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Title: Assessing the need for nuclear cardiology and other advanced cardiac imaging modalities in the developing world
Authors: João V. Vitola
Leslee J. Shaw
Adel H. Allam
Pilar Orellana
Amalia Peix
Annare Ellmann
Kevin C. Allman
B. N. Lee
Chanika Siritara
Felix Y.J. Keng
Gianmario Sambuceti
Marla C. Kiess
Raffaele Giubbini
Salaheddine E. Bouyoucef
Zuo Xiang He
Gregory S. Thomas
Fernando Mut
Maurizio Dondi
Quanta Medicina Nuclear
Emory University
Al-Azhar University
Pontificia Universidad Catolica de Chile
Institute of Cardiology
Universiteit Stellenbosch
The University of Sydney
Hospital Putrajaya
Mahidol University
National Heart Centre, Singapore
Universita degli Studi di Genova
The University of British Columbia
Spedali Civili Di Brescia
Centre Hospitalo-universitaire de Mustapha Bacha
Fuwai Hospital
University of California, Irvine
International Atomic Energy Agency, Vienna
Keywords: Medicine
Issue Date: 1-Dec-2009
Citation: Journal of Nuclear Cardiology. Vol.16, No.6 (2009), 956-961
Abstract: Background: In 2005, 80% of cardiovascular disease (CVD) deaths occurred in low- to middle-income countries (i.e., developing nations). Cardiovascular imaging, such as myocardial perfusion SPECT, is one method that may be applied to detect and foster improved detection of at-risk patients. This document will review the availability and utilization for nuclear cardiology procedures worldwide and propose strategies to devise regional centers of excellence to achieve quality imaging around the world. Methods: As a means to establish the current state of nuclear cardiology, International Atomic Energy Agency member and non-member states were queried as to annual utilization of nuclear cardiology procedures. Other sources for imaging statistics included data from medical societies (American Society of Nuclear Cardiology, European Society of Cardiology, and the European Association of Nuclear Medicine) and nuclear cardiology working groups within several nations. Utilization was calculated by dividing annual procedural volume by 2007 population statistics (/100,000) and categorized as high (>1,000/100,000), moderate-high (250-999/100,000), moderate (100-249/100,000), low-moderate (50-99/100,000) and low (<50/100,000). Results: High nuclear cardiology utilization was reported in the United States, Canada, and Israel. Most Western European countries, Australia, and Japan reported moderate-high utilization. With the exception of Argentina, Brazil, Colombia and Uruguay, South America had low usage. This was also noted across Eastern Europe, Russia, and Asia. Utilization patterns generally mirrored each country's gross domestic product. However, nuclear cardiology utilization was higher for developing countries neighboring moderate-high "user" countries (e.g., Algeria and Egypt); perhaps the result of accessible high-quality training programs. Conclusions: Worldwide utilization patterns for nuclear cardiology vary substantially and may be influenced by physician access to training and education programs. Development of regional training centers of excellence can guide utilization of nuclear cardiology through the application of guideline- and appropriateness-driven testing, training, continuing education, and quality assurance programs aiding developing nations to confront the epidemics of CVD. © 2009 American Society of Nuclear Cardiology.
ISSN: 10713581
Appears in Collections:Scopus 2006-2010

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