Document Detail


Nuclear stress testing in elderly patients: a review of its use in the assessment of cardiac risk, particularly in patients undergoing preoperative risk assessment.
MedLine Citation:
PMID:  17571912     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Stress myocardial perfusion imaging (MPI) plays an important role in the diagnostic and prognostic assessment of coronary artery disease (CAD) in patients of all age groups who are undergoing assessment prior to non-cardiac surgery. MPI may utilise exercise treadmill or pharmacological stress testing. While MPI has been evaluated in a wide variety of patient subpopulations, there are very limited data on its prognostic value in the elderly population, particularly those >75 years of age, who are making up an ever increasing proportion of the patient population. Because of the higher prevalence and greater severity of CAD in older patients, the sensitivity of noninvasive MPI increases with age, whereas specificity tends to decline. In addition, maximal aerobic exercise capacity tends to decrease with age, making it common practice for elderly patients being assessed for CAD to undergo pharmacological MPI to evaluate their cardiovascular risk. In this article, we review the literature with respect to cardiac risk estimation in elderly patients undergoing MPI, particularly with respect to making prognostic assessments prior to undergoing surgery. Current data allow for the proper application of stress MPI in the elderly population. Use of MPI facilitates identification of the severity and extent of ischaemia as well as left ventricular dilatation and systolic function in elderly patients undergoing non-cardiac surgery.
Authors:
Amgad N Makaryus; Joseph A Diamond
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drugs & aging     Volume:  24     ISSN:  1170-229X     ISO Abbreviation:  Drugs Aging     Publication Date:  2007  
Date Detail:
Created Date:  2007-06-18     Completed Date:  2007-08-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102074     Medline TA:  Drugs Aging     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  467-79     Citation Subset:  IM    
Affiliation:
Columbia University Medical Center, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Coronary Artery Disease / diagnosis*,  radionuclide imaging
Heart Function Tests / methods*
Humans
Preoperative Care
Prognosis
Risk Assessment / methods
Tomography, Emission-Computed / methods*

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