2017
Physical inactivity and cardiac events: An analysis of the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study
McCarthy M, Wackers F, Davey J, Chyun D. Physical inactivity and cardiac events: An analysis of the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. Journal Of Clinical & Translational Endocrinology 2017, 9: 8-14. PMID: 29067262, PMCID: PMC5651289, DOI: 10.1016/j.jcte.2017.05.005.Peer-Reviewed Original ResearchCoronary artery diseaseHigher pulse pressurePremature coronary artery diseaseCAD eventsPhysical inactivityPulse pressureDetection of ischemiaPeripheral numbnessDiabetes durationIndependent predictorsHip ratioFamily historyOlder adultsAsymptomatic Diabetics (DIAD) studyCAD event ratesProportional hazard modelingImportant risk factorType 2 diabetesCause of deathAsymptomatic diabeticsInsulin useBaseline characteristicsCardiac eventsArtery diseaseHemoglobin A1c
2015
Kinetics of Conventional and New Cardiac Radiotracers
Taillefer R, Wackers F. Kinetics of Conventional and New Cardiac Radiotracers. 2015, 58-80. DOI: 10.1093/med/9780199392094.003.0004.Peer-Reviewed Original ResearchMyocardial blood flowDetection of obstructive coronary artery diseaseObstructive coronary artery diseaseBlood flowSympathetic neuronal functionCellular mechanism of uptakeCoronary artery diseaseCardiac imaging protocolImage myocardial perfusionTime of imagingQuantification of regional myocardial blood flowAdjacent organsClinical impactArtery diseaseMyocardial perfusionCardiac imagingCardiac metabolismRegional myocardial blood flowImaging protocolCellular mechanismsNeuronal functionMyocardial extractionCardiac imaging agentMechanism of uptakeImaging agents
2012
Gender-based divergence of cardiovascular outcomes in asymptomatic patients with type 2 diabetes: Results from the DIAD study
Tandon S, Wackers F, Inzucchi SE, Bansal S, Staib LH, Chyun DA, Davey JA, Young LH. Gender-based divergence of cardiovascular outcomes in asymptomatic patients with type 2 diabetes: Results from the DIAD study. Diabetes And Vascular Disease Research 2012, 9: 124-130. PMID: 22228772, DOI: 10.1177/1479164111431470.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsymptomatic DiseasesCanadaCardiovascular DiseasesDiabetes ComplicationsDiabetes Mellitus, Type 2FemaleHumansIncidenceKaplan-Meier EstimateMaleMass ScreeningMiddle AgedMyocardial Perfusion ImagingPredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsSex FactorsTime FactorsUnited StatesConceptsType 2 diabetesMyocardial perfusion imagingCardiovascular outcomesStress myocardial perfusion imagingAsymptomatic Diabetics (DIAD) studyBetter cardiac outcomesHigh-risk womenCoronary artery diseaseHigh-risk menDetection of ischemiaMPI abnormalitiesAsymptomatic patientsAsymptomatic menCardiac eventsCardiac outcomesArtery diseaseAsymptomatic womenAbnormal screeningDiabetic studyPerfusion imagingDIAD studyWomenMenDiabetesOutcomes
2010
CARDIAC OUTCOMES AFTER SCREENING FOR ASYMPTOMATIC CORONARY ARTERY DISEASE IN PATIENTS WITH METABOLIC SYNDROME: POST-HOC ANALYSIS OF THE DIAD TRIAL
Bansal S, Wackers F, Inzucchi S, Young L, Chyun D. CARDIAC OUTCOMES AFTER SCREENING FOR ASYMPTOMATIC CORONARY ARTERY DISEASE IN PATIENTS WITH METABOLIC SYNDROME: POST-HOC ANALYSIS OF THE DIAD TRIAL. Journal Of The American College Of Cardiology 2010, 55: a141.e1325. DOI: 10.1016/s0735-1097(10)61326-5.Peer-Reviewed Original Research
2009
Cardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes : The DIAD Study: A Randomized Controlled Trial
