Document Detail


Do myocardial perfusion SPECT and radionuclide angiography studies in adult patients with hypertrophic cardiomyopathy have prognostic implications?
MedLine Citation:
PMID:  15472643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Some myocardial perfusion single photon emission computed tomography (SPECT) and radionuclide ventriculography studies have suggested that the presence of regional perfusion defects and diastolic abnormalities could have prognostic implications in patients with hypertrophic cardiomyopathy (HC). The aim of this prospective study was to analyze the prognostic value of these techniques in adult patients with HC. METHODS AND RESULTS: One hundred one patients with HC (44 women; mean age, 54 +/- 16 years; 55% obstructive) were prospectively studied by means of myocardial perfusion SPECT and radionuclide angiography. Of these patients, 55 (54.4%) had an abnormal myocardial perfusion SPECT study: 28 (27.7%) had fixed defects and 41 (40.6%) had reversible defects; 15 (14.8%) of these patients had both types of defect. Of the patients, 16% had left ventricular ejection fraction lower than 60%, 25.7% had an abnormal peak filling rate, and 51% had an abnormal time to peak filling rate. During 5.6 +/- 2.7 years of follow-up, 13 patients (12.8%) died (heart failure 8 and sudden death in 5) and 14 had one or more severe complications develop (syncope in 6, angina III-IV in 4, dyspnea III-IV in 10, and acute myocardial infarction in 3). The summed difference score was higher in patients with cardiac death (2.2 +/- 2.3 vs 1.1 +/- 1.3, P = .008), and fixed defects were more prevalent in patients with severe complications (57% vs 21%, P = .01). In the Kaplan-Meier survival plot analysis, severe complications were more likely in patients with fixed defects (P = .01) or ejection fraction lower than 60% ( P = .01). CONCLUSIONS: Prognostic information from myocardial perfusion SPECT and radionuclide angiography has limited clinical significance with regard to cardiac death in adult patients with HC. However, the presence of fixed defects and lower ejection fraction in these patients has an adverse prognostic meaning for severe complications.
Authors:
Guillermo Romero-Farina; Jaume Candell-Riera; Enrique Galve; Lluís Armadans; Francisca Ramos; Joan Castell; Santiago Aguadé; Juan M Nogales; Jordi Soler-Soler
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Validation Studies    
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  11     ISSN:  1071-3581     ISO Abbreviation:  J Nucl Cardiol     Publication Date:    2004 Sep-Oct
Date Detail:
Created Date:  2004-10-08     Completed Date:  2005-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  578-86     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Cardiomyopathy, Hypertrophic / mortality*,  radionuclide imaging*
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Middle Aged
Organophosphorus Compounds / diagnostic use*
Organotechnetium Compounds / diagnostic use*
Prognosis
Radionuclide Angiography / statistics & numerical data*
Radiopharmaceuticals / diagnostic use
Risk Assessment / methods*
Risk Factors
Spain / epidemiology
Survival Analysis
Tomography, Emission-Computed, Single-Photon / statistics & numerical data*
Chemical
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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