| Risk stratification with attenuation corrected stress Tc-99m sestamibi SPECT myocardial perfusion imaging in the absence of ECG-gating due to arrhythmias. | |
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MedLine Citation:
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PMID: 19288163 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Despite growing recognition of attenuation correction (AC) utilizing an external radiation source, prognostic studies using AC are lacking. METHODS: Consecutive patients (n = 419) who underwent stress Tc-99m sestamibi SPECT imaging with AC but without ECG-gating, due to arrhythmia, were followed for cardiac death or non-fatal myocardial infarction (MI). A 17-segment model and the summed stress score (SSS) were used to classify both the non-AC and AC images. RESULTS: The 419 patients had a mean age of 71.5 +/- 11.7 years and most (70.6%) underwent pharmacologic stress. In follow-up, 35 (8.4%) patients suffered an adverse cardiac event. Patients with AC-SSS 1-3 and AC-SSS 4-8 had similar cardiac event rates (11.4% vs 10.5%, P = NS). Accordingly, AC-SSS cutoffs of 0, 1-8, and >8 were selected to classify perfusion as normal, mildly abnormal, and moderately to severely abnormal with annualized event rates of 2.1%, 10.8%, and 18.7%, respectively (P < .001). In multivariable analysis, AC-SSS >8 was the most powerful predictor of cardiac events followed by AC-SSS 1-8, history of CAD, age >75 and pharmacologic stress. CONCLUSIONS: AC provides powerful risk stratification when added to clinical variables in patients undergoing stress Tc-99m sestamibi SPECT imaging without ECG-gating. Moreover, smaller/less severe defects on AC data are more significant than if the same defects were seen on non-AC data. |
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Authors:
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Sarkis B Baghdasarian; Gavin L Noble; Alan W Ahlberg; Deborah Katten; Gary V Heller |
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Publication Detail:
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Type: Journal Article Date: 2009-03-14 |
Journal Detail:
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Title: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology Volume: 16 ISSN: 1532-6551 ISO Abbreviation: J Nucl Cardiol Publication Date: 2009 Jul-Aug |
Date Detail:
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Created Date: 2009-07-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9423534 Medline TA: J Nucl Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 533-9 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Nuclear Cardiology Laboratory, Deborah Heart and Lung Center, 200 Trenton Road, Browns Mills, NJ 08015, USA. sarkisbmd@yahoo.com |
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Comment In:
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J Nucl Cardiol. 2009 Jul-Aug;16(4):490-2
[PMID:
19343462
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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