Edward Lyons - Academia.edu (original) (raw)

Papers by Edward Lyons

Research paper thumbnail of Diversion of Funds in Hospital Service

Research paper thumbnail of Cardiovascular Nuclear Imaging: Balancing Proven Clinical Value and Potential Radiation Risk

Journal of Nuclear Medicine, 2011

Research paper thumbnail of Use of technetium-99m isonitrile (RP-30A) in assessing left ventricular perfusion and function at rest and during exercise in coronary artery disease, and comparison with coronary arteriography and exercise thallium-201 SPECT imaging

The American Journal of Cardiology, 1989

Research paper thumbnail of Effect of exercise level on the ability of thallium-201 tomographic imaging in detecting coronary artery disease: Analysis of 461 patients

Journal of the American College of Cardiology, 1989

This study examined the effect of the level of exercise on the ability of thallium-201 imaging wi... more This study examined the effect of the level of exercise on the ability of thallium-201 imaging with single photon emission computed tomography (SPECT) to detect coronary artery disease. Patients in group 1 (n = 164) achieved adequate exercise end points, defined as positive exercise electrocardiograms or ~85% of maximal predicted heart rate. Patients in group 2 (n = 108) had submaximal exercise. The SPECT thallium301 images showed perfusion defects in 74%, 88% and 98%, respectively, of patients with one, two and three vessel coronary artery disease in group 1, compared with 52%, 84% and 79%, respectively, of such patients in group 2 (p < 0.05). Perfusion defects showed partial or complete redistribution consistent with ischemia in 56%, 80% and 88%, respectively, of patients with one, two and three vessel Exercise thallium-201 imaging has been wisely used in the diagnosis of coronary artery disease and risk stratification (14). Over the past 15 years, important developments have Single photon emission computed tomography (SPECT) with thallium-201 has certain advantages over planar images. occurred in this technique that have improved the quality of Because SPECT images are capable of displaying individual tomographic slices at different levels in multiple planes, the images and enhanced the accuracy of the results (5-10). there is no problem of superimposition of shallow and deep structures, and, therefore, identification of perfusion defects is easier. Also, with planar imaging, segments of the left ventricular myocardium that are farthest away from the detector are more difficult to visualize than those closest to

Research paper thumbnail of Addressing disparities in sudden cardiac arrest care and the underutilization of effective therapies

American Heart Journal, 2010

Sudden cardiac arrest (SCA) is the most common cause of death in the Unites States. Despite its m... more Sudden cardiac arrest (SCA) is the most common cause of death in the Unites States. Despite its major impact on public health, significant challenges exist at the patient, provider, public, and policy levels with respect to raising more widespread awareness and understanding of SCA risks, identifying patients at risk for SCA, addressing barriers to SCA care, and eliminating disparities in SCA care and outcomes. To address many of these challenges, the Duke Center for the Prevention of Sudden Cardiac Death at the Duke Clinical Research Institute (Durham, NC) held a think tank meeting on December 7, 2009, convening experts on this issue from clinical cardiology, cardiac electrophysiology, health policy and economics, the US Food and Drug Administration, the Centers for Medicare and Medicaid Services, the Agency for Health Care Research and Quality, and device and pharmaceutical manufacturers. The specific goals of the meeting were to examine existing educational tools on SCA for patients, health care providers and the public and explore ways to enhance and disseminate these tools, to propose a framework for improved identification of patients at risk of SCA, and to review the latest data on disparities in SCA care and explore ways to reduce these disparities. This paper summarizes the discussions that occurred at the meeting.

Research paper thumbnail of Use of oral dipyridamole SPECT thallium-201 imaging in detection of coronary artery disease

American Heart Journal, 1989

Dipyridamole thallium-201 imaging has been studied over the past several years for detection of c... more Dipyridamole thallium-201 imaging has been studied over the past several years for detection of coronary artery disease (CAD) in multiple clinical settings.r It has been shown to be a useful diagnostic tool in patients who cannot undergo exercise testing,2 as a predictor of subsequent cardiac events following myocardial infarction,3 for risk stratification prior to peripheral vascular surgery,4-6 and in assessment of residual coronary stenosis after angioplasty.7 The majority of these results were obtained by using intravenous dipyridamole, which is not yet commercially available. Oral dipyridamole is widely available, and has a lower incidence of and less severe side effects.8 This study summarizes our experience with oral dipyridamole single photon emission computed tomography (SPECT) with thallium-201 and examines the usefulness of the technique in the detection of CAD and in identifying high-risk patients with multivessel CAD. METHODOLOGY From February 1987 to March 1989, 241 patients were referred for oral dipyridamole SPECT thallium imaging. Of these, 65 patients also had coronary angiography within 3 months. These patients were not candidates for exercise testing because of physical limitations such as arthritis, claudication, amputation, deconditioning, or neurologic problems. Significant CAD was defined as L 50% diameter narrowing in one or more of the major coronary arteries or their major branches. Coronary angiograms were interpreted without prior knowledge of scintigraphic results. None of the patients had associated significant valvular heart disease or congenital heart disease.

