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CARDIOLOGY PROCEDURES

CARDIOLOGY PROCEDURES

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perfusiorepos

petfdg

cardiology-ang

Stress/rest baseline and pharmacological stimulated miocardic perfusion SPECT

DESCRIPTION: The stress/rest myocardial perfusion SPECT is the gold standard for evaluating minimally aggressive coronary disease.

PREPARATION: A 3-4 hour fasting is required. In the case of pharmacological stimulation with dipyridamole, it is essential to avoid the consumption of xanthines (caffeine, theophyllines: coffee, Coca Cola, tea) 24 hours before the test. Depending on the drug, the weight of the patient and the criteria of the nuclear medicine doctor, effort and rest detections can be made on the same day (short protocol) or on different days (long protocol).

INDICATIONS: It is indicated in:

  • Diagnosis of coronary disease in cases with atypical symptoms, diabetes, female sex.
  • Evaluation of myocardial viability.
  • Evaluation of coronary heart disease, evolutionary control and response to treatment control.

DURATION OF PROCEDURE: 4 hours.

cardiology-ang

REST CARDIAC PERFUSION
TOMOSCINTIGRAPHY (SPET)

DESCRIPTION: Normofunctional study of myocardial perfusion in a baseline situation by means of the intravenous administration of a radiotracer marked with technetium or thallium to evaluate the alterations of myocardial perfusion at rest (extension of necrosis and myocardial viability).

PREPARATION: No previous preparation is required. It may be necessary to administer sublingual nitrates and to monitor blood pressure.

INDICATIONS: Evaluation of the extent of myocardial necrosis. Assessment of myocardial viability.

DURATION OF PROCEDURE: Administration-detection times depend on the radiotracer used (thallium: 3-4 and 24 hours, technetium compounds: 60 minutes).

cardiology-ang

18F-FDG CARDIAC PET-CT

DESCRIPTION: Study of the metabolism of cardiac glucose, as part of myocardial perfusion studies.

PREPARATION: Six-hour fasting is required. The patient should not perform intense physical exercise 24 hours before the study. Insulin clamp or glucose oral overload is required.

INDICATIONS: Study of myocardial viability.

DURATION OF PROCEDURE: 2 hours.

petinflam

ventriesforçrepos

ventrirepos

cardiology-ang

18F-FDG PET-CT FOR THE DETECTION OF INFLAMMATORY AND INFECTIOUS PROCESSES
IN CARDIOVASCULAR DEVICES

DESCRIPTION: Detection of areas with inflammatory or infectious phenomena.

PREPARATION: 6-hour fasting is required. A special diet is needed to inhibit the physiological uptake of FDG by the heart. Good hydration.

INDICATIONS: Suspected infection of intravascular devices, pacemakers and catheters.

DURATION OF PROCEDURE: 90 minutes.

cardiology-ang

GATED/NON-GATED EQUILIBRIUM ISOTOPE VENTRICULOGRAPHY (STRESS/REST)

POST-PHARMACOLOGIC-INTERVENTION (DOBUTAMINE) EQUILIBRIUM ISOTOPIC VENTRICULOGRAPHY

DESCRIPTION: Evaluation of blood circulation through the heart and assessment of its pumping and contracting function after physical effort. The systolic and diastolic function of both cardiac ventricles is assessed, as well as their overall ejection fraction, the regional left ventricle ejection fraction, and the regional contractility. The procedure also allows for the calculation of ventricular volumes during the effort phase.

PREPARATION: A 4-hour minimum fasting is required.

INDICATIONS: Assessment of left ventricular ejection fraction behavior at rest and the subsequent response to a physical effort, mainly for the diagnosis of coronary artery disease of patients who have suffered a cardiac infarction and for the evolutionary control of patients with aortic insufficiency.

DURATION OF PROCEDURE: 90 minutes.

cardiology-ang

REST EQUILIBRIUM ISOTOPE VENTRICULOGRAPHY

GATED-SPET ISTOTOPE VENTRICULOGRAPHY

DESCRIPTION: Evaluation of blood circulation through the heart and assessment of its pumping and contracting function IN BASELINE SITUATION. The systolic and diastolic function of both cardiac ventricles is assessed, as well as their overall ejection fraction, the regional left ventricle ejection fraction, and the regional contractility. The procedure also allows for the calculation of ventricular volumes.

PREPARATION: No previous preparation is required.

INDICATIONS: Ischemic cardiophaty: Diagnosis: Evaluation of ejection fraction of left ventricle at rest and the existence of alterations of the regional contractility. Acute cardiac infarction: Stratification of patients according to their functional situation after necrosis by means of ejection fraction measurements, being this and VTS the parameters with the highest prognostic value after an infarct; evaluation of regional contractility (areas of hypokinesia, akinesia or dyskinesia, and detection of right ventricle infarction) and study of ventricular remodeling after necrosis. Valvulopathies: evolutionary control of the function and ventricular volumes. Conduction disorders: Evaluation of ventricular function and description of the myocardial contraction sequence: pacemaker situation, pre-excitation syndromes, ventricular tachycardia. Myocardiopathies: Evolution of the function in myocardial pathology of any etiology. Control of myocardial involvement by chemotherapies (adriamycin).

