2011
85% of maximal age-predicted heart rate is not a valid endpoint for exercise treadmill testing
Jain M, Nkonde C, Lin BA, Walker A, Wackers FJ. 85% of maximal age-predicted heart rate is not a valid endpoint for exercise treadmill testing. Journal Of Nuclear Cardiology 2011, 18: 1026-1035. PMID: 21922347, DOI: 10.1007/s12350-011-9454-0.Peer-Reviewed Original ResearchConceptsMaximal age-predicted heart rateAge-predicted heart rateInducible ischemiaPeak exerciseExercise testingPositive ECGHeart rateExercise endpointPositive exercise ECGExercise treadmill testingRegistry patientsProspective registryExercise capacityRetrospective cohortTreadmill testingPatient cohortExercise ECGValid endpointPatientsMore womenEndpointIschemiaClinical laboratoriesECGCohort
2009
Chest pain in the emergency department: role of cardiac imaging
Wackers FJ. Chest pain in the emergency department: role of cardiac imaging. Heart 2009, 95: 1023. PMID: 19478114, DOI: 10.1136/hrt.2008.152967.Peer-Reviewed Original Research
2008
Association of Leukocyte and Neutrophil Counts With Infarct Size, Left Ventricular Function and Outcomes After Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction
Chia S, Nagurney J, Brown D, Raffel O, Bamberg F, Senatore F, Wackers F, Jang I. Association of Leukocyte and Neutrophil Counts With Infarct Size, Left Ventricular Function and Outcomes After Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction. The American Journal Of Cardiology 2008, 103: 333-337. PMID: 19166685, DOI: 10.1016/j.amjcard.2008.09.085.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionLeft ventricular ejection fractionPrimary PCIST-segment elevation myocardial infarctionElevation myocardial infarctionLarger infarct sizePercutaneous coronary interventionInfarct sizeNeutrophil countMyocardial infarctionElevated leukocytesLeukocyte countCardiac eventsCoronary interventionFirst ST-segment elevation myocardial infarctionAcute Myocardial Infarction StudyST-elevation myocardial infarctionAssociation of leukocytesComposite cardiac eventsIntracellular calcium modulatorsLeft Ventricular SalvageAdverse cardiac eventsElevated leukocyte countPlacebo-controlled trialMyocardial Infarction Study
2007
A randomized, double-blind, placebo-controlled study of the safety and efficacy of intravenous MCC-135 as an adjunct to primary percutaneous coronary intervention in patients with acute myocardial infarction: Evaluation of MCC-135 for left ventricular salvage in acute myocardial infarction (EVOLVE)
Jang I, Weissman N, Picard M, Zile M, Pettigrew V, Shen S, Tatsuno J, Hibberd M, Tzivoni D, Wackers F, Investigators T. A randomized, double-blind, placebo-controlled study of the safety and efficacy of intravenous MCC-135 as an adjunct to primary percutaneous coronary intervention in patients with acute myocardial infarction: Evaluation of MCC-135 for left ventricular salvage in acute myocardial infarction (EVOLVE). American Heart Journal 2007, 155: 113.e1-113.e8. PMID: 18082500, DOI: 10.1016/j.ahj.2007.08.020.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplasty, Balloon, CoronaryBenzenesulfonatesCardiac CatheterizationCombined Modality TherapyCoronary AngiographyDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleElectrocardiographyFemaleFollow-Up StudiesHumansInfusions, IntravenousMaleMiddle AgedMyocardial InfarctionPiperazinesProbabilityReference ValuesRisk AssessmentSalvage TherapyStroke VolumeSurvival RateTreatment OutcomeVentricular Function, LeftConceptsPrimary percutaneous coronary interventionLeft ventricular ejection fractionST-elevation myocardial infarctionPrimary PCIMCC-135Percutaneous coronary interventionAcute myocardial infarctionInfarct sizeMyocardial infarctionDay 5Coronary interventionClinical outcomesCalcium overloadPreservation of LVEFAcute ST-elevation myocardial infarctionEnd pointTarget populationComposite clinical outcomeLeft Ventricular SalvagePlacebo-controlled studyPrimary end pointSecondary end pointsLow-dose groupVentricular ejection fractionHigh-dose groupResolution of Asymptomatic Myocardial Ischemia in Patients With Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study
Wackers FJ, Chyun DA, Young LH, Heller GV, Iskandrian AE, Davey JA, Barrett EJ, Taillefer R, Wittlin SD, Filipchuk N, Ratner RE, Inzucchi SE. Resolution of Asymptomatic Myocardial Ischemia in Patients With Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study. Diabetes Care 2007, 30: 2892-2898. PMID: 17682123, DOI: 10.2337/dc07-1250.Peer-Reviewed Original ResearchConceptsResolution of ischemiaType 2 diabetesDetection of ischemiaNew ischemiaAsymptomatic Diabetics (DIAD) studyCardiovascular risk factorsAsymptomatic myocardial ischemiaAdenosine stress myocardial perfusionRepeat stressIschemia increasesAsymptomatic patientsCardiac eventsMore patientsACE inhibitorsMyocardial ischemiaRisk factorsIntensive treatmentDiabetic studyIschemiaMyocardial perfusionPatientsMedical treatmentDiabetesInitial evaluationGreater increase
2005
New hybrid count- and geometry-based method for quantification of left ventricular volumes and ejection fraction from ECG-gated SPECT: Methodology and validation
Liu YH, Sinusas AJ, Khaimov D, Gebuza BI, Wackers FJ. New hybrid count- and geometry-based method for quantification of left ventricular volumes and ejection fraction from ECG-gated SPECT: Methodology and validation. Journal Of Nuclear Cardiology 2005, 12: 55-65. PMID: 15682366, DOI: 10.1016/j.nuclcard.2004.09.015.Peer-Reviewed Original ResearchMeSH KeywordsAdultAlgorithmsElectrocardiographyFemaleGated Blood-Pool ImagingHumansImage Interpretation, Computer-AssistedMaleMiddle AgedPhantoms, ImagingReproducibility of ResultsSensitivity and SpecificitySeverity of Illness IndexStroke VolumeTomography, Emission-Computed, Single-PhotonVentricular Dysfunction, Left
2003
Prognostic significance of ischemic electrocardiographic changes during adenosine infusion in patients with normal myocardial perfusion imaging
Abbott B, Afshar M, Berger A, Wackers F. Prognostic significance of ischemic electrocardiographic changes during adenosine infusion in patients with normal myocardial perfusion imaging. Journal Of Nuclear Cardiology 2003, 10: 9-16. PMID: 12569326, DOI: 10.1067/mnc.2002.127625.Peer-Reviewed Original ResearchConceptsNormal myocardial perfusion imagingAdenosine myocardial perfusion imagingST-segment depressionMyocardial perfusion imagingIschemic ECG changesCardiac eventsECG changesAdenosine infusionCardiac deathPrognostic significanceECG groupNormal myocardial perfusion imagesBaseline electrocardiographic abnormalitiesAdverse cardiac eventsIschemic electrocardiographic changesNonfatal myocardial infarctionSubsequent cardiac eventsFuture cardiac eventsNormal myocardial perfusionSex-matched groupPerfusion imagesECG evidenceElectrocardiographic abnormalitiesIndependent predictorsElectrocardiographic changes
2002
Pharmacologic stress perfusion imaging with adenosine: Role of simultaneous low-level treadmill exercise
Samady H, Wackers FJ, Joska TM, Zaret BL, Jain D. Pharmacologic stress perfusion imaging with adenosine: Role of simultaneous low-level treadmill exercise. Journal Of Nuclear Cardiology 2002, 9: 188-196. PMID: 11986564, DOI: 10.1067/mnc.2002.119973.Peer-Reviewed Original ResearchConceptsLow-level treadmill exerciseMyocardial perfusion imagingTreadmill exerciseElectrocardiographic changesAdverse effectsAdenosine myocardial perfusion imagingSestamibi single-photon emissionPharmacologic stress myocardial perfusion imagingStress myocardial perfusion imagingIschemic electrocardiographic changesLow-level exerciseMore adverse effectsUnfavorable side effectsSingle photon emissionAdenosine studyAdenosine TcMore patientsMyocardial ischemiaHemodynamic responseStress perfusionSide effectsPerfusion imagingTracer uptakePatientsMPI studies
2001
Selective use of single-photon emission computed tomography myocardial perfusion imaging in a chest pain center
Abbott B, Abdel-Aziz I, Nagula S, Monico E, Schriver J, Wackers F. Selective use of single-photon emission computed tomography myocardial perfusion imaging in a chest pain center. The American Journal Of Cardiology 2001, 87: 1351-1355. PMID: 11397352, DOI: 10.1016/s0002-9149(01)01551-x.Peer-Reviewed Original ResearchConceptsChest pain centerChest pain patientsCoronary artery diseasePain patientsSingle photon emissionChest painPain centerArtery diseaseMyocardial infarctionEmergency department chest pain centersEmergency department chest pain patientsTomography myocardial perfusion imagingTomography myocardial perfusionAcute myocardial infarctionMyocardial perfusion imagingSelective useCPC patientsNonischemic electrocardiogramHospital dischargeAppropriate patientsHospital admissionFinal diagnosisMyocardial perfusionPatientsPerfusion imaging
2000
Association of patients’ perception of health status and exercise electrocardiogram, myocardial perfusion imaging, and ventricular function measures
