Document Detail


Prognostic stratification of obese patients by stress 99mTc-tetrofosmin myocardial perfusion imaging.
MedLine Citation:
PMID:  16883009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Obesity is a major heath problem associated with increased cardiovascular mortality. There are currently no data to support a role for stress imaging techniques in the risk stratification of obese patients. The aim of this study was to assess the independent value of stress 99mTc-tetrofosmin SPECT in predicting mortality and hard cardiac events in obese patients. METHODS: We studied 265 patients with a body mass index greater than 30 kg/m2 by exercise or dobutamine stress 99mTc-tetrofosmin myocardial perfusion tomography. Endpoints during follow-up were cardiac death and death of any cause. RESULTS: The mean patient age (+/-SD) was 59 +/- 10 y, and 110 of the patients were men (42%). The mean body mass index was 37 +/- 7 kg/m2. Scan findings were normal in 113 patients (43%). Myocardial perfusion abnormalities were fixed in 62 patients (23%) and reversible in 90 patients (34%). During a mean follow-up period of 5.5 +/- 2 y, 41 patients (15%) died. Death was considered cardiac in 22 patients (8%). Nonfatal myocardial infarction occurred in 20 patients (7.5%). The annual cardiac death rate was 0.6% in patients with normal perfusion and 3.3% in patients with abnormal perfusion. Patients with a multiple-vessel distribution of abnormalities had a higher cardiac death rate than did patients with a single-vessel distribution (4.1% vs. 2.5%, P < 0.05). The annual mortality rate was 1.3% in patients with normal perfusion and 4.2% in patients with abnormal perfusion. In a multivariate analysis, perfusion abnormalities were independently predictive of cardiac mortality (risk ratio, 3.2; 95% confidence interval, 1.5-6.7) and overall mortality (risk ratio, 2.7; 95% confidence interval, 1.4-4.3). CONCLUSION: Stress 99mTc-tetrofosmin myocardial perfusion imaging is a useful tool for predicting cardiac and overall mortality in obese patients.
Authors:
Abdou Elhendy; Arend F L Schinkel; Ron T van Domburg; Jeroen J Bax; Roelf Valkema; Elena Biagini; Don Poldermans
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  47     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-02     Completed Date:  2006-09-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1302-6     Citation Subset:  IM    
Affiliation:
Thoraxcenter, University Hospital Rotterdam, Rotterdam, The Netherlands. Aelhendy@unmc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Body Mass Index
Cardiotonic Agents / pharmacology
Dobutamine / pharmacology
Female
Humans
Male
Middle Aged
Myocardial Reperfusion
Myocardium / pathology
Obesity / therapy*
Organophosphorus Compounds / diagnostic use*
Organotechnetium Compounds / diagnostic use*
Prognosis
Radiopharmaceuticals / diagnostic use*
Tomography, Emission-Computed, Single-Photon / methods*
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 34368-04-2/Dobutamine

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


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