Cardiovascular Medicine and Cardiac Surgery

Biography

Biography: Hamid Amer

Abstract

Purpose: The significance of electrocardiographic ECG changes during adenosine stress test is debatable. This study will further elaborate the significance of these changes in predicting the possibility of CAD.

Methods: This was a retrospective observational registry performed in a single center at the Kingdom of Saudi Arabia. The data were collected from the nuclear medicine database identifying all the reported Gated myocardial perfusion SPECT with adenosine stress tests between January 2013 and January 2014. The adenosine dose were fixed with all patients based on body weight and was given as a continuous infusion of 140 mcg/kg/min over a 6-minute period.

Results: There were 346 patients identified with cardiac nuclear scans in the pre-specified time frame who were subjected to adenosine stress scan. 152 of these patients were male accounting for 44% of the total population. Average age at the time of examination was 60.82±11.29 years. Patients were presented with one or more risk factors. Patients with base line abnormalities, past history of CAD with or without PCI or CABG and previous MI were excluded from the study. Ninety-eight patients (28%) were reported as positive for CAD, 40 patients were reported with ischemic ECG changes (12%) during adenosine infusion, 23 patients who have ischemic changes were positive on MPI, while 17 patients who have positive ECG had a negative MPI. Odd Ratio (OR) was 4.16, 95% C.I. was (2.11-8.18). Fisher Exact test was applied and showed a P value of <0.01. No reported case of asystole, myocardial infarction or complete heart block in this study period.

Conclusions: Our study showed that the probability of a positive MPI is 4 times higher with positive ECG ischemic changes during adenosine stress test and consequently these ECG ischemic changes should be taken in consideration in the final report.

References : 

1. H. Amer, K.Niaz, Imran Ali, A.Jelani, M.Sheikh: The Significance of ECG Changes During Adenosine Infusion as a stress agent for Myocardial Perfusion Imaging (MPI) in Predicting Coronary Artery Disease (CAD). Proceedings Asia Oceania Journal of Nuclear Medicine and Biology (2015):Vol3, (suppl 1);S498-499.

2. H. AMER, status of nuclear medicine in Saudi Arabia. Proceedings Asia Oceania Journal of Nuclear Medicine and Biology (2015):Vol3, (suppl 1);S391-392.

3. H. Amer, K. Niaz, M.Saleem, A. Baltyour, A. Jelani, M. Sheikh: Side Effects of Adenosine as a Pharmacological Stress Agent for Myocardial Perfusion Scan in a local setup. Proceedings Eur J Nucl Med Mol Imaging (2015):42 (suppl 1); S1- S924.

4. Amer H., Niaz K., Jelani A., Alqaseer M., Saleem M.,Sheikh MY.: Future cardiac events in normally diagnosed Gated Myocardial Perfusion SPECT. European Scientific Journal, 2015;May Special Edition(2):9-17.

5. K. Niaz, A. Jelani,H.Amer, AA. Al-Qarni, M. Al-Qaseer et.al: Prevalence of Coronary Artery Disease in Asymptomatic Patients with Type-2 Diabetes Using Myocardial Perfusion Scan as Screening Tool. Proceedings Eur J Nucl Med Mol Imaging (2014):41(suppl 2); S604-605.

6. H. Amer, K. Niaz: Prone Versus Supine Myocardial Gated SPECT in the Evaluation of Ventriclar Volumes, Ejection Fraction and Myocardial Perfusion. Proceedings Eur J Nucl Med Mol Imaging (2011):38 (suppl 2); S306-307.

7. Amer H.1, Niaz.K.1, Samiri H.2, Sheikh M.1, Alothman M.1, Alhammad M.1 :Future Cardiac Events in Patients with Ischemic ECG Changes during Adenosine Infusion as a Myocardial Stress Agent with Normal Cardiac Scan. Accepted for Oral presentation in annual meeting of the Asian School of Nuclear Medicine. that will be held Shanghai/China 5-8 of May 2016.

8. K. Niaz, A. Jelani, H.Amer, AA. Al-Qarni, M. Al-Qaseer et.al: Prevalence of Coronary Artery Disease in Asymptomatic Patients with Type-2 Diabetes Using Myocardial Perfusion Scan as Screening Tool. Preliminary Results. In The 18th Annual Scientific Session of the American Society of Nuclear

Cardiology on 26^th -29^th September, 2013 at Chicago IL, USA.

9. K. Niaz, A. Jelani, H.Amer, AA. Al-Qarni, M. Al-Qaseer et.al: Prevalence of Coronary Artery Disease in Asymptomatic Patients with Type-2 Diabetes Using Myocardial Perfusion Scan as Screening Tool. In The Annual Scientific Congress of the European Association of Nuclear Medicine on 18th-22^nd October, 2014 at Gothenburg, Sweden.

10. Amer H., Niaz K., Jelani A., Alqaseer M., Saleem M., Sheikh MY.: Future cardiac events in normally diagnosed Gated Myocardial Perfusion SPECT. In The 1st Pan American Interdisciplinary Conference on 13-16th March 2015 at Buenos Aires Argentina.

11. H. Amer, K. Niaz, M.Saleem, A. Baltyour, A. Jelani, M. Sheikh: Side Effects of Adenosine as a Pharmacological Stress Agent for Myocardial Perfusion Scan in a local setup. In 28th Annual Congress of the European Association of Nuclear Medicine, 10 - 14 October 2015 Hamburg,Germany.

12. H. Amer, K.Niaz, Imran Ali, A.Jelani, M.Sheikh: The Significance of ECG Changes During Adenosine Infusion as a stress agent for Myocardial Perfusion Imaging (MPI) in Predicting Coronary Artery Disease (CAD). October 31 to November 4the 11th Annual Congress of Asia Oceania Congress of Nuclear Medicine and Biology (AOCNMB 2015) October 31 to November 4, 2015 in Jeju Island, Korea International Conference on Fibromyalgia and Chronic Pain (June 15-16, 2016 Philadelphia, USA

12. J Pain Relief ISSN: 2167-0846 JPAR an open access journa Fibromyalgia 2016 June 15-16, 2016

Volume 5, Issue 3(Suppl)Page 40

13. H. AMER, status of nuclear medicine in Saudi Arabia 4th of November 2015 as oral presentation during the 11th Annual Congress of Asia Oceania Congress of Nuclear Medicine and Biology (AOCNMB 2015) October 31 to November 4, 2015 in Jeju Island, Korea

14. H. Amer, K. Niaz: Prone Versus Supine Myocardial Gated SPECT in the Evaluation of Ventriclar Volumes, Ejection Fraction and Myocardial Perfusion. . In 24th Annual Congress of the European Association of Nuclear Medicine, 15 – 19^th October 2011 Birmingham, UK