Nuclear Cardiology Department of KIHD started functioning from 29th December 2008 in older block adjacent to Catheterization Laboratory. This was a very compact department with no dedicated waiting area for injected patients. In March 2010, department was extended by using the space of hot store and clinical laboratory as the later was shifted to new block. Dedicated “hot waiting area” and a large cardiac stress laboratory where dynamic and pharmacological stress can be performed simultaneously.

Myocardial Perfusion Imaging
Nuclear Cardiology Department of KIHD is equipped with a state of the art dedicated cardiac SPECT with a stress laboratory with treadmill and pharmacological stress options. KIHD is the only public sector institute which is performing Gated SPECT as a routine due to its inbuilt strength to predict about prognosis and risk stratification. All stress procedures are conducted by qualified and credentialed nuclear physicians with well trained technical staff and good emergency support too. A comprehensive report comprised of perfusion images, perfusion status of various coronaries, volume and EF parameters provide high magnitude of information to referring physicians. This helps the cardiologist in selecting a better treatment modality with confidence as this is the age of evidence based medicine.

ESMR stands for Extracorporeal Shockwave Myocardial Revascularization. ESMR can also be termed Non Invasive Cardiac Angiogenesis Therapy (Ni-Cath).

Shockwaves are delivered during the treatment which are kind of sound waves (like ultrasound) with high intensity and short duration. The sound waves are generated by an underwater high voltage spark, which are delivered non-invasively, focused by a special ellipsoid reflector. The reflector is coupled to the patient’s skin near the affected area with a water cushion. The focal zone distance into the patient’s body is adjusted according to the clinical requirements.

ESMR therapy is a new non-invasive therapy approach using Extracorporeal Shockwave technology for Myocardial Revascularization (i.e. to improve the blood supply to heart muscles). Ischemic myocardial areas no longer accessible by conventional revascularization therapies like bypass surgery or balloon angioplasty and stenting, could be treated with the ESMR therapy to relieve symptoms resulted from the myocardial ischemia.

Achievements of department KIHD by Dr Maseh Uz Zaman

TRAINING

Recognized by PMDC and CPSP for training in Nuclear Cardiology for FCPS II trainees in Cardiology.
Approved for Nuclear Cardiology Rotation for Diploma Cardiology programs of KIHD and Civil Hospital Karachi.
Running Diploma Nuclear Cardiology Technologist approved by Sind Board of Technical Education.

PARTICPATION IN ACADEMIC EVENTS

1. Prognostic value of Gated Myocardial SPECT imaging” in pre-symposium workshop of 2nd Annual Dr. Abdul Haque Khan Memorial International Cardiology Symposium held in Karachi Institute of Heart Disease on 13-15th February 2009.
2. Presented a poster “Assessing the adriamycin induced early cardiotoxicity by estimating LVEF using Tc-99m MUGA. S. EANM 2009 10-14th October 2009 (SPAIN).
3. Oral presentation “Predictive value of pathological Q waves for fixed perfusion defect and its impact on LV function estimated by gated SPECT” in 10th International Radiological Conference held in Karachi 7-9th November 2009.
4. Oral presentation “Predictive value of pathological Q waves for fixed perfusion defect and its impact on LV function estimated by gated SPECT” in 47th annual medical symposium Jinnah Post Graduate Medical Centre 21st Feb 2010.
5. Poster on “Negative predictive value of a normal stress-only Gated MPI: A paradigm shift” in 26th Annual Radiology Conference 29-31Oct 2010 in Karachi.
6. Oral Presentation “Predictive and Prognostic value of Transient Ischemic Dilatation of Left Ventricular Cavity for Coronary Artery Diseases: Its impact on various management in clinical outcome using Gated SPECT” in 4th annual Dr. Abdul Haque Khan International Symposium at Karachi Institute of Heart Diseases from 4-6th February 2011.
7. Oral presentation on “high event rate in patients with a normal Gated MPI with dipyridamole than exercise: “run for reliability” in SGH Nuclear Medicine Update 2012 at Singapore General Hospital 7-10 March 2012.
8. Oral Presentation on “high event rate in patients with a normal Gated MPI with dipyridamole than exercise: “run for reliability” at one day CPSP symposium Golden Jubilee celebration at regional office of College of physician and surgeons Pakistan Lahore 17th March 2012.
9. Oral Presentation on “Pulmonary Embolism in pregnancy: A diagnostic dilemma” at one day CPSP symposium Golden Jubilee celebration at regional office of College of physician and surgeons Pakistan Lahore 17th March 2012.
10. Oral presentation on “Impact of glycosylated hemoglobin (HBA1C) on extent of perfusion abnormalities and left ventricular dysfunction seen on gated myocardial perfusion imaging and clinical outcomes in diabetics” at European Association of nuclear Medicine EANM congress in 27-31 October 2012 at Milan Italy.
11. Oral presentation on Impact of glycosylated hemoglobin (HBA1C) on extent of perfusion abnormalities and left ventricular dysfunction seen on gated myocardial perfusion imaging and clinical outcomes in diabetics” in SGH Nuclear Medicine Update 2012 at Singapore General Hospital 6-9 March 2013.
12. Poster presentation on “Incremental Prognostic Value of Gated SPECT Myocardial Perfusion Scans with Dipyridamole Stress in Patients with Left Bundle Branch Block” in SGH Nuclear Medicine Update 2012 at Singapore General Hospital 6-9 March 2013.
13. Poster presentation on “Pulmonary Embolism in Pregnancy: A Diagnostic Dilemma’ in SGH Nuclear Medicine Update 2012 at Singapore General Hospital 6-9 March 2013.

