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Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography
BACKGROUND: Exercise (99m)Tc-tetrofosmin single-photon emission computed tomography (SPECT) is a useful tool for short- and medium-term risk stratifications. Currently, the long-term prognostic application of this technique has not been evaluated. METHODS AND RESULTS: Exercise (99m)Tc-tetrofosmin wa...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer-Verlag
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462311/ https://www.ncbi.nlm.nih.gov/pubmed/22875719 http://dx.doi.org/10.1007/s12350-012-9585-y |
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author | Boiten, Hendrik J. van der Sijde, Johannes N. Ruitinga, Pauline R. Valkema, Roelf Geleijnse, Marcel L. Sijbrands, Eric J. G. van Domburg, Ron T. Schinkel, Arend F. L. |
author_facet | Boiten, Hendrik J. van der Sijde, Johannes N. Ruitinga, Pauline R. Valkema, Roelf Geleijnse, Marcel L. Sijbrands, Eric J. G. van Domburg, Ron T. Schinkel, Arend F. L. |
author_sort | Boiten, Hendrik J. |
collection | PubMed |
description | BACKGROUND: Exercise (99m)Tc-tetrofosmin single-photon emission computed tomography (SPECT) is a useful tool for short- and medium-term risk stratifications. Currently, the long-term prognostic application of this technique has not been evaluated. METHODS AND RESULTS: Exercise (99m)Tc-tetrofosmin was performed in 655 consecutive patients. Ten patients who underwent revascularization <60 days after nuclear testing were excluded from the analysis. The present data are based on 638 patients with complete follow-up. An abnormal SPECT study was defined as the presence of fixed and/or reversible perfusion defects. End points were cardiac death, nonfatal infarction, and late coronary revascularization. A total of 344 (54%) patients had an abnormal SPECT study. Perfusion defects included fixed defects alone in 186 patients (29%) and reversible defects in 158 (25%) patients. During a mean follow-up of 11.0 ± 3.3 years, 174 (27%) patients died (all-cause mortality). Nonfatal myocardial infarction occurred in 76 (12%) patients, and late coronary revascularization was performed in 194 (30%) patients. Univariable and multivariable Cox proportional hazard regression analyses showed that exercise (99m)Tc-tetrofosmin SPECT provided prognostic information incremental to clinical data and exercise test data. Patients with a normal SPECT had a relatively favorable long-term prognosis, in contrast to patients with an abnormal study who had a significantly increased risk of cardiac events. The SPECT parameters abnormal scan, reversible defect, and summed rest score were strong predictors of long-term outcome. CONCLUSION: Exercise (99m)Tc-tetrofosmin myocardial perfusion SPECT has an incremental long-term prognostic value over clinical and stress test parameters for the prediction of major adverse cardiac events. |
format | Online Article Text |
id | pubmed-3462311 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-34623112012-10-03 Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography Boiten, Hendrik J. van der Sijde, Johannes N. Ruitinga, Pauline R. Valkema, Roelf Geleijnse, Marcel L. Sijbrands, Eric J. G. van Domburg, Ron T. Schinkel, Arend F. L. J Nucl Cardiol Original Article BACKGROUND: Exercise (99m)Tc-tetrofosmin single-photon emission computed tomography (SPECT) is a useful tool for short- and medium-term risk stratifications. Currently, the long-term prognostic application of this technique has not been evaluated. METHODS AND RESULTS: Exercise (99m)Tc-tetrofosmin was performed in 655 consecutive patients. Ten patients who underwent revascularization <60 days after nuclear testing were excluded from the analysis. The present data are based on 638 patients with complete follow-up. An abnormal SPECT study was defined as the presence of fixed and/or reversible perfusion defects. End points were cardiac death, nonfatal infarction, and late coronary revascularization. A total of 344 (54%) patients had an abnormal SPECT study. Perfusion defects included fixed defects alone in 186 patients (29%) and reversible defects in 158 (25%) patients. During a mean follow-up of 11.0 ± 3.3 years, 174 (27%) patients died (all-cause mortality). Nonfatal myocardial infarction occurred in 76 (12%) patients, and late coronary revascularization was performed in 194 (30%) patients. Univariable and multivariable Cox proportional hazard regression analyses showed that exercise (99m)Tc-tetrofosmin SPECT provided prognostic information incremental to clinical data and exercise test data. Patients with a normal SPECT had a relatively favorable long-term prognosis, in contrast to patients with an abnormal study who had a significantly increased risk of cardiac events. The SPECT parameters abnormal scan, reversible defect, and summed rest score were strong predictors of long-term outcome. CONCLUSION: Exercise (99m)Tc-tetrofosmin myocardial perfusion SPECT has an incremental long-term prognostic value over clinical and stress test parameters for the prediction of major adverse cardiac events. Springer-Verlag 2012-08-09 2012 /pmc/articles/PMC3462311/ /pubmed/22875719 http://dx.doi.org/10.1007/s12350-012-9585-y Text en © The Author(s) 2012 https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Article Boiten, Hendrik J. van der Sijde, Johannes N. Ruitinga, Pauline R. Valkema, Roelf Geleijnse, Marcel L. Sijbrands, Eric J. G. van Domburg, Ron T. Schinkel, Arend F. L. Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography |
title | Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography |
title_full | Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography |
title_fullStr | Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography |
title_full_unstemmed | Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography |
title_short | Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography |
title_sort | long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462311/ https://www.ncbi.nlm.nih.gov/pubmed/22875719 http://dx.doi.org/10.1007/s12350-012-9585-y |
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