Document Detail

Prognostic value of treadmill exercise and dobutamine stress positron emission tomography.
MedLine Citation:
PMID:  19584976     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although positron emission tomography (PET) is routinely performed using vasodilator stress, exercise and dobutamine stress are available alternatives. Evidence suggests that vasodilator PET myocardial perfusion imaging (MPI) has prognostic value, but the prognostic value of treadmill exercise and dobutamine PET MPI is unknown.
OBJECTIVE: To determine the potential prognostic value of nonvasodilator stress PET MPI.
METHODS: Patients underwent treadmill exercise or dobutamine PET MPI. Images were assessed qualitatively and semiquantitatively. PET results were categorized as normal (summed stress score [SSS] of less than 4), abnormal (SSS of 4 or greater) or inconclusive (SSS of less than 4 and submaximal peak stress heart rate). Patient follow-up (cardiac death, nonfatal myocardial infarction [MI] and/or late revascularization) was performed.
RESULTS: Of the 124 patients (mean follow-up period of 2.3+/-1.6 years), 46 patients (37%) had a normal study, 15 patients (12%) had an inconclusive study and 63 (51%) had an abnormal PET. Patients with a normal PET had no deaths or nonfatal MI. One patient with a normal PET underwent late revascularization (annual event rate of 1.7%). Patients with an abnormal PET had 15 cardiac events (one cardiac death, four nonfatal MIs and 10 late revascularizations), with an annual event rate of 13.0% (P=0.002).
CONCLUSIONS: Although small, the present study suggests that defects seen on PET myocardial perfusion, resulting from stressors (treadmill exercise and dobutamine) that increase myocardial oxygen demand, may have prognostic value.
Benjamin J W Chow; Owayed M Al Shammeri; Rob S Beanlands; Li Chen; Robert A deKemp; Jean DaSilva; Terrence D Ruddy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  25     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-08     Completed Date:  2009-07-31     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e220-4     Citation Subset:  IM    
Department of Medicine (Cardiology and Nuclear Medicine), University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7, Canada.
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MeSH Terms
Cardiotonic Agents / diagnostic use*
Coronary Artery Disease / diagnosis*,  mortality,  radionuclide imaging
Dobutamine / diagnostic use*
Exercise Test*
Middle Aged
Positron-Emission Tomography / methods*
Prospective Studies
Survival Analysis
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

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