The significance of post-stress decrease in left ventricular ejection fraction in patients undergoing regadenoson stress gated SPECT myocardial perfusion imaging

Autor: Rami Doukky, Adebayo Olusanya, J. P. Gomez, Yasmeen Golzar, Ibtihaj Fughhi
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Gated SPECT
030204 cardiovascular system & hematology
Ventricular Function
Left
030218 nuclear medicine & medical imaging
Coronary artery disease
03 medical and health sciences
Myocardial perfusion imaging
0302 clinical medicine
Internal medicine
Humans
Medicine
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Myocardial infarction
Aged
Ejection fraction
medicine.diagnostic_test
business.industry
Myocardial Perfusion Imaging
Area under the curve
Stroke Volume
Middle Aged
medicine.disease
Confidence interval
Regadenoson
Purines
Exercise Test
cardiovascular system
Cardiology
Pyrazoles
Female
Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography
Cardiology and Cardiovascular Medicine
business
circulatory and respiratory physiology
medicine.drug
Zdroj: Journal of Nuclear Cardiology. 25:1313-1323
ISSN: 1532-6551
1071-3581
DOI: 10.1007/s12350-017-0802-6
Popis: The significance of post-stress decrease in left ventricular ejection fraction (LVEF) with regadenoson stress gated SPECT (GSPECT) myocardial perfusion imaging (MPI) has not been studied. Consecutive patients who underwent rest/regadenoson stress GSPECT-MPI followed by coronary angiography within 6 months were analyzed. Change in LVEF by GSPECT-MPI was calculated as stress LVEF minus rest LVEF; a significant decrease was tested at 5% and 10% thresholds. In a diagnostic cohort of 793 subjects, LVEF change was not predictive of severe/extensive coronary artery disease (area under the curve, 0.50; 95% confidence interval, 0.44-0.57; P = 0.946). There was no significant difference in the rates of severe/extensive coronary artery disease in patients with or without a decrease in LVEF, irrespective of MPI findings. In an outcome cohort of the 929 subjects followed for 30 ± 16 months, post-regadenoson stress decrease in LVEF was not associated with increased risk of the composite endpoint of cardiac death or myocardial infarction or in the risk of coronary revascularization. In patients selected to undergo coronary angiography following regadenoson stress GSPECT-MPI, a decrease in LVEF after regadenoson stress is not predictive of severe/extensive CAD or adverse clinical outcomes, irrespective of MPI findings.
Databáze: OpenAIRE
Externí odkaz: