| Prognostic value of vasodilator myocardial perfusion imaging in patients with left bundle-branch block. | |
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MedLine Citation:
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PMID: 9593561 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The prognostic value of tomographic myocardial perfusion imaging with dipyridamole or adenosine in patients with left bundle-branch block has not been established. METHODS AND RESULTS: The study group consisted of 245 patients with left bundle-branch block who underwent tomographic (single photon emission tomography) myocardial perfusion imaging with thallium-201 (n=173) or technetium-99m sestamibi (n=72) and either dipyridamole (n=153) or adenosine (n=92) stress. Patients were prospectively classified into two groups. Patients were classified as "high risk" if they had (1) a large severe fixed defect (n=28), (2) a large reversible defect (n=36), or (3) cardiac enlargement and either increased pulmonary uptake (thallium) or a decreased resting ejection fraction (sestamibi) (n=20). The remaining 161 patients (66% of the study group) were at "low risk." Follow-up was 99% complete at 3+/-1.4 years. Three-year overall survival was 57% in the high-risk group compared with 87% in the low-risk group (P<.0001). Survival free of cardiac death/nonfatal myocardial infarction/cardiac transplantation was 55% in the high-risk group and 93% in the low-risk group (P<.0001). The presence of a high-risk scan had significant incremental prognostic value after adjustment for age, sex, diabetes, and previous myocardial infarction (P<.0001). Patients with a low-risk scan had an overall survival that was not significantly different from that of a US age-matched population (P=.86). CONCLUSIONS: Tomographic myocardial perfusion imaging with adenosine or dipyridamole stress provides important prognostic information in patients with left bundle-branch block, which is incremental to clinical assessment. |
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Authors:
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H M Wagdy; D Hodge; T F Christian; T D Miller; R J Gibbons |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 97 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1998 Apr |
Date Detail:
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Created Date: 1998-06-04 Completed Date: 1998-06-04 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1563-70 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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administration & dosage* Aged Bundle-Branch Block / physiopathology* Dipyridamole / administration & dosage* Electrocardiography Female Follow-Up Studies Humans Male Middle Aged Myocardial Reperfusion* Predictive Value of Tests Prognosis Vasodilator Agents / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 58-32-2/Dipyridamole; 58-61-7/Adenosine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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