2012-10-01
Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography
Publication
Publication
Journal of Nuclear Cardiology , Volume 19 - Issue 5 p. 907- 913
Background. Exercise 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) is a useful tool for short- and medium-term risk stratifications. Currently, the longterm prognostic application of this technique has not been evaluated. Methods and Results. Exercise 99mTc-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 99mTc-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 99mTc-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. (J Nucl Cardiol 2012;19:907-13.).
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| doi.org/10.1007/s12350-012-9585-y, hdl.handle.net/1765/73090 | |
| Journal of Nuclear Cardiology | |
| Organisation | Department of Pathology |
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Boiten, H.-J., van der Sijde, J., Ruitinga, W., Valkema, R., Geleijnse, M., Sijbrands, E., … Schinkel, A. (2012). Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography. Journal of Nuclear Cardiology, 19(5), 907–913. doi:10.1007/s12350-012-9585-y |
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