Incremental prognostic value of cardiac single-photon emission computed tomography after nitrate administration in patients with ischemic left ventricular dysfunction View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-02

AUTHORS

Laura Evangelista, Wanda Acampa, Mario Petretta, Adele Ferro, Francesca Ricci, Luca Luongo, Stefania Daniele, Giorgio Punzo, Alberto Cuocolo

ABSTRACT

BACKGROUND: We evaluated the incremental prognostic value of viability assessment by nitrate single-photon emission computed tomography (SPECT) in patients with ischemic left ventricular (LV) dysfunction. METHODS AND RESULTS: One hundred and sixty-four patients with previous myocardial infarction and LV dysfunction (ejection fraction 29% +/- 15%) underwent two Tc-99m sestamibi SPECT studies, under control conditions and after sublingual nitrate administration, for evaluation of myocardial viability. In each patient, viability was defined as the presence of > or = 2 severely dysfunctional segments with preserved tracer uptake (> or = 55% of peak activity). Cardiac death, myocardial infarction, and late (> 2 months) revascularization were considered events. Follow-up was 98% complete at a mean period of 30 +/- 24 months. At baseline SPECT, 119 (73%) patients had evidence of viable myocardium, while 45 (27%) did not. Of these latter patients, 18 (40%) had evidence of viability after nitrate administration. Cardiac events occurred in 58 (35%) patients. Cumulative probability of event-free survival was similar in patients with and without viability at baseline SPECT (log rank 0.3, P = NS), while it was lower in patients with viability at nitrate SPECT compared to those without (log rank 6.3, P < .01). The addition of nitrate SPECT data significantly improved the prognostic power of the model including clinical, functional, angiographic, and baseline SPECT data (P < .01). CONCLUSIONS: In patients with previous myocardial infarction and LV dysfunction, nitrate SPECT imaging provides incremental prognostic information over those obtained from clinical, functional, angiographic variables, and baseline SPECT data. More... »

PAGES

38-44

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12350-008-9004-6

DOI

http://dx.doi.org/10.1007/s12350-008-9004-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1051843399

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19152127


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45 schema:description BACKGROUND: We evaluated the incremental prognostic value of viability assessment by nitrate single-photon emission computed tomography (SPECT) in patients with ischemic left ventricular (LV) dysfunction. METHODS AND RESULTS: One hundred and sixty-four patients with previous myocardial infarction and LV dysfunction (ejection fraction 29% +/- 15%) underwent two Tc-99m sestamibi SPECT studies, under control conditions and after sublingual nitrate administration, for evaluation of myocardial viability. In each patient, viability was defined as the presence of > or = 2 severely dysfunctional segments with preserved tracer uptake (> or = 55% of peak activity). Cardiac death, myocardial infarction, and late (> 2 months) revascularization were considered events. Follow-up was 98% complete at a mean period of 30 +/- 24 months. At baseline SPECT, 119 (73%) patients had evidence of viable myocardium, while 45 (27%) did not. Of these latter patients, 18 (40%) had evidence of viability after nitrate administration. Cardiac events occurred in 58 (35%) patients. Cumulative probability of event-free survival was similar in patients with and without viability at baseline SPECT (log rank 0.3, P = NS), while it was lower in patients with viability at nitrate SPECT compared to those without (log rank 6.3, P < .01). The addition of nitrate SPECT data significantly improved the prognostic power of the model including clinical, functional, angiographic, and baseline SPECT data (P < .01). CONCLUSIONS: In patients with previous myocardial infarction and LV dysfunction, nitrate SPECT imaging provides incremental prognostic information over those obtained from clinical, functional, angiographic variables, and baseline SPECT data.
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