DURATION OF PROCEDURE: 1 hour.

perfusiorepos

petfdg

cardiology-ang

LEFT-RIGHT CARDIAC SHORT CIRCUIT SCINTIGRAPHY

SHUNTS QUANTIFICATION

FIRST-PASS ISOTOPE VENTRICULOGRAPHY

DESCRIPTION: Study of the arrival of a radioactive tracer to the heart and lungs through central circulation. 

PREPARATION: No preparation is required.

INDICATIONS: Evaluation of left-right shunts. Diagnosis, quantification and monitoring of heart short circuits. Evaluation of left and right ventricular function.

DURATION OF PROCEDURE: 15 minutes.

cardiology-ang

PYROPHOSPHATE CARDIAC
TOMOSCINTIGRAPHY (SPET)

PYROPHOSPHATE CARDIAC
SCINTIGRAPHY

DESCRIPTION: Assessment of acute myocardial damage.

PREPARATION: Sufficient hydration, from the moment of administration of the dose until detection (2-3 hours). No fasting required. The maximum sensitivity interval is between the second and fifth days after the acute episode in the case of heart infarction.

INDICATIONS: Diagnosis of cardiac infarction in situations where the usual procedures have limited efficacy (infarction without Q wave, preoperative, driving disorders). Predictive cardiac infarction information (right-ventricle affectation, location, size). Diagnosis of infectious myocardiopathies: amyloidosis and scleroderma.

DURATION OF PROCEDURE: About 3 hours.

cardiology-ang

123I-MIBG CARDIAC INNERVATION SCINTIGRAPHY

CARDIAC INNERVATION TOMOSCINTIGRAPHY (SPET/SPET-CT)

DESCRIPTION: Study of sympathetic adrenergic activity.

PREPARATION: Blocking of the thyroid gland with 20 drops of potassium iodine, 45-60 minutes before tracer injection.

INDICATIONS: Study of sympathetic adrenergic activity in patients with ventricular arrhythmias, Parkinson’s disease, dementia with Lewy bodies, diabetes, ischemic heart disease, heart transplants.

DURATION OF PROCEDURE: From 5 to 6 hours.

Stress/rest baseline and
pharmacological stimulated)
miocardic perfusion SPECT

DESCRIPTION

The stress/rest myocardial perfusion SPECT is the gold standard for evaluating minimally aggressive coronary disease.

PREPARATION

  • A 3-4 hour fasting is required.
  • In the case of pharmacological stimulation with dipyridamole, it is essential to avoid the consumption of xanthines (caffeine, theophyllines: coffee, Coca Cola, tea) 24 hours before the test.
  • Depending on the drug, the weight of the patient and the criteria of the nuclear medicine doctor, effort and rest detections can be made on the same day (short protocol) or on different days (long protocol).

INDICATIONS

  • Diagnosis of coronary disease in cases with atypical symptoms, diabetes, female sex.
  • Evaluation of myocardial viability.
  • Evaluation of coronary heart disease, evolutionary control and response to treatment control.

DURATION OF PROCEDURE

4 hours.

REST CARDIAC PERFUSION
TOMOSCINTIGRAPHY (SPET)

DESCRIPTION

Normofunctional study of myocardial perfusion in a baseline situation by means of the intravenous administration of a radiotracer marked with technetium or thallium to evaluate the alterations of myocardial perfusion at rest (extension of necrosis and myocardial viability).

PREPARATION

  • No previous preparation is required.

  • It may be necessary to administer sublingual nitrates and to monitor blood pressure.

INDICATIONS

  • Evaluation of the extent of myocardial necrosis.

  • Assessment of myocardial viability.

DURATION OF PROCEDURE

Administration-detection times depend on the radiotracer used:

  • Thallium: 3-4 and 24 hours
  • Technetium compounds: 60 minutes).

18F-FDG CARDIAC PET-CT

DESCRIPTION

Study of the metabolism of cardiac glucose, as part of myocardial perfusion studies.

PREPARATION

  • Six-hour fasting is required.

  • The patient should not perform intense physical exercise 24 hours before the study. 

  • Insulin clamp or glucose oral overload is required.

INDICATIONS

Study of myocardial viability.

DURATION OF PROCEDURE

2 hours.

18F-FDG PET-CT FOR THE DETECTION OF INFLAMMATORY AND INFECTIOUS PROCESSES IN CARDIOVASCULAR DEVICES

DESCRIPTION

Detection of areas with inflammatory or infectious phenomena.

PREPARATION

  • 6-hour fasting is required.

  • A special diet is needed to inhibit the physiological uptake of FDG by the heart.

  • Good hydration.

INDICATIONS

Suspected infection of intravascular devices, pacemakers and catheters.

DURATION OF PROCEDURE

90 minutes.

GATED/NON-GATED EQUILIBRIUM ISOTOPE
VENTRICULOGRAPHY (STRESS/REST)

POST-PHARMACOLOGIC-INTERVENTION (DOBUTAMINE)
EQUILIBRIUM ISOTOPIC VENTRICULOGRAPHY

DESCRIPTION

Evaluation of blood circulation through the heart and assessment of its pumping and contracting function after physical effort. The systolic and diastolic function of both cardiac ventricles is assessed, as well as their overall ejection fraction, the regional left ventricle ejection fraction, and the regional contractility. The procedure also allows for the calculation of ventricular volumes during the effort phase.

PREPARATION

A 4-hour minimum fasting is required.

INDICATIONS

Assessment of left ventricular ejection fraction behavior at rest and the subsequent response to a physical effort, mainly for the diagnosis of coronary artery disease of patients who have suffered a cardiac infarction and for the evolutionary control of patients with aortic insufficiency.

DURATION OF PROCEDURE

90 minutes.

REST EQUILIBRIUM ISOTOPE VENTRICULOGRAPHY

GATED-SPET ISTOTOPE VENTRICULOGRAPHY

DESCRIPTION

Evaluation of blood circulation through the heart and assessment of its pumping and contracting function IN BASELINE SITUATION. The systolic and diastolic function of both cardiac ventricles is assessed, as well as their overall ejection fraction, the regional left ventricle ejection fraction, and the regional contractility. The procedure also allows for the calculation of ventricular volumes.

PREPARATION

No previous preparation is required.

INDICATIONS

  • Ischemic cardiophaty:
    • Diagnosis: Evaluation of ejection fraction of left ventricle at rest and the existence of alterations of the regional contractility. 
    • Acute cardiac infarction: Stratification of patients according to their functional situation after necrosis by means of ejection fraction measurements, being this and VTS the parameters with the highest prognostic value after an infarct:
      • Evaluation of regional contractility (areas of hypokinesia, akinesia or dyskinesia, and detection of right ventricle infarction)
      • Study of ventricular remodeling after necrosis.
  • Valvulopathies: Evolutionary control of the function and ventricular volumes.
  • Conduction disorders: Evaluation of ventricular function and description of the myocardial contraction sequence: pacemaker situation, pre-excitation syndromes, ventricular tachycardia.
  • Myocardiopathies: 
    • Evolution of the function in myocardial pathology of any etiology. 
    • Control of myocardial involvement by chemotherapies (adriamycin).

DURATION OF PROCEDURE

1 hour.

LEFT-RIGHT CARDIAC SHORT CIRCUIT SCINTIGRAPHY

SHUNTS QUANTIFICATION

FIRST-PASS ISOTOPE VENTRICULOGRAPHY

DESCRIPTION

Study of the arrival of a radioactive tracer to the heart and lungs through central circulation. 

PREPARATION

No previous preparation is required.

INDICATIONS

  • Evaluation of left-right shunts. 
  • Diagnosis, quantification and monitoring of heart short circuits. 
  • Evaluation of left and right ventricular function.

DURATION OF PROCEDURE

15 minutes.

PYROPHOSPHATE CARDIAC
TOMOSCINTIGRAPHY (SPET)

PYROPHOSPHATE CARDIAC
SCINTIGRAPHY

DESCRIPTION

Assessment of acute myocardial damage.

PREPARATION

  • Sufficient hydration, from the moment of administration of the dose until detection (2-3 hours). No fasting required. 

  • The maximum sensitivity interval is between the second and fifth days after the acute episode in the case of heart infarction.

INDICATIONS

  • Diagnosis of cardiac infarction in situations where the usual procedures have limited efficacy (infarction without Q wave, preoperative, driving disorders). 

  • Predictive cardiac infarction information (right-ventricle affectation, location, size). 

  • Diagnosis of infectious myocardiopathies: amyloidosis and scleroderma.

DURATION OF PROCEDURE

About 3 hours.

123I-MIBG CARDIAC INNERVATION SCINTIGRAPHY

CARDIAC INNERVATION TOMOSCINTIGRAPHY (SPET/SPET-CT)

DESCRIPTION

Study of sympathetic adrenergic activity.

PREPARATION

Blocking of the thyroid gland with 20 drops of potassium iodine, 45-60 minutes before tracer injection.

INDICATIONS

Study of sympathetic adrenergic activity in patients with:

  • ventricular arrhythmias
  • Parkinson’s disease
  • Dementia with Lewy bodies
  • Diabetes
  • Ischemic heart disease
  • Heart transplants

DURATION OF PROCEDURE

From 5 to 6 hours.

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Josep Irla & Bosch Street, 5, Building 2, Barcelona 08034, Catalonia, SPAIN

PHONE: (+34) 93 204 6439
FAX: (+34) 93 204 9641
E-MAIL: info@simm.barcelona

Josep Irla & Bosch Street, 5, Building 2
Barcelona 08034, Catalonia, SPAIN

PHONE: (+34) 93 204 6439
FAX: (+34) 93 204 9641
E-MAIL: info@simm.barcelona

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