Myocardial Perfusion Imaging (MPI): Performance, Potential Risks and Outcomes


Fadi Gabriel Hage, M.D. (Editor)
Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, US

Series: Cardiology Research and Clinical Developments
BISAC: MED010000

Myocardial perfusion imaging (MPI) is the most commonly used non-invasive stress imaging test for the diagnosis and risk stratification of coronary artery disease. Although MPI has been around for decades, recent advances have made possible fundamental changes in the performance of this test. While exercise is the preferred modality of stress with MPI, pharmacologic stress testing can be used when exercise is not an option due to contra-indications or when patients are unable to achieve an adequate level of exercise. MPI provides a wealth of diagnostic and prognostic data encompassing both perfusion and non-perfusion variables that can guide patient management. The non-perfusion data include exercise variables, hemodynamic response to exercise or pharmacologic stress, electrocardiographic changes and left ventricular dyssynchrony. The test is widely used for risk stratification in patients with suspected or known to have coronary disease, but has also found special applications in evaluation prior to kidney or liver transplantation.
While stress testing, whether with exercise or pharmacologic stress, it is relatively important to be cognizant of adverse effects that can be encountered in the stress laboratory, especially in high risk and special populations, and to have plans to manage these appropriately. There has been increasing emphasis on the ionizing radiation exposure to patients from medical diagnostic imaging including MPI. It is therefore essential to be aware of novel protocols that can be implemented in day-to-day practice to reduce radiation exposure to patients and staff without adversely affecting the diagnostic quality of the studies.

Table of Contents

Table of Contents


Chapter 1. Stress Testing in Myocardial Perfusion Imaging: A Practical Guide for Performance
(Amalia Peix, MD, PhD and Vanessa Peña, MD, Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, Havana, Cuba, and others)

Chapter 2. Artifacts and Incidental Findings on Myocardial Perfusion Imaging
(Rayan Saab, MD, Ayman Farag, MD, Sharon White, PhD, Fadi Hage, MD, Pradeep Bhambhvani, MD, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, US, and others)

Chapter 3. The Prognostic Value of Cardiorespiratory Fitness and Exercise Stress Testing
(Ahmed Aljizeeri and Mouaz H. Al-Mallah, MD, King Abdulaziz Cardiac Center, King Abdualaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia, and others)

Chapter 4. Prognostic Value of Myocardial Perfusion Imaging
(Mouin Abdallah, MD, and Harshal Patil, Assistant Professor of Medicine, Case Western Reserve University, Robert and Suzanne Tomsich, Department of Cardiovascular Medicine at Cleveland Clinic, Cleveland, OH, US)

Chapter 5. Prognostic Significance of Non-Perfusion Variables Obtained from Exercise and Vasodilator Stress Myocardial Perfusion Imaging
(Hussein Abu Daya, MD, Amier Ahmad, MD, Farah Abou Daya, and Fadi G. Hage, MD, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, US, and others)

Chapter 6. Assessment of Cardiac Dyssynchrony Using Radionuclide Imaging: Performance and Outcomes
(Saurabh Malhotra, MD and Prem Soman, MD, PhD, Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, US, and others)

Chapter 7. Use of Myocardial Perfusion Imaging in the Assessment of Patients Undergoing Solid Organ Transplant
(Nadia El Hangouche, MD and Rami Doukky MD, Division of Cardiology, Cook County Health and Hospitals System, Chicago, IL, US, and others)

Chapter 8. Novel Protocols for Radiation Reduction and Faster Acquisition
(Tarun Tandon, MD and W. Lane Duvall, MD, Preventive/Non-Invasive Cardiology Fellow, Division of Cardiology, Hartford Hospital, Hartford, CT, US, and others)

Chapter 9. Adverse Effects Associated with Vasodilator Stress Testing
(Efstathia Andrikopoulou, MD and Fadi G. Hage, MD, Sub-Division of Non-Invasive Cardiovascular Imaging, Division of Cardiovascular Disease, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, US, and others)

Chapter 10. Safety of Regadenoson as a Pharmacologic Stress Agent in Patients with Chronic Kidney and Pulmonary Disease
(Stephanie El-Hajj, MD, Milad El-Hajj, MD and Fadi G. Hage, MD, Division of Cardiovascular Disease, Department of Medicine, Medical University of South Carolina, Charleston, SC, US, and others)


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