Mattera J, de Leon C, Wackers F, Williams C, Wang Y, Krumholz H. Association of patients’ perception of health status and exercise electrocardiogram, myocardial perfusion imaging, and ventricular function measures. American Heart Journal 2000, 140: 409-418. PMID: 10966538, DOI: 10.1067/mhj.2000.108518.Peer-Reviewed Original ResearchConceptsGeneral health perceptionHealth-related qualityPhysical functioningHealth perceptionMyocardial perfusion imagingHealth statusExercise testingPerfusion imagingMedical Outcomes Study Short Form SurveyPatients' health-related qualityShort Form SurveyAssociation of patientGeneral health statusImportant outcome measureSuccess of treatmentConsecutive patientsSF-36Metabolic equivalentsNoninvasive testingExercise testPatient outcomesIndividual patientsOutcome measuresForm SurveyPatient's viewpointReproducibility and accuracy of gated SPECT for determination of left ventricular volumes and ejection fraction: experimental validation using MRI.
Vallejo E, Dione DP, Bruni WL, Constable RT, Borek PP, Soares JP, Carr JG, Condos SG, Wackers FJ, Sinusas AJ. Reproducibility and accuracy of gated SPECT for determination of left ventricular volumes and ejection fraction: experimental validation using MRI. Journal Of Nuclear Medicine 2000, 41: 874-82; discussion 883-6. PMID: 10809204.Peer-Reviewed Original ResearchAn economic analysis of an aggressive diagnostic strategy with single photon emission computed tomography myocardial perfusion imaging and early exercise stress testing in emergency department patients who present with chest pain but nondiagnostic electrocardiograms: Results from a randomized trial
Stowers S, Eisenstein E, Wackers F, Berman D, Blackshear J, Jones A, Szymanski T, Lam L, Simons T, Natale D, Paige K, Wagner G. An economic analysis of an aggressive diagnostic strategy with single photon emission computed tomography myocardial perfusion imaging and early exercise stress testing in emergency department patients who present with chest pain but nondiagnostic electrocardiograms: Results from a randomized trial. Annals Of Emergency Medicine 2000, 35: 17-25. PMID: 28140201, DOI: 10.1016/s0196-0644(00)70100-4.Peer-Reviewed Original ResearchMeSH KeywordsAgedChest PainClinical ProtocolsCoronary AngiographyCost ControlElectrocardiographyEmergency TreatmentExercise TestFemaleHospital CostsHumansLength of StayMaleMedicareMiddle AgedMyocardial InfarctionReproducibility of ResultsRisk FactorsSingle-Blind MethodTomography, Emission-Computed, Single-PhotonUnited StatesConceptsEarly exercise stress testingExercise stress testingLength of stayChest painHospital costsSingle photon emissionCoronary angiographyStress testingDiagnostic strategiesTomography myocardial perfusion imagingCost/charge ratiosAggressive diagnostic strategyNegative scan resultsPositive scan resultsAcute chest painIntermediate-risk patientsAcute coronary syndromeExercise treadmill testingAdverse clinical outcomesShorter median lengthEmergency department patientsAcute myocardial infarctionScan resultsMyocardial perfusion imagingPhoton emission
1999
Quantification of regional myocardial wall thickening on electrocardiogram-gated SPECT imaging
Shen M, Liu Y, Sinusas A, Fetterman R, Bruni W, Drozhinin O, Zaret B, Wackers F. Quantification of regional myocardial wall thickening on electrocardiogram-gated SPECT imaging. Journal Of Nuclear Cardiology 1999, 6: 583-595. PMID: 10608585, DOI: 10.1016/s1071-3581(99)90095-8.Peer-Reviewed Original ResearchMeSH KeywordsAlgorithmsComputer SimulationDiastoleElectrocardiographyHeart VentriclesHumansImage Processing, Computer-AssistedModels, CardiovascularMyocardial InfarctionObserver VariationPhantoms, ImagingPilot ProjectsRadiopharmaceuticalsReproducibility of ResultsSoftwareSystoleTechnetium Tc 99m SestamibiTomography, Emission-Computed, Single-PhotonVentricular Function, LeftVentricular RemodelingVentriculography, First-PassConceptsPrior myocardial infarctionRegional wall thickeningNormal subjectsMyocardial infarctionWall thickeningNormal wall thickeningPilot studyRegional left ventricular functionLeft ventricular functionAbnormal wall thickeningPercent count increaseECG-gated SPECT imagesSingle photon emissionSPECT imagesCardiac cycleLeft ventricular wallReproducibility of interpretationRegional left ventricular wallPrior infarctionCoronary diseaseVentricular functionValidation studyInfarct areaNormal rangeAnatomic areasCan acute rest imaging shorten evaluation in chest pain centers?
