or in patients with left bundle branch block (LBBB). However, the presented patient did not have the history of any intervention or LBBB. Perfusion and function discordance can be encountered in non-ischemic dilated cardiomyopathy patients; nonetheless, EF is markedly reduced in these patients.

The presented case, J point elevation in the ECG associated with relative wall motion abnormality was an important clue to determine CAD in the lack of evident perfusion defects or significant ECG findings.

The presence of wall motion abnormalities during stress study to predict CAD in patients with normal perfusion pattern, owing to balanced ischemia, was not only reported in multi-vessel disease but also in single-vessel disease without having presented the association between either regional wall motion abnormality or a localized particular ECG pattern and culprit lesion territory.

The interesting part of the presented case is, notwithstanding the myocardial perfusion pattern is normal, the abnormal gated finding with ECG changes having the concordant localization can be a significant milestone on the way to the diagnosis. To the best of investigators knowledge, the association between J point elevation and wall motion abnormality have not been described yet. Therefore, the investigators would like to draw attention to the importance of adjoining trivial ECG changes and wall motion abnormality for readers anymore.


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Study Type : Observational
Actual Enrollment : 1 participants
Observational Model: Other
Time Perspective: Other
Official Title: The Unidentified Association of Gated SPECT Abnormality With J Point Elevation
Actual Study Start Date : December 27, 2017
Actual Primary Completion Date : January 17, 2018
Actual Study Completion Date : January 17, 2018



Primary Outcome Measures :
  1. Case Report Proposal [ Time Frame: December 2017-January 2018 ]
    Cure



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Ages Eligible for Study:   55 Years to 55 Years   (Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Case Report
Criteria

Inclusion Criteria:

  • Case Report

Exclusion Criteria:

  • None

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03472898


Locations
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Turkey
AnkaraERH
Ankara, Altindag, Turkey, 06340
Sponsors and Collaborators
Ankara Education and Research Hospital
Investigators
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Study Chair: Aylin Akbulut Ankara Education and Research Hospital

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Responsible Party: Aylin AKBULUT, University of Health Sciences Ankara Training and Research Hospital, Ankara Education and Research Hospital
ClinicalTrials.gov Identifier: NCT03472898     History of Changes
Other Study ID Numbers: 0001
First Posted: March 21, 2018    Key Record Dates
Last Update Posted: March 22, 2018
Last Verified: March 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Hypokinesia
Myocardial Ischemia
Ischemia
Cardiovascular Diseases
Pathologic Processes
Heart Diseases
Vascular Diseases
Dyskinesias
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms