Prognostic Value of PET-Derived Myocardial Flow Reserve in Patients With Very High Coronary Artery Calcium Score.

Background: Coronary artery calcium (CAC) is a strong predictor of cardiovascular outcomes, with patients having high CAC experiencing event rates similar to those in secondary prevention populations. Emerging evidence suggests that patients with extremely high CAC (≥1000) represent a distinct high-risk group. Therefore, this study aims to evaluate the prognostic value of myocardial flow reserve (MFR) in patients with very high CAC.

The Different Facets of Myocarditis by Cardiac Magnetic Resonance Imaging.

Myocarditis is an inflammatory condition affecting the myocardium and may have different etiologies. Patients usually present with chest pain and elevated levels of cardiac enzymes, mainly troponin. Cardiac magnetic resonance (CMR) imaging has emerged as the cornerstone test in the diagnosis of myocarditis.

Prognostic Value of Normal Triglyceride Levels among Patients with Target Low-density Lipoproteins Presenting with First Acute Coronary Syndrome.

Introduction: Hypercholesterolemia, mainly low-density lipoprotein cholesterol (LDL-C) and triglycerides (TGs), is a major risk factor for coronary artery disease (CAD). The prognostic value of lowering LDL-C and TG in patients with CAD is well studied. We sought to examine the prognostic value of TG among patients presenting with acute coronary syndrome (ACS) and target LDL-C level.

Evaluation of Noninvasive Diagnostic Techniques in Identifying Coronary Artery Disease: A Systematic Review.

Background: Coronary artery disease (CAD) poses a significant global health burden, necessitating optimal diagnostic strategies for risk assessment and management. This study systematically reviews randomized controlled trials (RCTs) comparing different noninvasive imaging modalities for CAD evaluation, focusing on their subsequent invasive outcomes and major adverse cardiac events (MACEs).

Methods: A comprehensive electronic search was conducted across multiple databases, identifying 24 relevant RCTs published between 2010 and 2023.

Real-World Efficacy and Safety of Apixaban vs. Warfarin in Obese Atrial Fibrillation Patients: Propensity Matching Analysis.

: The use of direct oral anticoagulants (DOACs) in obese patients is scarcely studied despite having many advantages over warfarin. Consequently, this study aims to assess the real-world safety and effectiveness of apixaban compared to warfarin in treating atrial fibrillation (AF) in obese patients. : A retrospective cohort study examined consecutive AF patients with a BMI of ≥ 30 kg/m treated with apixaban or warfarin.

A Saudi Heart Association Position Statement on Cardiovascular Diseases and Diabetes Mellitus.

Background: Cardiovascular disease (CVD) and diabetes mellitus are prominent public health concerns in Saudi Arabia owing to their increasingly high prevalence and burden. Based on this, the Saudi Heart Association (SHA) set out to develop an official position statement on CVD and diabetes mellitus, with a focus on the prevention and management of these conditions and relevant special populations in the context of Saudi Arabia.

Methods: A multidisciplinary panel of experts met under the auspices of the SHA in a series of meetings to review and discuss available evidence on the prevention and management of comorbid CVD and diabetes mellitus.

Appraisal of amyloidosis imaging practices in the Middle East/North Africa (PYP-MENA).

Aims: Whereas recommendations to optimize performance and yield of cardiac scintigraphy studies with bone-seeking tracers have been published, little is known about real-world adherence to these best practices, especially outside North America and Europe. Accordingly, we described imaging practices with this modality in a sample of nuclear laboratories in the Middle East/North Africa (MENA) region.

Methods And Results: Laboratories performing radionuclide imaging for cardiac amyloidosis in the MENA region were invited to participate in this study to describe installed camera systems, type and dose of bone-avid tracers used, imaging protocols, and criteria used for study interpretation.

Cardiac Morbidity and Mortality in Patients with Sarcoma: A Population-Based Study.

Background: Soft tissue sarcoma (STS) is a rare malignancy that affects soft tissues. It encompasses various subtypes and requires different treatment strategies. Doxorubicin is a commonly used anthracycline in the management of localized and metastatic STS.

Best Practices in Nuclear Imaging for the Diagnosis of Transthyretin Amyloid Cardiomyopathy (ATTR-CM) in KSA: The Eagle Eyes of Local Experts.

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a complex and serious form of heart failure caused by the accumulation of transthyretin amyloid protein in the heart muscle. Variable symptoms of ATTR-CM can lead to a delayed diagnosis. Recognizing the diagnostic indicators is crucial to promptly detect this condition.

Incremental prognostic value of positron emission tomography-derived myocardial flow reserve in patients with and without diabetes mellitus.

Aims: We aimed to assess the incremental prognostic value of positron emission tomography (PET)-derived myocardial flow reserve (MFR) among patients with diabetes and those without diabetes.

Methods And Results: Consecutive patients with clinically indicated PET MPI for suspected or established coronary artery disease (CAD) were included. Myocardial blood flow (MBF) in mL/min/g was obtained from dynamic images at rest and stress, while MFR was calculated as the ratio of stress to rest MBF.

