Document Detail


Exercise technetium 99m sestamibi single-photon emission computed tomography late after coronary artery bypass surgery: long-term follow-up.
MedLine Citation:
PMID:  9294670     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND HYPOTHESIS: The prognostic value of exercise technetium 99m sestamibi single-photon emission computed tomography (SPECT) imaging in patients with previous bypass surgery is unknown. The aim of our study was to assess the prognostic information obtained with exercise scintigraphy performed for routine follow-up or reappearance of symptoms. METHODS: We studied 75 patients referred to our Center at a mean of 38 +/- 53 months from the revascularization procedure and prospectively followed them for 38 +/- 24 months. RESULTS: Fifteen patients (20%) had events at follow-up: there were 4 cardiac deaths, 3 nonfatal acute myocardial infarctions, 8 late revascularization procedures (4 percutaneous transluminal angioplasty and 4 repeat bypass surgery). Univariate analysis identified a history of typical angina (p = 0.001), a clinically positive ergometric test (p = 0.009), peak exercise heart rate (p = 0.0003), percentage of maximal predicted heart rate (p = 0.0001), peak exercise double product (p = 0.048), therapy during exercise (p = 0.003), scintigraphic summed reversibility score (i.e., the summation of the segmental differences between stress and rest) (p = 0.014), as significant predictors of events. Three multivariate models were built, with clinical variables (Model 1, chi square 15.97), ergometric variables (Model 2, chi square 19.66), and with scintigraphic variables added to clinical/ergometric variables (Model 3, chi square 31.13). The scintigraphic variable selected in the model as significant predictor of events was the summed reversibility score (p = 0.008). CONCLUSIONS: Exercise sestamibi SPECT scintigraphy provides optimal prognostic information after clinical and ergometric parameters in patients with previous bypass surgery.
Authors:
A Desideri; G Candelpergher; P Zanco; G Suzzi; R Terlizzi; N Borsato; G Colangeli; C Daskalakis; F Chierichetti; L Celegon
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  20     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-10-20     Completed Date:  1997-10-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  779-84     Citation Subset:  IM    
Affiliation:
Coronary Care Unit, S. Giacomo Hospital, Castelfranco Veneto, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Artery Bypass*
Exercise Test
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Ischemia / mortality,  radionuclide imaging*,  surgery
Predictive Value of Tests
Prognosis
Prospective Studies
Radiopharmaceuticals / diagnostic use*
Survival Rate
Technetium Tc 99m Sestamibi / diagnostic use*
Time Factors
Tomography, Emission-Computed, Single-Photon / methods*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

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