Wackers F. Can acute rest imaging shorten evaluation in chest pain centers? Journal Of Nuclear Cardiology 1999, 6: 676-678. PMID: 10608597, DOI: 10.1016/s1071-3581(99)90106-x.Peer-Reviewed Original Research
1998
Exercise testing with myocardial perfusion imaging in patients with normal baseline electrocardiograms: Cost savings with a stepwise diagnostic strategy
Mattera J, Arain S, Sinusas A, Finta L, Wackers F. Exercise testing with myocardial perfusion imaging in patients with normal baseline electrocardiograms: Cost savings with a stepwise diagnostic strategy. Journal Of Nuclear Cardiology 1998, 5: 498-506. PMID: 9796897, DOI: 10.1016/s1071-3581(98)90181-7.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCoronary DiseaseCost SavingsElectrocardiographyExercise TestFemaleFollow-Up StudiesHeartHumansMaleMiddle AgedRadionuclide ImagingConceptsExercise myocardial perfusion imagingCoronary artery diseaseNormal exercise electrocardiogramMyocardial perfusion imagingNormal myocardial perfusion imagingNormal resting electrocardiogramsExercise electrocardiogramExercise testingArtery diseaseIntermediate likelihoodResting electrocardiogramsAbnormal myocardial perfusion imagingDiagnostic strategiesAbnormal exercise electrocardiogramGroup 3 patientsHard cardiac eventsNonfatal myocardial infarctionNormal baseline electrocardiogramSubsequent coronary revascularizationIncremental diagnostic informationDiagnostic testing strategiesCoronary revascularizationCardiac eventsUnstable anginaConsecutive patientsClinical Value of Acute Rest Technetium-99m Tetrofosmin Tomographic Myocardial Perfusion Imaging in Patients With Acute Chest Pain and Nondiagnostic Electrocardiograms
Heller G, Stowers S, Hendel R, Herman S, Daher E, Ahlberg A, Baron J, de Leon C, Rizzo J, Wackers F. Clinical Value of Acute Rest Technetium-99m Tetrofosmin Tomographic Myocardial Perfusion Imaging in Patients With Acute Chest Pain and Nondiagnostic Electrocardiograms. Journal Of The American College Of Cardiology 1998, 31: 1011-1017. PMID: 9562001, DOI: 10.1016/s0735-1097(98)00057-6.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionTomographic myocardial perfusionMyocardial infarctionChest painNondiagnostic electrocardiogramEmergency departmentHospital periodHospital admissionRest technetiumTetrofosmin SPECTMyocardial perfusionLow cardiac event rateTetrofosmin single photon emissionMultiple logistic regression analysisAcute chest painCardiac event rateNormal SPECT imagesMean cost savingsUnnecessary hospital admissionsLogistic regression analysisSingle photon emissionSPECT imagesAbnormal SPECTCardiac eventsRest Tc
1996
Distortion of the Terminal Portion of the QRS on the Admission Electrocardiogram in Acute Myocardial Infarction and Correlation With Infarct Size and Long-Term Prognosis (Thrombolysis In Myocardial Infarction 4 Trial)**This study was supported in part by a grant from SmithKline Beecham, Philadelphia, Pennsylvania.
