Transient ischemic dilatation with adenosine 99m Tc-sestamibi stress: prognostic significance in patients with normal myocardial perfusion.

Autor: Juweid ME; Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University of Jordan Hospital, University of Jordan, Queen Rania Street, Al Jubeiha, Amman, 11942, Jordan. mjuweid@yahoo.com., Alhouri A; Division of Cardiology, Department of Medicine, University of Jordan, Amman, Jordan., Baniissa B; Division of Cardiology, Department of Medicine, University of Jordan, Amman, Jordan., Rimawi D; King Hussein Cancer Center, Amman, Jordan., A-Risheq ZF; Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University of Jordan Hospital, University of Jordan, Queen Rania Street, Al Jubeiha, Amman, 11942, Jordan., Rabadi N; Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University of Jordan Hospital, University of Jordan, Queen Rania Street, Al Jubeiha, Amman, 11942, Jordan., Safi M; Division of Cardiology, Department of Medicine, University of Jordan, Amman, Jordan., Akkawi M; Division of Cardiology, Department of Medicine, University of Jordan, Amman, Jordan., Ismael AB; Division of Cardiology, Department of Medicine, University of Jordan, Amman, Jordan., Alhanafi A; Division of Cardiology, Department of Medicine, University of Jordan, Amman, Jordan., Alkhaldi S; Division of Cardiology, Department of Medicine, University of Jordan, Amman, Jordan., Obeidat OS; Division of Cardiology, Department of Medicine, University of Jordan, Amman, Jordan.
Jazyk: angličtina
Zdroj: Annals of nuclear medicine [Ann Nucl Med] 2021 May; Vol. 35 (5), pp. 569-579. Date of Electronic Publication: 2021 Mar 10.
DOI: 10.1007/s12149-021-01599-3
Abstrakt: Objective: To determine the significance of transient ischemic dilatation (TID) in patients with normal perfusion on adenosine stress/rest.
Methods: We analyzed 430 consecutive patients with normal perfusion on 2-day adenosine stress/rest 99m Tc-sestamibi. A group of 70 patients with Framingham 10-year coronary heart disease risk < 10% was used to derive abnormal TID thresholds (derivation group). The significance of TID at these thresholds was validated in the remaining 360 patients (validation group) followed for cardiac events for 31.2 ± 9.7 (mean ± SD) months.
Results: Transient ischemic dilatation in the derivation group was 1.05 ± 0.13. Three definitions of an abnormal TID were used: > mean + 2SD (TID ≥ 1.32), > mean + 1SD (TID ≥ 1.19) and a TID in the group's highest quartile (TID ≥ 1.15). Of the 360 validation group patients, 12 (3.3%), 48 (13.3%) and 70 (19.4%) had TID ≥ 1.32, 1.19 and 1.15, respectively. Age, gender, family history of coronary artery disease (CAD), known CAD, smoking, hypertension, diabetes, dyslipidemia, rest LVEF, post-stress LVEF, ΔLVEF, ≥ 5% or 10% decrease in LVEF did not predict TID ≥ 1.32. However, TID ≥ 1.19 was predicted by rest LVEF and ≥ 5% decrease in LVEF (P = 0.04 and 0.02, respectively) and TID ≥ 1.15 was predicted by ≥ 5% decrease in LVEF (P = 0.02). Cardiac event-free survivals were similar in patients with a TID ≥ and < 1.32 (P = 0.68), ≥ and < 1.19 (P = 0.40) and ≥ and < 1.15 (P = 0.79).
Conclusions: Transient ischemic dilatation does not confer adverse prognosis in patients with normal perfusion on adenosine stress/rest 99m Tc-sestamibi irrespective of the threshold used for its definition.
Databáze: MEDLINE
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