Prognostic value of quantitative stress myocardial perfusion imaging in unstable angina patients with negative cardiac enzymes and no new ischemic ECG changes.

Background: Limited data are available on the value of quantitative stress myocardial perfusion imaging (MPI) in patients with unstable angina. In this report we sought to study the long-term prognostic value of quantitative stress MPI in patients hospitalized with unstable angina with no new ischemic electrocardiographic changes and negative cardiac enzymes.

Methods And Results: The study population consisted of 136 patients who were hospitalized at the Methodist Hospital, Houston, Tex, with unstable angina and subsequently underwent MPI before discharge.

Acute myocardial infarction and cardiac arrest in a patient receiving paclitaxel.

A 68-year-old man suffered an acute myocardial infarction while receiving an intravenous infusion of paclitaxel. Coronary angiograms revealed only mild plaquing of the infarct-related artery without significant angiographic obstructions. The authors postulate that paclitaxel may have caused coronary vasospasm and myocardial infarction.

Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography: comparison with dobutamine echocardiography and thallium-201 scintigraphy.

Background: There are currently no data on the accuracy of intravenous myocardial contrast echocardiography (MCE) in detecting myocardial hibernation in man and its comparative accuracy to dobutamine echocardiography (DE) or thallium 201 (Tl(201)) scintigraphy.

Methods And Results: Twenty patients with coronary artery disease and ventricular dysfunction underwent MCE 1 to 5 days before bypass surgery and repeat echocardiography at 3 to 4 months. Patients also underwent DE (n=18) and rest-redistribution Tl(201) tomography (n=16) before revascularization.

Gated SPECT in patients with hypertrophic obstructive cardiomyopathy undergoing transcoronary ethanol septal ablation.

Background: Transcoronary ethanol septal ablation (TESA) is a novel treatment for obstructive hypertrophic cardiomyopathy (HOCM). Our objective was to evaluate the use of gated single photon emission computed tomography (SPECT) in patients with HOCM and the effects of TESA on myocardial perfusion.

Methods And Results: We performed gated SPECT and Doppler echocardiography before and 6 weeks after TESA in 30 patients with severe HOCM.

Reversible and irreversible cardiac dysfunction associated with trastuzumab in breast cancer.

One of the newest agents used in the treatment of breast cancer is trastuzumab (Herceptin), a new recombinant DNA-derived humanized monoclonal antibody against the proto-oncogene, HER-2/neu gene product. However, despite its proven clinical efficacy, serious adverse effects leading to trastuzumab-induced cardiomyopathy have been described in up to 27% of patients receiving combination therapy with anthracyclines. There has been little published on the clinical syndrome of trastuzumab-induced cardiomyopathy.