Successful Long-Term Anticoagulation with Low Molecular Weight Heparin in a Patient with Mechanical Mitral Valve and Atrial Flutter.

Mechanical heart valves are associated with high risk of thrombosis and thromboembolic complications. Vitamin K antagonist is the only approved oral medication for the anticoagulation in cases of mechanical heart valves. This poses a challenge in cases where vitamin K antagonists are contraindicated.

Cardiovascular magnetic resonance for suspected cardiac amyloidosis: where are we now?

Cardiac amyloidosis (CA) is an underdiagnosed form of restrictive cardiomyopathy leading to a rapid progression into heart failure. Evaluation of CA requires a multimodality approach making use of echocardiography, cardiac magnetic imaging (CMR), and nuclear imaging. With superior tissue characterization, high-resolution imaging, and precise cardiac assessment, CMR has emerged as a versatile tool in the workup of cardiac amyloidosis with a wide array of parameters both visual and quantitative.

A Vanishing Cardiac Mass.

The prevalence of extrapulmonary tuberculosis (TB) is very common in the Middle East; however, myocardial involvement is among the most infrequent manifestations of extrapulmonary TB. We present a young adult who was incidentally found to have a large right atrial tuberculoma, diagnosed by non-invasive cardiac imaging and effectively treated with standard first-line anti-TB treatment, steroids, and anticoagulation. This case is a classical presentation of nodular myocardial involvement of TB, highlighting advantages of advanced imaging, e.

The prognostic role of cardiac positron emission tomography imaging in patients with sarcoidosis: A systematic review.

Purpose: Sarcoidosis is a multi-systemic inflammatory disease of unknown etiology. Cardiac sarcoidosis (CS) has been reported in as much as 25% of patients with systemic involvement. Fluorodeoxyglucose (FDG) positron emission tomography (PET) has a high diagnostic sensitivity/specificity in the diagnosis of CS.

Myocardial Flow Reserve and Coronary Calcification in Prognosis of Patients With Suspected Coronary Artery Disease.

Objectives: The aim of this analysis is to examine the incremental prognostic value of coronary artery calcium (CAC) score and myocardial flow reserve (MFR) in patients with suspected coronary artery disease (CAD) undergoing positron emission tomography (PET) myocardial perfusion imaging (MPI).

Background: Advances in cardiac PET and computed tomography imaging enabled the simultaneous acquisition of anatomic and physiological data for patients suspected of CAD.

Methods: Consecutive patients who underwent PET MPI and CAC score calculation at King Abdulaziz Cardiac Center, Riyadh, Saudi Arabia, between May 2011 and May 2018 were included in the study.

Left ventricular mass on positron emission tomography: Validation against cardiovascular magnetic resonance.

Background: Left ventricular hypertrophy (LVH) is an important clinical finding that is independently associated with mortality and cardiovascular events. We aimed to assess the interstudy variability of LV mass quantitation between PET and CMR.

Methods: Patients who underwent both PET and CMR within 1 year were identified from prospective institutional registries.

Non-invasive Cardiac Imaging During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Statement from the Cardiac Imaging Working Group of the Saudi Heart Association.

COVID-19 pandemic has led to major changes in the delivery of medical care around the globe. Many investigations and elective procedures had to be rescheduled to decrease the risk of spreading the infection. Non-invasive cardiac imaging studies are requested to guide appropriate cardiac care in a variety of urgent, semi-urgent, and elective procedures.

Coronary artery disease in patients with human immunodeficiency virus infection.

The life expectancy of people infected with human immunodeficiency virus (HIV) is rising due to better access to combination anti-retroviral therapy (ART). Although ART has reduced acquired immune deficiency syndrome (AIDS) related mortality and morbidity, there has been an increase in non-AIDS defining illnesses such as diabetes mellitus, hypercholesterolemia and coronary artery disease (CAD). HIV is a disease marked by inflammation which has been associated with specific biological vascular processes increasing the risk of premature atherosclerosis.

Myocardial Perfusion Imaging Using Positron Emission Tomography.

Coronary artery disease (CAD), also known as ischemic heart disease, is a major cause of morbidity and mortality worldwide, and timely noninvasive diagnosis of clinical and subclinical CAD is imperative to mitigate its burden on individual patients and populations. Positron emission tomography (PET) is a versatile tool that can perform relative myocardial perfusion imaging (MPI) with high accuracy; furthermore, it provides valuable information about the coronary microvasculature using rest and stress myocardial blood flow (MBF) and coronary flow reserve (CFR) measurements. Several radiotracers are approved by the US Food and Drug Administration to help with MPI, MBF, and CFR evaluation.

Prevalence and predictors of frailty in a high-income developing country: A cross-sectional study.

Frailty is a state of vulnerability and a decreased physiological response to stressors. As the population ages, the prevalence of frailty is expected to increase. Thus, identifying tools and resources that efficiently predict frailty among the Saudi population is important.