Young LH, Wackers FJ, Chyun DA, Davey JA, Barrett EJ, Taillefer R, Heller GV, Iskandrian AE, Wittlin SD, Filipchuk N, Ratner RE, Inzucchi SE, Investigators F. Cardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes : The DIAD Study: A Randomized Controlled Trial. JAMA 2009, 301: 1547-1555. PMID: 19366774, PMCID: PMC2895332, DOI: 10.1001/jama.2009.476.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseType 2 diabetesNonfatal myocardial infarctionAsymptomatic coronary artery diseaseMyocardial perfusion imagingCardiac event rateMyocardial infarctionCardiac deathMPI defectsCardiac outcomesEvent ratesScreened groupArtery diseaseSymptoms of CADRadionuclide myocardial perfusion imagingAsymptomatic Diabetics (DIAD) studyHigh cardiac riskLow event ratesPositive predictive valueDetection of ischemiaPrimary medical preventionCoronary revascularizationDiabetes clinicIdentifies patientsControlled TrialsDetection of coronary artery disease with perfusion stress echocardiography using a novel ultrasound imaging agent: two Phase 3 international trials in comparison with radionuclide perfusion imaging
Senior R, Monaghan M, Main M, Zamorano J, Tiemann K, Agati L, Weissman N, Klein A, Marwick T, Ahmad M, DeMaria A, Zabalgoitia M, Becher H, Kaul S, Udelson J, Wackers F, Walovitch R, Picard M. Detection of coronary artery disease with perfusion stress echocardiography using a novel ultrasound imaging agent: two Phase 3 international trials in comparison with radionuclide perfusion imaging. European Heart Journal - Cardiovascular Imaging 2009, 10: 26-35. PMID: 19131498, DOI: 10.1093/ejechocard/jen321.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overArea Under CurveContrast MediaCoronary Artery DiseaseDipyridamoleEchocardiography, StressFemaleFluorocarbonsGated Blood-Pool ImagingHumansImage EnhancementImage Interpretation, Computer-AssistedInternational CooperationMaleMiddle AgedObserver VariationROC CurveSensitivity and SpecificityStatistics, NonparametricTomography, Emission-Computed, Single-PhotonYoung AdultConceptsChest pain patientsPain patientsStress echocardiographyPerfusion imagingNon-inferior sensitivityPhase 3 trialCoronary artery diseaseCoronary artery disease detectionQuantitative coronary angiographyNon-inferiority analysisRadionuclide perfusion imagingSingle photon emissionAdverse eventsArtery diseaseCoronary angiographyBlinded cardiologistsClinical reviewDipyridamole stressMyocardial perfusionSPECT perfusionInternational trialRAMP 1Diagnostic performanceSPECTCharacteristic curve
2008
Different manifestations of coronary artery disease by stress SPECT myocardial perfusion imaging, coronary calcium scoring, and multislice CT coronary angiography in asymptomatic patients with type 2 diabetes mellitus
Scholte A, Schuijf J, Kharagjitsingh A, Dibbets-Schneider P, Stokkel M, Jukema J, van der Wall E, Bax J, Wackers F. Different manifestations of coronary artery disease by stress SPECT myocardial perfusion imaging, coronary calcium scoring, and multislice CT coronary angiography in asymptomatic patients with type 2 diabetes mellitus. Journal Of Nuclear Cardiology 2008, 15: 503-509. PMID: 18674717, DOI: 10.1016/j.nuclcard.2008.02.015.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCalcinosisComorbidityCoronary Artery DiseaseDiabetes Mellitus, Type 2FemaleHumansIncidenceMaleMiddle AgedNetherlandsReproducibility of ResultsRisk AssessmentRisk FactorsSensitivity and SpecificityTomography, Emission-Computed, Single-PhotonTomography, X-Ray ComputedVentricular Dysfunction, LeftConceptsType 2 diabetes mellitusCoronary artery diseaseMSCT coronary angiographyAsymptomatic patientsCoronary angiographyDiabetes mellitusPositive CAC scoreMyocardial perfusion imagingCAC scoreCoronary atherosclerosisArtery diseaseCAC scoringCalcium scoringPerfusion imagingAbnormal diagnostic test resultsSilent coronary artery diseaseStress single-photon emissionCoronary artery calcium scoringMultislice CT coronary angiographyTomography myocardial perfusion imagingStress SPECT myocardial perfusion imagingSilent coronary atherosclerosisSPECT myocardial perfusion imagingRelative prognostic valueTomographic coronary angiography
2006
Screening Asymptomatic Diabetic Patients for Coronary Artery Disease Why Not?
