Document Detail


Risk stratification with attenuation corrected stress Tc-99m sestamibi SPECT myocardial perfusion imaging in the absence of ECG-gating due to arrhythmias.
MedLine Citation:
PMID:  19288163     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
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.
Authors:
Sarkis B Baghdasarian; Gavin L Noble; Alan W Ahlberg; Deborah Katten; Gary V Heller
Related Documents :
9853343 - Stress and rest myocardial spet quantification with 201tl and 99tcm-tetrofosmin: a comp...
1387053 - Acute subendocardial infarction with diffuse intense tc-99m pyp uptake and minimal tl-2...
18819073 - Endothelial function in patients with and without diabetes mellitus with different degr...
Publication Detail:
Type:  Journal Article     Date:  2009-03-14
Journal Detail:
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:
Created Date:  2009-07-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  533-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Nuclear Cardiology Laboratory, Deborah Heart and Lung Center, 200 Trenton Road, Browns Mills, NJ 08015, USA. sarkisbmd@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Comments/Corrections
Comment In:
J Nucl Cardiol. 2009 Jul-Aug;16(4):490-2   [PMID:  19343462 ]

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


Previous Document:  Measurement of the mechanical properties of bone: a recent history.
Next Document:  Mechanism for myocardial localization and rapid liver clearance of Tc-99m-N-MPO: a new perfusion rad...