Document Detail


Enhanced prognostic stratification of patients with left ventricular hypertrophy with the use of single-photon emission computed tomography.
MedLine Citation:
PMID:  10966548     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with left ventricular hypertrophy (LVH) are at increased risk of future cardiovascular events. Little is known about risk stratification of these patients with the use of myocardial perfusion imaging. This study sought to assess the prognostic stratification of patients with LVH by using myocardial perfusion single-photon emission computed tomography (SPECT). METHODS AND RESULTS: We studied 633 consecutive patients with electrocardiographic evidence of LVH who underwent dual isotope myocardial perfusion SPECT (rest thallium 201/stress technetium 99m sestamibi) and were followed up for a mean period of 22 +/- 7 months. During the follow-up period, 67 events (35 cardiac deaths and 32 nonfatal myocardial infarctions) occurred (6% annual event rate). The results of the perfusion scan significantly risk-stratified the population; patients with normal scans had a low rate of nonfatal myocardial infarction and cardiac death (<1% per year of follow-up). The rates of cardiac events increased significantly as a function of the scan result: 4.9% in patients with mildly abnormal scans and 10. 3% in moderately to severely abnormal scans. Cox proportional hazards analysis demonstrated that after adjusting for pretest likelihood of coronary artery disease (the most predictive clinical variable; chi(2) = 15.5, P <.001), summed stress score (the most predictive nuclear variable; chi(2) = 18, P <.0001) added significant incremental prognostic information (global chi(2) increased from 15.5 to 36; P <.001). CONCLUSIONS: In patients with LVH with an overall high cardiac event rate, SPECT provided enhanced stratification by adding significant incremental prognostic information over clinical and historic variables.
Authors:
A M Amanullah; D S Berman; X Kang; I Cohen; G Germano; J D Friedman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  140     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-09-27     Completed Date:  2000-09-27     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  456-62     Citation Subset:  AIM; IM    
Affiliation:
Departments of Medicine (Division of Cardiology) and Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Disease / etiology*
Female
Follow-Up Studies
Humans
Hypertrophy, Left Ventricular / pathology,  radionuclide imaging*
Male
Middle Aged
Predictive Value of Tests
Prognosis
Radiopharmaceuticals / diagnostic use
Risk Assessment
Technetium Tc 99m Sestamibi / diagnostic use
Thallium / diagnostic use
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 7440-28-0/Thallium

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


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