Miller T, Redberg R, Wackers F. Screening Asymptomatic Diabetic Patients for Coronary Artery Disease Why Not? Journal Of The American College Of Cardiology 2006, 48: 761-764. PMID: 16904546, DOI: 10.1016/j.jacc.2006.04.076.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseAsymptomatic diabetic patientsDiabetic patientsArtery diseaseSilent coronary artery diseaseStress single-photon emissionImportant coronary artery diseaseAnti-ischemic medicationNon-diabetic patientsClinical scoring systemAbnormal SPECT imagesSingle photon emissionCardiovascular eventsAggressive treatmentDiabetes statusPatient subsetsHigh prevalenceScreening programElevated riskHigh riskPatientsConsensus documentTrue prevalenceScoring systemDIAD studyThe Impact of Screening for Asymptomatic Myocardial Ischemia in Individuals With Type 2 Diabetes
Chyun DA, Katten DM, Melkus GD, Talley S, Davey JA, Wackers FJ. The Impact of Screening for Asymptomatic Myocardial Ischemia in Individuals With Type 2 Diabetes. The Journal Of Cardiovascular Nursing 2006, 21: e1-e7. PMID: 16601520, DOI: 10.1097/00005082-200603000-00015.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAntihypertensive AgentsAnxietyAspirinDepressionDiabetes Mellitus, Type 2EmotionsFemaleFibrinolytic AgentsFollow-Up StudiesHealth BehaviorHumansHypolipidemic AgentsMaleMass ScreeningMiddle AgedMotor ActivityMultivariate AnalysisMyocardial IschemiaPersonal AutonomyProspective StudiesQuality of LifeRisk AssessmentSocioeconomic FactorsConceptsCoronary artery diseaseType 2 diabetesAsymptomatic coronary artery diseasePoor emotional outcomesAsymptomatic myocardial ischemiaRisk factor behaviorsImpact of screeningSelf-administered questionnaireAggressive screeningArtery diseaseProspective studyStudy baselineMyocardial ischemiaScreening TrialMyocardial perfusionEmotional outcomesOutcomesDiabetesBehavior outcomesLaboratory testsLow levelsScreeningHigh levelsIschemiaPerfusionScreening of asymptomatic patients with type 2 diabetes mellitus for silent coronary artery disease: Combined use of stress myocardial perfusion imaging and coronary calcium scoring
Scholte A, Bax J, Wackers F. Screening of asymptomatic patients with type 2 diabetes mellitus for silent coronary artery disease: Combined use of stress myocardial perfusion imaging and coronary calcium scoring. Journal Of Nuclear Cardiology 2006, 13: 11-18. PMID: 16464712, DOI: 10.1016/j.nuclcard.2005.11.002.Peer-Reviewed Original ResearchMeSH KeywordsAlgorithmsCalcinosisComorbidityCoronary Artery DiseaseDiabetes Mellitus, Type 2Diagnosis, Computer-AssistedExercise TestHumansIncidenceMass ScreeningPrognosisRadionuclide ImagingReproducibility of ResultsRisk AssessmentRisk FactorsSensitivity and SpecificitySurvival RateVentricular Dysfunction, LeftConceptsSilent coronary artery diseaseCoronary artery diseaseCoronary calcium scoringType 2 diabetes mellitusMyocardial perfusion imagingArtery diseaseDiabetes mellitusCalcium scoringPerfusion imagingAsymptomatic individualsStress myocardial perfusion imagingRadionuclide myocardial perfusion imagingEarly appropriate treatmentRecent prospective studiesRates of morbidityAsymptomatic patientsCardiovascular complicationsProspective studyOverall prevalenceClinical combinationAppropriate treatmentClinical investigationMellitusClinical importanceDisease
2004
Abnormal heart rate response to adenosine infusion is associated with silent myocardial ischemia in asymptomatic patients with diabetes mellitus
