Mahwash Kassi

Optimizing Evaluation of Patients with Low-to-Intermediate-Risk Acute Chest Pain: A Randomized Study Comparing Stress Myocardial Perfusion Tomography Incorporating Stress-Only Imaging Versus Cardiac CT

The purpose of this study was to determine whether stress myocardial perfusion (SPECT) optimized with stress-only (SO) imaging is comparable to cardiac CT angiography (CTA) for evaluating patients with acute chest pain (ACP). Methods: This was a prospective randomized observational study in 598 ACP patients who underwent CTA versus SPECT. The primary endpoint was length of hospital stay, and secondary endpoints were test feasibility, time to diagnosis, diagnostic accuracy, radiation exposure, and overall cost. Median follow-up was 6.5 mo, with a 3.8% cardiac event rate defined as death or an acute coronary syndrome. Results: Of 2,994 patients screened, 1,703 (56.9%) were not candidates for CTA because of prior cardiac disease (41%) or imaging contraindications (16%). Time to diagnosis (8.1 ± 8.5 vs. 9.4 ± 7.4 h) and length of hospital stay (19.7 ± 27.8 vs. 23.5 ± 34.4 h) were significantly shorter with CTA than with SPECT (P = 0.002). However, time to diagnosis (7.0 ± 6.2 vs. 6.8 ± 5.9 h, P = 0.20), length of stay (15.5 ± 17.2 vs. 16.7 ± 15.3 h, P = 0.36), and hospital costs (

MDCT assessment of mechanical circulatory support device complications

4,242 ±

Association Between Hematological Indices and Coronary Calcification in Symptomatic Patients without History of Coronary Artery Disease

3,871 vs.

Case report: It wasn't cupid: multimodality imaging of inferior vena cava filter fracture with strut migration to the interventricular septum.

4,364 ± 1781, P = 0.86) were comparable with CTA versus SO SPECT, respectively. SO was also superior to conventional SPECT regarding all of the above metrics and significantly reduced radiation exposure (5.5 ± 4.4 vs. 12.5 ± 2.7 mSv, P < 0.0001). Conclusion: Stress SPECT when optimized with SO imaging is similar to CTA in time to diagnosis, length of hospital stay, and cost, with improved prognostic accuracy and less radiation exposure. Our results emphasize the importance of SO imaging, particularly in low-intermediate-risk emergency room patients who are a population likely to have a normal test result.

A Rare Case of Cardiac Hemangioma Causing Ventricular Fibrillation

THE RISING NUMBER OF PATIENTS WITH ADVANCED HEART FAILURE WHO RECEIVE DURABLE MECHANICAL CIRCULATORY SUPPORT (MCS) DEVICES requires improved recognition of device complications [(1)][1]. Imaging is invariably needed because the clinical presentation is nonspecific. In our institution, we perform

Role of multimodality imaging in patients with left ventricular assist device.

Background: Atherosclerotic coronary artery disease (CAD) has long been shown to involve chronic low-grade subclinical inflammation. However, whether there is association between hematological indices assessed by complete blood count (CBC) and coronary atherosclerotic burden has not been well studied. Materials and Methods: Consecutive 868 patients without known CAD who presented with acute chest pain to emergency department and underwent coronary artery calcium (CAC) scoring evaluation by multi-detector cardiac computed tomography were included in our study. Clinical characteristics and CBC indices were compared among different CAC groups. Results: The cohort comprised 60% male with a mean age of 61 (SD = 14) years. Median Framingham risk of CAD was 4% (range 1-16%). Median CAC score was 0 (IQR 0-43). Higher CAC groups had significantly higher Framingham risk of CAD than lower CAC groups (P < 0.001). Among different CAC categories, there was no statistically significant difference in hemoglobin level (p 0.45), mean corpuscular volume (p 0.43), mean corpuscular hemoglobin (p 0.28), mean corpuscular hemoglobin volume (p 0.36), red cell distribution width (0.42), total white blood cell counts (p 0.291), neutrophil counts (p 0.352), lymphocyte counts (p 0.92), neutrophil to lymphocyte ratio (p 0.68), monocyte count (p 0.48), and platelet counts (p 0.25). Conclusion: Our study did not detect significant association between hematological indices assessed with CBC and coronary calcification in symptomatic patients without known CAD.

Optimizing evaluation of patients with low-to-intermediate-risk acute chest pain

198 houstonmethodist.org/debakey-journal M. Kassi, M.D. IT WASN’T CUPID: MULTIMODALITY IMAGING OF INFERIOR VENA CAVA FILTER FRACTURE WITH STRUT MIGRATION TO THE INTERVENTRICULAR SEPTUM Mahwash Kassi, M.D.a; Jose Lopezb; Colin Barker, M.D.b; Scott Trerotola, M.D.c; Neal Kleiman, M.D.b; Karla Kurrelmeyer, M.D.b aHouston Methodist Hospital, Houston, Texas; bHouston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas; cUniversity of Pennsylvania Medical Center, Philadelphia, Pennsylvania

UTILITY OF ECHOCARDIOGRAPHY IN DEFINING INFLOW CANNULA MALPOSITION IN LEFT VENTRICULAR ASSIST DEVICE AND THE ASSOCIATION WITH ADVERSE OUTCOME

Internal Medicine, The Methodist Hospital, Houston, Texas; yMethodist DeBakey Heart and Vascular Center, The Methodist Hospital, Houston, Texas; and the zDepartment of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas. Manuscript received January 7, 2013; revised manuscript received January 23, 2013, accepted January 29, 2013. Journal of the American College of Cardiology Vol. 62, No. 6, 2013 2013 by the American College of Cardiology Foundation ISSN 0735-1097/

THE COANDA EFFECT: HIDING THE TRUE ETIOLOGY OF HEART FAILURE

36.00 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jacc.2013.01.104

Optimizing Evaluation of Patients with Low to Intermediate Risk Acute Chest Pain: A Randomized Study Comparing Stress Myocardial Perfusion Tomography Incorporating Stress-only Imaging to Cardiac Computed Tomography

Purpose of review The article provides an overview of recent advances in imaging patients with a left ventricular assist device (LVAD). Recent findings There is a growing population of patients with LVADs. LVADs improve survival in patients with end-stage heart failure, but are also associated with significant adverse outcomes. Imaging, particularly echocardiography, plays a critical role in patient selection and in predicting and detecting complications. Summary Recent studies have illustrated links between imaging parameters with adverse outcomes, such as pump thrombosis, right ventricular failure, and continuous aortic regurgitation. Novel parameters and imaging techniques have been developed.