Publications

1. Fatima N, Zaman M, Hashmi A, Hameed A, Kamal S. Assessing the adriamycin induced early cardiotoxicity by estimating LVEF using Tc-99m MUGA. Eur J Nucl med Mol Imag 2009; 36(suppl 2):S322-323.
2. Zaman M, Fatima N, Samad A, Ishaq M, Rasheed S Z. Prevalence of positive gated myocardial SPECT in diabetic and non-diabetic women and impact of other risk factors: KIHD perspective. PJC 2009;  20 (3 and 4):03-09.
3. Fatima N, Zaman M, Samad A, Ishaq M, Rasheed S Z. Predictive value of pathological Q waves for fixed perfusion defect and its impact on LV function estimated by GSPECT. PJC 2009;  20 (3 and 4):10-16.
4. Zaman M, Fatima N, Hashmi I. Recent developments and future prospects of SPECT myocardial perfusion imaging. Ann Nucl Med. 2010; 24:565–69.
5. Zaman M, Fatima N, Samad A, Ishaq M, et al. Prognostic value of stress only MPI protocol: Time for Paradigm shift. PJR Jan-Mar 2010: 20(1): 12-16.
6. Zaman M, Zafar Sajjad, Nosheen Fatima. Global Molybdenum crisis: Basic facts and alternative options (editorial). PJR Jan-Mar 2010: 20(1): 1-2.
7. Zaman M, Fatima N, Samad A, Ishaq M, et al. Overall and gender-based negative predictive value of a normal gated myocardial perfusion SPECT study: a single center Experience. Ann Ncul Med 2011; 25: 207-11.
8. Fatima N, Zaman M, Kamal S, Hameed A. Assessing the adriamycin induced cardiotoxicity by LVEF estimated by MUGA and echo. Nucl Med Com 2011, 32:381–385.
9.  Zaman M, Fatima N, et al. Predictive and prognostic values of transient ischemic dilatation of left ventricular cavity for coronary artery disease and impact of various managements on clinical outcome using technetium-99m sestamibi gated myocardial perfusion imaging. Ann Nucl Med 2011; 25: 566-70.
10. Fatima N, Zaman M, et al. Pulmonary embolism in pregnancy: a diagnostic dilemma. Ann Nucl Med 2011; 25:603-608.
11. Zaman M, Fatima N, Naqvi SM, et al.Radiation dosimety: From Thermoluminisence (TLD) to optically stimulated dosimetr (OSLD). PJR July - September 2011; 21(3): 107-109.
12. Fatima N, Zaman M, Karimi ZA, et al. Incidence of coronary artery disease in propensity matched diabetics and non-diabetics using MPI and its correlation with coronray angioography. PJR 2011; 21 (4): 152-58
13. Zaman M, Fatima N, Danish I, et al. Apical hypertrophic cardiomyopathy: Is it a conundrum for Gated SPECT MPI?. PJNM 2011, 1:20-25.
14. Fatima N, Zaman M, Ishaq M, et al. Incremenatl prognosticv value of GMPI with dipyridamole stress in patients with LBBB. PJC 2012; 23: 25-31.
15. Zaman M, Fatima N, Sajjad Z, et al. Radiation in Surgeon's Arena. Editorial PJR Jan-March 2012; 22 (1): IV.
16. Fatima N, Zaman M, et al. Impact of glycosylated hemoglobin (HBA1C) on the extent of perfusion abnormalities and left ventricular dysfunction using gated myocardial perfusion imaging and clinical outcomes in diabetic patients. Nucl Med Commun 2013;  34:489–94
17. Fatima N, Zaman MU, Ishaq M, Rasheed SZ, Baloch DJ, Wali A, et al. High event rate in patient with a normal gated myocrdail perfusion imaging with dipyridamole than exercise: Run for relaibility. Ind Jourl Nucl Med 2012; 12:172-5 (Published in May 2013).

Awards

1. Gold medal award for best oral presentation “Predictive value of pathological Q waves for fixed perfusion defect and its impact on LV function estimated by gated SPECT” in 47th annual medical symposium Jinnah Post Graduate Medical Centre 21st Feb 2010.
2. Gold Medal award of best poster presentation “Assessing the Adriamycin induced early cardiotoxicity by estimating LVEF using Tc-99m MUGA scan and Echocardiography” in 47th annual medical symposium Jinnah Post Graduate Medical Centre 21st Feb 2010.
3. Gold medal award for best oral presentation “. Prevalence of positive gated myocardial SPECT in diabetic and non-diabetic women and impact of other risk factors: KIHD perspective” in 3rd annual Dr. Abdul Haque Khan International Symposium at Karachi Institute of Heart Diseases from May 2010.
4. Gold medal award for best research paper Oral Presentation “Predictive and Prognostic value of Transient Ischemic Dilatation of Left Ventricular Cavity for Coronary Artery Diseases: Its impact on various management in clinical outcome using Gated SPECT” in 4th annual Dr. Abdul Haque Khan International Symposium at Karachi Institute of Heart Diseases from 4-6th February 2011.
5. Gold medal award for best oral presentation “Prognostic value of stress only MPI protocol: Time for Paradigm shift” in 48th annual medical symposium Jinnah Post Graduate Medical Centre 21st March 2011.
6. Gold medal award for best poster presentation “Overall and gender-based negative predictive value of a normal gated myocardial perfusion SPECT study: a single center Experience” in 49th annual medical symposium Jinnah Post Graduate Medical Centre 21st March 2012.
7. Best poster award on “Apical hypertrophic cardiomyopathy: Is it a conundrum for Gated SPECT MPI? At Singapore General Hospital March 2013.