Research paper thumbnail of Diversion of Funds in Hospital Service

Research paper thumbnail of Cardiovascular Nuclear Imaging: Balancing Proven Clinical Value and Potential Radiation Risk

Journal of Nuclear Medicine, 2011

Research paper thumbnail of Use of technetium-99m isonitrile (RP-30A) in assessing left ventricular perfusion and function at rest and during exercise in coronary artery disease, and comparison with coronary arteriography and exercise thallium-201 SPECT imaging

The American Journal of Cardiology, 1989

Research paper thumbnail of Effect of exercise level on the ability of thallium-201 tomographic imaging in detecting coronary artery disease: Analysis of 461 patients

Journal of the American College of Cardiology, 1989

This study examined the effect of the level of exercise on the ability of thallium-201 imaging wi... more This study examined the effect of the level of exercise on the ability of thallium-201 imaging with single photon emission computed tomography (SPECT) to detect coronary artery disease. Patients in group 1 (n = 164) achieved adequate exercise end points, defined as positive exercise electrocardiograms or ~85% of maximal predicted heart rate. Patients in group 2 (n = 108) had submaximal exercise. The SPECT thallium301 images showed perfusion defects in 74%, 88% and 98%, respectively, of patients with one, two and three vessel coronary artery disease in group 1, compared with 52%, 84% and 79%, respectively, of such patients in group 2 (p < 0.05). Perfusion defects showed partial or complete redistribution consistent with ischemia in 56%, 80% and 88%, respectively, of patients with one, two and three vessel Exercise thallium-201 imaging has been wisely used in the diagnosis of coronary artery disease and risk stratification (14). Over the past 15 years, important developments have Single photon emission computed tomography (SPECT) with thallium-201 has certain advantages over planar images. occurred in this technique that have improved the quality of Because SPECT images are capable of displaying individual tomographic slices at different levels in multiple planes, the images and enhanced the accuracy of the results (5-10). there is no problem of superimposition of shallow and deep structures, and, therefore, identification of perfusion defects is easier. Also, with planar imaging, segments of the left ventricular myocardium that are farthest away from the detector are more difficult to visualize than those closest to

Research paper thumbnail of Addressing disparities in sudden cardiac arrest care and the underutilization of effective therapies

American Heart Journal, 2010

Sudden cardiac arrest (SCA) is the most common cause of death in the Unites States. Despite its m... more Sudden cardiac arrest (SCA) is the most common cause of death in the Unites States. Despite its major impact on public health, significant challenges exist at the patient, provider, public, and policy levels with respect to raising more widespread awareness and understanding of SCA risks, identifying patients at risk for SCA, addressing barriers to SCA care, and eliminating disparities in SCA care and outcomes. To address many of these challenges, the Duke Center for the Prevention of Sudden Cardiac Death at the Duke Clinical Research Institute (Durham, NC) held a think tank meeting on December 7, 2009, convening experts on this issue from clinical cardiology, cardiac electrophysiology, health policy and economics, the US Food and Drug Administration, the Centers for Medicare and Medicaid Services, the Agency for Health Care Research and Quality, and device and pharmaceutical manufacturers. The specific goals of the meeting were to examine existing educational tools on SCA for patients, health care providers and the public and explore ways to enhance and disseminate these tools, to propose a framework for improved identification of patients at risk of SCA, and to review the latest data on disparities in SCA care and explore ways to reduce these disparities. This paper summarizes the discussions that occurred at the meeting.

Research paper thumbnail of Use of oral dipyridamole SPECT thallium-201 imaging in detection of coronary artery disease

American Heart Journal, 1989

Dipyridamole thallium-201 imaging has been studied over the past several years for detection of c... more Dipyridamole thallium-201 imaging has been studied over the past several years for detection of coronary artery disease (CAD) in multiple clinical settings.r It has been shown to be a useful diagnostic tool in patients who cannot undergo exercise testing,2 as a predictor of subsequent cardiac events following myocardial infarction,3 for risk stratification prior to peripheral vascular surgery,4-6 and in assessment of residual coronary stenosis after angioplasty.7 The majority of these results were obtained by using intravenous dipyridamole, which is not yet commercially available. Oral dipyridamole is widely available, and has a lower incidence of and less severe side effects.8 This study summarizes our experience with oral dipyridamole single photon emission computed tomography (SPECT) with thallium-201 and examines the usefulness of the technique in the detection of CAD and in identifying high-risk patients with multivessel CAD. METHODOLOGY From February 1987 to March 1989, 241 patients were referred for oral dipyridamole SPECT thallium imaging. Of these, 65 patients also had coronary angiography within 3 months. These patients were not candidates for exercise testing because of physical limitations such as arthritis, claudication, amputation, deconditioning, or neurologic problems. Significant CAD was defined as L 50% diameter narrowing in one or more of the major coronary arteries or their major branches. Coronary angiograms were interpreted without prior knowledge of scintigraphic results. None of the patients had associated significant valvular heart disease or congenital heart disease.