Sudhakar S, Chyun D, Young L, Inzucchi S, Davey J, Wackers F. Abnormal heart rate response to adenosine infusion is associated with silent myocardial ischemia in asymptomatic patients with diabetes mellitus. Journal Of Nuclear Cardiology 2004, 11: s20. DOI: 10.1016/j.nuclcard.2004.06.064.Peer-Reviewed Original ResearchHeart rate responseSilent myocardial ischemiaLarge myocardial perfusion defectsMyocardial perfusion defectsLarger perfusion abnormalityAsymptomatic patientsNegative predictive valuePerfusion abnormalitiesMyocardial ischemiaPerfusion defectsAdenosine infusionRate responsePredictive valueAbnormal heart rate responseBlunted heart rate responseHigh negative predictive valueLower heart rate responseCoronary artery diseaseMyocardial perfusion abnormalitiesDetection of ischemiaMales 53Autonomic neuropathyArtery diseaseDiabetes mellitusPoor outcomeCardiac Abnormalities in Diabetic Patients With Neuropathy
Johnson BF, Nesto RW, Pfeifer MA, Slater WR, Vinik AI, Chyun DA, Law G, Wackers FJ, Young LH. Cardiac Abnormalities in Diabetic Patients With Neuropathy. Diabetes Care 2004, 27: 448-454. PMID: 14747227, DOI: 10.2337/diacare.27.2.448.Peer-Reviewed Original ResearchMeSH KeywordsAldehyde ReductaseBenzothiazolesCardiac OutputDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Diabetic NeuropathiesDouble-Blind MethodEnzyme InhibitorsExercise TestFemaleHeartHeart Conduction SystemHeart RateHumansMaleMiddle AgedPhthalazinesPlacebosStroke VolumeThiazolesVentricular Function, LeftConceptsLeft ventricular ejection fractionDiabetic patientsARI treatmentCardiac outputStroke volumeCardiac abnormalitiesAldose reductase inhibitorExercise left ventricular ejection fractionAbnormal heart rate variabilityDiastolic peak filling rateAsymptomatic cardiac abnormalitiesGated radionuclide ventriculographyMaximal bicycle exercisePlacebo-treated subjectsDiastolic filling rateVentricular ejection fractionCoronary artery diseaseValvular heart diseasePeak filling rateExercise cardiac outputLV stroke volumeHeart rate variabilityBlinded treatmentInsulin useArtery disease
2003
SPECT Detection of Coronary Artery Disease
Wackers F. SPECT Detection of Coronary Artery Disease. 2003, 63-77. DOI: 10.1007/978-1-4615-6496-6_4.Peer-Reviewed Original Research
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
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 ResearchConceptsExercise 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 patientsEffects of Mental Stress on Left Ventricular and Peripheral Vascular Performance in Patients With Coronary Artery Disease
Jain D, Shaker M, Burg M, Wackers F, Soufer R, Zaret B. Effects of Mental Stress on Left Ventricular and Peripheral Vascular Performance in Patients With Coronary Artery Disease. Journal Of The American College Of Cardiology 1998, 31: 1314-1322. PMID: 9581726, DOI: 10.1016/s0735-1097(98)00092-8.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionPeripheral vascular resistanceCoronary artery diseaseRate-pressure productStress-induced fallSystolic blood pressureArtery diseaseBlood pressureCardiac outputHeart rateMental stressGroup IHemodynamic variablesAnger recallGroup IIMental stressorsEnd-systolic ventricular elastanceMental stress-induced changesSemisupine bicycle exerciseGroup II patientsComparable increaseDiastolic blood pressureVentricular ejection fractionExercise-induced changesVascular resistanceLimitations of dobutamine for enhancing flow heterogeneity in the presence of single coronary stenosis: implications for technetium-99m-sestamibi imaging.
