Document Detail


Etiology and pathophysiology of new-onset heart failure: evaluation by myocardial perfusion imaging.
MedLine Citation:
PMID:  19152132     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The IMAGING in Heart Failure study was a prospective, multi-national trial designed to explore the role of single-photon emission computed tomographic (SPECT) myocardial perfusion imaging (MPI) as an initial investigative strategy in patients hospitalized with new-onset heart failure. METHODS: We recruited 201 patients (age 65.3 +/- 14.5 years, 43% women) hospitalized with their first episode of heart failure. Rest/stress gated SPECT Tc-99m sestamibi MPI was performed during or within 2 weeks of the index hospitalization, in addition to standard care. RESULTS: SPECT MPI revealed a broad range of ejection fractions with preserved systolic function in 36% of patients. Forty-one percent of patients had normal perfusion. In the remaining patients, perfusion abnormalities were predominantly due to prior myocardial infarction, with extensive ischemia seen only in 6%. Among patients who underwent coronary angiography, SPECT performance characteristics revealed excellent negative predictive value (96%) for extensive coronary artery disease (CAD). In multivariable analyses, the extent of perfusion abnormality and advancing age predicted the presence of extensive CAD. CONCLUSIONS: These preliminary data derived from a non-randomized observational cohort suggest potential diagnostic utility of MPI for ischemic LV dysfunction in new-onset HF, and sets the stage for a prospective randomized study to confirm these findings.
Authors:
Prem Soman; Avijit Lahiri; Jennifer H Mieres; Dennis A Calnon; David Wolinsky; George A Beller; Tina Sias; Kenneth Burnham; Laurence Conway; Peter A McCullough; Edouard Daher; Mary N Walsh; Joseph Wight; Gary V Heller; James E Udelson
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-01-20
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  16     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:    2009 Jan-Feb
Date Detail:
Created Date:  2009-01-19     Completed Date:  2009-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  82-91     Citation Subset:  IM    
Affiliation:
Nuclear Cardiology, University of Pittsburgh Medical Center, Presbyterian University Hospital, A-429 Scaife Hall, 200 Lothrop Street, Pittsburgh, PA 15213, USA. somanp@upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Comorbidity
Female
Great Britain / epidemiology
Heart Failure / epidemiology*,  radionuclide imaging*
Humans
Incidence
Male
Middle Aged
Radiopharmaceuticals / diagnostic use
Risk Assessment / methods
Risk Factors
Technetium Tc 99m Sestamibi / diagnostic use*
Tomography, Emission-Computed, Single-Photon / statistics & numerical data*
United States / epidemiology
Ventricular Dysfunction, Left / epidemiology*,  radionuclide imaging*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

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


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