Can regional training courses reduce interobserver variability?

Cardiovascular disease (CVD) is the principal cause of death worldwide. Noninvasive studies have been used for the evaluation of CVD. Ensuring an accurate diagnosis of CVD requires well-trained and qualified professionals. IAEA has implemented regional training courses which are mainly aimed at professionals from countries with less economic development in order to raise their professional level so that it is in accordance with international standards and thus be able to homogenize the practice of nuclear cardiology globally.

Comorbid conditions in individuals assessed by SPECT: Study of a reference cardiology center in Mexico City.

BACKGROUND: There is an increasing prevalence of comorbidities in patients with ischemic heart disease (IHD) in developing countries. The aim of this work is to assess the prevalence of comorbidities and associated factors for IHD among patients at a reference cardiology center. DESIGN AND METHODS: This was a cross-sectional study. A complete clinical history which focused on the main comorbidities, previous myocardial infarction, and the main reason of referral was assessed. A single-photon emission computed tomography (SPECT) myocardial perfusion study (MPS) with two protocols was performed. RESULTS: We included 1998 patients, 64.2% male, median age 63 (I.R.: 56-71) years. 1514 (75.8%) subjects had at least one associated comorbidity. The main comorbidity was diabetes (T2D) (772: 38.6%), followed by systemic hypertension (737: 36.9%), smoking (518: 25.9%), and dyslipidemia (517: 25.9%). 806 (40.3%) had histories of previous myocardial infarctions. The main cause of referral was angina (923: 46.2%). We identified 1330 (66.5%) abnormal MPS. 460 (23%) had ischemia, 292 (14.6%) infarction, and 578 (28.9%) ischemia and infarction. CONCLUSION: An increased prevalence of comorbidities was found in patients who were studied in the Nuclear Cardiology Department (NCD): most of them had traditional risk factors attributable to myocardial infarction. A great percentage were newly diagnosed with both ischemia and infarction.

Assessment of Atypical Cardiovascular Risk Factors Using Single Photon Emission Computed Tomography in Mexican Women.

BACKGROUND: Ischemic heart disease (IHD) is a health care problem in women that increases morbimortality, particularly in developing countries. There is limited information regarding atypical risk factors associated with IHD in Mexican women. AIM: To explore risk factors in women that could contribute to IHD and myocardial dysfunction using the single photon emission computed tomography (SPECT) myocardial perfusion study (MPS). METHODS: We designed a cross-sectional study in which we evaluated atypical and typical risk factors using a clinical questionnaire. We performed a SPECT-MPS to evaluate the presence of ischemia/infarction, decreased left ventricular ejection fraction, systolic dyssynchrony and diastolic function by peak filling rate and time to peak filling rate. RESULTS: 172 women were included, 64 with IHD. Adverse events during pregnancy (premature birth and miscarriage), rheumatoid arthritis, gynecological conditions (menopause and age of first menstruation) and low educational level, together with previously known typical risk factors were associated with infarction or ischemia and ventricular dysfunction. Potential associated factors for systolic dyssynchrony were rheumatoid arthritis (OR: 2.90, 95% CI: 0.95-8.66, p = 0.054) and history of premature birth (OR: 0.13, 95% CI: 0.01-0.66, p <0.01). Although those women with arterial hypertension and smoking shown an increased risk for dyssynchrony, these factors were not statistically significant. Low-educational level (OR 2.16, 95% CI 1.1-4.18, p = 0.019) was associated with decreased peak filling rate. CONCLUSION: The presence of atypical risk factors in women could lead to decreased myocardial function, particularly in women at risk of developing IHD.

[A septal rupture of atypical location after myocardial infarction. A clinical case]. / Ruptura septal de localización atípica posterior a infarto del miocardio. Caso clínico

Paciente masculino de 46 años de edad con antecedentes personales de hipertensión arterial sistémica, tabaquismo y etilismo y heredofamiliares de hipertensión arterial sistémica. El padecimiento inició con cuadro de astenia, adinamia, disnea progresiva, edema de miembros inferiores y aumento del volumen abdominal, por lo que acudió con el médico, quien decidió hospitalizarlo. El paciente recibió tratamiento médico con captopril, furosemida y espironolactona, sin mejoría de los síntomas, motivo por el cual se lo refirió a la institución de los autores. Al llegar al servicio de urgencias, el sujeto se encontraba estable.