Wu JC, Yun JJ, Heller EN, Dione DP, DeMan P, Liu YH, Zaret BL, Wackers FJ, Sinusas AJ. Limitations of dobutamine for enhancing flow heterogeneity in the presence of single coronary stenosis: implications for technetium-99m-sestamibi imaging. Journal Of Nuclear Medicine 1998, 39: 417-25. PMID: 9529285.Peer-Reviewed Original ResearchConceptsSingle-vessel stenosisMyocardial blood flowDobutamine stressCoronary stenosisTechnetium-99mBlood flowLeft circumflex artery stenosisCircumflex artery stenosisFlow deficitsSingle coronary stenosisCoronary artery diseaseRate-pressure productRegional myocardial blood flowLeft ventricular pressurePeak dobutamine stressOpen-chest dogsNonischemic flowArtery diseaseArtery stenosisPeak dobutamineSestamibi activitySevere stenosisVentricular pressureSestamibi imagingIschemic zone
1997
Effect of left ventricular function on the assessment of myocardial viability by technectium-99m sestamibi and correlation with positron emission tomography in patients with healed myocardial infarcts or stable angina pectoris, or both
Arrighi J, Ng C, Dey H, Wackers F, Soufer R. Effect of left ventricular function on the assessment of myocardial viability by technectium-99m sestamibi and correlation with positron emission tomography in patients with healed myocardial infarcts or stable angina pectoris, or both. The American Journal Of Cardiology 1997, 80: 1007-1013. PMID: 9352969, DOI: 10.1016/s0002-9149(97)00594-8.Peer-Reviewed Original ResearchConceptsCoronary artery diseasePositron emission tomographyLV dysfunctionArtery diseaseGroup 2Myocardial viabilityGroup 1Ejection fractionModerate coronary artery diseaseEmission tomographyModerate LV dysfunctionSevere LV dysfunctionStable angina pectorisLV ejection fractionGlobal LV dysfunctionAccuracy of technetiumSingle photon emissionSemiquantitative SPECTVentricular dysfunctionViability detectionAngina pectorisVentricular functionReduced perfusionSestamibi SPECTMyocardial infarctRelationship of scar and ischemia to the results of programmed electrophysiological stimulation in patients with coronary artery disease
Gradel C, Jain D, Batsford W, Wackers F, Zaret B. Relationship of scar and ischemia to the results of programmed electrophysiological stimulation in patients with coronary artery disease. Journal Of Nuclear Cardiology 1997, 4: 379-386. PMID: 9362014, DOI: 10.1016/s1071-3581(97)90029-5.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseMyocardial perfusion imagingSustained ventricular tachycardiaPerfusion defect sizeVentricular tachycardiaElectrophysiological studiesArtery diseaseIndependent predictorsMultivariate analysisChronic coronary artery diseaseLeft ventricular ejection fractionSustained monomorphic ventricular tachycardiaGlobal left ventricular functionVentricular ejection fractionLeft ventricular functionPrevious myocardial infarctionMonomorphic ventricular tachycardiaBest independent predictorSize of ischemiaAdditional ischemiaArrhythmia historyInducible patientsNoninducible patientsSize of scarClinical predictorsRelevance of Increased Lung Thallium Uptake on Stress Imaging in Patients With Unstable Angina and Non-Q Wave Myocardial Infarction: Results of the Thrombolysis in Myocardial Infarction (TIMI)-IIIB Study fn1fn1This study was supported in part by a research grant from Mallinckrodt Medical Inc., Saint Louis, Missouri.
Jain D, Thompson B, Wackers F, Zaret B, Investigators F. Relevance of Increased Lung Thallium Uptake on Stress Imaging in Patients With Unstable Angina and Non-Q Wave Myocardial Infarction: Results of the Thrombolysis in Myocardial Infarction (TIMI)-IIIB Study fn1fn1This study was supported in part by a research grant from Mallinckrodt Medical Inc., Saint Louis, Missouri. Journal Of The American College Of Cardiology 1997, 30: 421-429. PMID: 9247514, DOI: 10.1016/s0735-1097(97)00164-2.Peer-Reviewed Original ResearchConceptsLung/heart ratioAdverse cardiac eventsNon-Q-wave myocardial infarctionCoronary artery diseaseCardiac eventsPerfusion abnormalitiesMyocardial infarctionUnstable anginaArtery diseaseStress-induced left ventricular dysfunctionHigher cardiac event rateLeft ventricular ejection fractionAggressive interventional managementHigher revascularization rateLung thallium uptakeCardiac event rateTotal exercise timeFrequency of anginaLeft ventricular dysfunctionST-segment depressionLower exercise capacityVentricular ejection fractionPrevious myocardial infarctionMyocardial perfusion abnormalitiesNormal myocardial perfusion