Achieving an Exercise Workload of ≥10 Metabolic Equivalents Predicts a Very Low Risk of Inducible Ischemia
| Autor: | Jamieson M. Bourque, George A. Beller, Benjamin H. Holland, Denny D. Watson |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Ischemia Perfusion scanning Physical exercise 030204 cardiovascular system & hematology medicine.disease Metabolic equivalent Surgery Coronary artery disease 03 medical and health sciences Myocardial perfusion imaging 0302 clinical medicine Internal medicine Heart rate medicine Cardiology 030212 general & internal medicine Risk factor Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American College of Cardiology. 54:538-545 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2009.04.042 |
| Popis: | Objectives We sought to identify prospectively the prevalence of significant ischemia (≥10% of the left ventricle [LV]) on exercise single-photon emission computed tomography (SPECT) imaging relative to workload achieved in consecutive patients referred for myocardial perfusion imaging (MPI). Background High exercise capacity is a strong predictor of a good prognosis, and the role of MPI in patients achieving high workloads is questionable. Methods Prospective analysis was performed on 1,056 consecutive patients who underwent quantitative exercise gated 99mTc-SPECT MPI, of whom 974 attained ≥85% of their maximum age-predicted heart rate. These patients were further divided on the basis of attained exercise workload ( Results Of these 974 subjects, 473 (48.6%) achieved ≥10 METs. This subgroup had a very low prevalence of significant ischemia (2 of 473, 0.4%). Those attaining Conclusions In this referral cohort of patients with an intermediate-to-high clinical risk of coronary artery disease, achieving ≥10 METs with no ischemic ST-segment depression was associated with a 0% prevalence of significant ischemia. Elimination of MPI in such patients, who represented 31% (430 of 1,396) of all patients undergoing exercise SPECT in this laboratory, could provide substantial cost-savings. |
| Databáze: | OpenAIRE |
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