Birnbaum Y, Kloner R, Sclarovsky S, Cannon C, McCabe C, Davis V, Zaret B, Wackers F, Braunwald E. Distortion of the Terminal Portion of the QRS on the Admission Electrocardiogram in Acute Myocardial Infarction and Correlation With Infarct Size and Long-Term Prognosis (Thrombolysis In Myocardial Infarction 4 Trial)**This study was supported in part by a grant from SmithKline Beecham, Philadelphia, Pennsylvania. The American Journal Of Cardiology 1996, 78: 396-403. PMID: 8752182, DOI: 10.1016/s0002-9149(96)00326-8.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAngina PectorisCardiac Output, LowCoronary AngiographyCreatine KinaseDouble-Blind MethodElectrocardiographyFemaleFollow-Up StudiesHumansMaleMiddle AgedMyocardial InfarctionPatient AdmissionPrognosisRecurrenceRetrospective StudiesStroke VolumeSurvival RateTechnetium Tc 99m SestamibiThrombolytic TherapyTreatment OutcomeVentricular Function, LeftConceptsAcute myocardial infarctionLong-term prognosisAnterior acute myocardial infarctionCreatine kinase releaseInfarct sizeMyocardial infarctionMyocardial infarction (TIMI) 4 trialAnterior AMI patientsOne-year mortalityCoronary angiographic findingsLarger infarct sizeVentricular ejection fractionAdmission electrocardiogramHospital mortalityPrevious anginaSestamibi defectsAngiographic findingsBaseline characteristicsEjection fractionHeart failureAMI patientsClinical outcomesQRS distortionPatientsEnd pointDetection and significance of myocardial ischemia in women versus men within six months of acute myocardial infarction or unstable angina
Moriel M, Benhorin J, Brown M, Raubertas R, Severski P, Van Voorhees L, Bodenheimer M, Tzivoni D, Wackers F, Moss A, Group T. Detection and significance of myocardial ischemia in women versus men within six months of acute myocardial infarction or unstable angina. The American Journal Of Cardiology 1996, 77: 798-804. PMID: 8623730, DOI: 10.1016/s0002-9149(97)89172-2.Peer-Reviewed Original ResearchConceptsAcute coronary eventsThallium-201 stress scintigraphyPrimary end pointCoronary eventsEnd pointUnstable anginaStress scintigraphyPatient 1Myocardial infarctionNoninvasive testsExercise electrocardiogramAmbulatory electrocardiogramIschemia detectionCardiac event rateNonfatal myocardial infarctionSubsequent cardiac eventsAcute myocardial infarctionCardiac eventsIschemia testCardiac deathCox analysisPrognostic significanceMyocardial ischemiaEvent ratesWomen
1994
Limited usefulness of exercise testing and thallium scintigraphy in evaluation of ambulator patients several months after recovery from an acute coronary event: Implications for management of stable coronary heart disease
Krone R, Gregory J, Freedland K, Kleiger R, Wackers F, Bodenheimer M, Benhorin J, Schwartz R, Parker J, van Voorhees L, Moss A, Group F. Limited usefulness of exercise testing and thallium scintigraphy in evaluation of ambulator patients several months after recovery from an acute coronary event: Implications for management of stable coronary heart disease. Journal Of The American College Of Cardiology 1994, 24: 1274-1281. PMID: 7930250, DOI: 10.1016/0735-1097(94)90109-0.Peer-Reviewed Original ResearchConceptsStable coronary diseaseAcute coronary eventsNonfatal myocardial infarctionThallium-201 scintigraphyCardiac eventsCoronary eventsCoronary diseaseCardiac deathHospital admissionMyocardial infarctionNonfatal infarctionEnd pointUnstable anginaExercise testingObstructive coronary artery diseaseStable coronary heart diseaseExercise testing variablesSubsequent cardiac eventsCoronary artery diseaseGroup of patientsCoronary heart diseaseProportional hazards modelThallium perfusionCardiac causesIdentifies patientsExercise myocardial perfusion imaging.
Wackers F. Exercise myocardial perfusion imaging. Journal Of Nuclear Medicine 1994, 35: 726-9. PMID: 8151402.Peer-Reviewed Original ResearchMeSH KeywordsCoronary CirculationCoronary DiseaseElectrocardiographyExercise TestHeartHumansSurvival RateTomography, Emission-Computed, Single-Photon