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Relationship Between Myocardial Perfusion-Gated SPECT and the Performance of Coronary Revascularization in Patients With Ischemic Cardiomyopathy.
MedLine Citation:
PMID:  22955070     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: Ischemic cardiomyopathy (ICM) is a disease with high morbidity and mortality. There are several published studies on the evolution and prognosis of patients with ICM. However, reports on the therapeutic management in clinical practice are scarce. The aim of this study was to analyze coronary revascularization (CR) performance in patients with ICM and suitable coronary anatomy according to myocardial perfusion stress-rest gated SPECT results.
PATIENTS AND METHODS: Eighty-seven consecutive patients (mean age, 62.4 y; 20 women), with ischemic heart disease, left ventricular ejection fraction of 40% or less, coronary anatomy suitable for CR, and without previous CR, were evaluated by means of stress-rest gated SPECT.
RESULTS: Sixty-four percent of patients had scintigraphic criteria of viability and 62.1% showed scintigraphic ischemia in stress-rest gated SPECT. Forty-five percent of patients were revascularized, and the remainder received medical treatment only. Coronary revascularization was more frequent in patients with scintigraphic viability (P = 0.012), in those with scintigraphic ischemia (P = 0.007), and in those with low left ventricular end-systolic volume (P = 0.006). Cox regression analysis identified multivessel disease [hazard ratio (HR), 3.3; 95% confidence interval (CI), 4-7.8], summed difference score greater than 4 (HR, 3.9; 95% CI, 1.5-9.8), and left ventricular end-systolic volume less than 120 mL (HR, 3.2; 95% CI, 1.3-8.2) as the best independent predictors of CR treatment.
CONCLUSIONS: In patients with ICM and suitable coronary arteries who are able to perform a stress myocardial perfusion-gated SPECT, the presence of multivessel disease and myocardial ischemia and the absence of severely increased left ventricular volume were associated to a decision of CR.
Guillermo Romero-Farina; Jaume Candell-Riera; Santiago Aguadé-Bruix; Ignacio Ferreira-Gonzalez; Albert Igual; David García-Dorado
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  37     ISSN:  1536-0229     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  965-70     Citation Subset:  IM    
From the *Servei de Cardiologia, Àrea del Cor, †Servei de Medicina Nuclear, and ‡Servei de Cirurgia Cardiaca, Hospital Universitari Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, Spain.
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