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Utility of nuclear stress imaging for detecting coronary artery bypass graft disease

BACKGROUND: The value of Single Photon Emission Computed Tomography stress myocardial perfusion imaging (SPECT-MPI) for detecting graft disease after coronary artery bypass surgery (CABG) has not been studied prospectively in an unselected cohort. METHODS: Radial Artery Versus Saphenous Vein Graft S...

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Autores principales: Al Aloul, Basel, Mbai, Mackenzi, Adabag, Selcuk, Garcia, Santiago, Thai, Hoang, Goldman, Steven, Holman, William, Sethi, Gulshan, Kelly, Rosemary, Ward, Herbert B, McFalls, Edward O
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469356/
https://www.ncbi.nlm.nih.gov/pubmed/22862805
http://dx.doi.org/10.1186/1471-2261-12-62
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author Al Aloul, Basel
Mbai, Mackenzi
Adabag, Selcuk
Garcia, Santiago
Thai, Hoang
Goldman, Steven
Holman, William
Sethi, Gulshan
Kelly, Rosemary
Ward, Herbert B
McFalls, Edward O
author_facet Al Aloul, Basel
Mbai, Mackenzi
Adabag, Selcuk
Garcia, Santiago
Thai, Hoang
Goldman, Steven
Holman, William
Sethi, Gulshan
Kelly, Rosemary
Ward, Herbert B
McFalls, Edward O
author_sort Al Aloul, Basel
collection PubMed
description BACKGROUND: The value of Single Photon Emission Computed Tomography stress myocardial perfusion imaging (SPECT-MPI) for detecting graft disease after coronary artery bypass surgery (CABG) has not been studied prospectively in an unselected cohort. METHODS: Radial Artery Versus Saphenous Vein Graft Study is a Veterans Affairs Cooperative Study to determine graft patency rates after CABG surgery. Seventy-nine participants agreed to SPECT-MPI within 24 hours of their coronary angiogram, one-year after CABG. The choice of the stress protocol was made at the discretion of the nuclear radiologist and was either a symptom-limited exercise test (n = 68) or an adenosine infusion (n = 11). The SPECT-MPI results were interpreted independent of the angiographic results and estimates of sensitivity, specificity and accuracy were based on the prediction of a graft stenosis of ≥70% on coronary angiogram. RESULTS: A significant stenosis was present in 38 (48%) of 79 patients and 56 (22%) of 251 grafts. In those stress tests with an optimal exercise heart rate response (>80% maximum predicted heart rate) (n = 26) sensitivity, specificity and accuracy of SPECT-MPI for predicting the graft stenosis was 77%, 69% and 73% respectively. With adenosine (n = 11) it was 75%, 57% and 64%, respectively. Among participants with a suboptimal exercise heart rate response, the sensitivity of SPECT-MPI for predicting a graft stenosis was <50%. The accuracy of SPECT-MPI for detecting graft disease did not vary significantly with ischemic territory. CONCLUSIONS: Under optimal stress conditions, SPECT-MPI has a good sensitivity and accuracy for detecting graft disease in an unselected patient population 1 year post-CABG.
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spelling pubmed-34693562012-10-12 Utility of nuclear stress imaging for detecting coronary artery bypass graft disease Al Aloul, Basel Mbai, Mackenzi Adabag, Selcuk Garcia, Santiago Thai, Hoang Goldman, Steven Holman, William Sethi, Gulshan Kelly, Rosemary Ward, Herbert B McFalls, Edward O BMC Cardiovasc Disord Research Article BACKGROUND: The value of Single Photon Emission Computed Tomography stress myocardial perfusion imaging (SPECT-MPI) for detecting graft disease after coronary artery bypass surgery (CABG) has not been studied prospectively in an unselected cohort. METHODS: Radial Artery Versus Saphenous Vein Graft Study is a Veterans Affairs Cooperative Study to determine graft patency rates after CABG surgery. Seventy-nine participants agreed to SPECT-MPI within 24 hours of their coronary angiogram, one-year after CABG. The choice of the stress protocol was made at the discretion of the nuclear radiologist and was either a symptom-limited exercise test (n = 68) or an adenosine infusion (n = 11). The SPECT-MPI results were interpreted independent of the angiographic results and estimates of sensitivity, specificity and accuracy were based on the prediction of a graft stenosis of ≥70% on coronary angiogram. RESULTS: A significant stenosis was present in 38 (48%) of 79 patients and 56 (22%) of 251 grafts. In those stress tests with an optimal exercise heart rate response (>80% maximum predicted heart rate) (n = 26) sensitivity, specificity and accuracy of SPECT-MPI for predicting the graft stenosis was 77%, 69% and 73% respectively. With adenosine (n = 11) it was 75%, 57% and 64%, respectively. Among participants with a suboptimal exercise heart rate response, the sensitivity of SPECT-MPI for predicting a graft stenosis was <50%. The accuracy of SPECT-MPI for detecting graft disease did not vary significantly with ischemic territory. CONCLUSIONS: Under optimal stress conditions, SPECT-MPI has a good sensitivity and accuracy for detecting graft disease in an unselected patient population 1 year post-CABG. BioMed Central 2012-08-03 /pmc/articles/PMC3469356/ /pubmed/22862805 http://dx.doi.org/10.1186/1471-2261-12-62 Text en Copyright ©2012 Al Aloul et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Al Aloul, Basel
Mbai, Mackenzi
Adabag, Selcuk
Garcia, Santiago
Thai, Hoang
Goldman, Steven
Holman, William
Sethi, Gulshan
Kelly, Rosemary
Ward, Herbert B
McFalls, Edward O
Utility of nuclear stress imaging for detecting coronary artery bypass graft disease
title Utility of nuclear stress imaging for detecting coronary artery bypass graft disease
title_full Utility of nuclear stress imaging for detecting coronary artery bypass graft disease
title_fullStr Utility of nuclear stress imaging for detecting coronary artery bypass graft disease
title_full_unstemmed Utility of nuclear stress imaging for detecting coronary artery bypass graft disease
title_short Utility of nuclear stress imaging for detecting coronary artery bypass graft disease
title_sort utility of nuclear stress imaging for detecting coronary artery bypass graft disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469356/
https://www.ncbi.nlm.nih.gov/pubmed/22862805
http://dx.doi.org/10.1186/1471-2261-12-62
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