Abstract
Background: Some specifics of cardiac stress protocols, i.e., stressor used or exercise level achieved, may impact myocardial perfusion imaging (MPI) accuracy.
Methods: Four-hundred and seventy-five patients were submitted to MPI and coronary angiography. MPI was performed after exercise (303 patients) or dipyridamole stress (172 patients). A coronary stenosis ≥70% was considered significant. In case of exercise test, a peak heart rate (HR) 75% and
Results: At coronary angiography, 312/475 (66%) patients showed significant stenosis. In the overall population, MPI showed a high accuracy in unmasking significant coronary stenosis, independently of the stress protocol adopted (AUC .76 for exercise vs .78 for vasodilator; P = NS). However, in case of an exercise stress test, a significant interaction between peak %HR and MPI diagnostic power was evident. While an elevated accuracy was still maintained in “Group 1” patients (AUC .79; P vs maximal exercise = NS), a significant drop was demonstrated in “Group 2” patients (AUC .66; P vs maximal exercise = .012, and P vs “Group 1” = .042).
Conclusions: The accuracy of MPI is not influenced by the stress protocol adopted. Exercise MPI maintains an elevated accuracy as long as the %HR remains >75%.
| Original language | English |
|---|---|
| Journal | Journal of Nuclear Cardiology |
| DOIs | |
| Publication status | Accepted/In press - Mar 27 2015 |
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Keywords
- CZT
- exercise stress test
- ischemic heart disease
- Myocardial perfusion imaging
- pharmacological stress test
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Radiology Nuclear Medicine and imaging
Cite this
Influence of cardiac stress protocol on myocardial perfusion imaging accuracy : The role of exercise level on the evaluation of ischemic burden. / Gimelli, Alessia; Liga, Riccardo; Pasanisi, Emilio Maria; Casagranda, Mirta; Coceani, Michele; Marzullo, Paolo.
In: Journal of Nuclear Cardiology, 27.03.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Influence of cardiac stress protocol on myocardial perfusion imaging accuracy
T2 - The role of exercise level on the evaluation of ischemic burden
AU - Gimelli, Alessia
AU - Liga, Riccardo
AU - Pasanisi, Emilio Maria
AU - Casagranda, Mirta
AU - Coceani, Michele
AU - Marzullo, Paolo
PY - 2015/3/27
Y1 - 2015/3/27
N2 - Background: Some specifics of cardiac stress protocols, i.e., stressor used or exercise level achieved, may impact myocardial perfusion imaging (MPI) accuracy.Methods: Four-hundred and seventy-five patients were submitted to MPI and coronary angiography. MPI was performed after exercise (303 patients) or dipyridamole stress (172 patients). A coronary stenosis ≥70% was considered significant. In case of exercise test, a peak heart rate (HR) 75% and Results: At coronary angiography, 312/475 (66%) patients showed significant stenosis. In the overall population, MPI showed a high accuracy in unmasking significant coronary stenosis, independently of the stress protocol adopted (AUC .76 for exercise vs .78 for vasodilator; P = NS). However, in case of an exercise stress test, a significant interaction between peak %HR and MPI diagnostic power was evident. While an elevated accuracy was still maintained in “Group 1” patients (AUC .79; P vs maximal exercise = NS), a significant drop was demonstrated in “Group 2” patients (AUC .66; P vs maximal exercise = .012, and P vs “Group 1” = .042).Conclusions: The accuracy of MPI is not influenced by the stress protocol adopted. Exercise MPI maintains an elevated accuracy as long as the %HR remains >75%.
AB - Background: Some specifics of cardiac stress protocols, i.e., stressor used or exercise level achieved, may impact myocardial perfusion imaging (MPI) accuracy.Methods: Four-hundred and seventy-five patients were submitted to MPI and coronary angiography. MPI was performed after exercise (303 patients) or dipyridamole stress (172 patients). A coronary stenosis ≥70% was considered significant. In case of exercise test, a peak heart rate (HR) 75% and Results: At coronary angiography, 312/475 (66%) patients showed significant stenosis. In the overall population, MPI showed a high accuracy in unmasking significant coronary stenosis, independently of the stress protocol adopted (AUC .76 for exercise vs .78 for vasodilator; P = NS). However, in case of an exercise stress test, a significant interaction between peak %HR and MPI diagnostic power was evident. While an elevated accuracy was still maintained in “Group 1” patients (AUC .79; P vs maximal exercise = NS), a significant drop was demonstrated in “Group 2” patients (AUC .66; P vs maximal exercise = .012, and P vs “Group 1” = .042).Conclusions: The accuracy of MPI is not influenced by the stress protocol adopted. Exercise MPI maintains an elevated accuracy as long as the %HR remains >75%.
KW - CZT
KW - exercise stress test
KW - ischemic heart disease
KW - Myocardial perfusion imaging
KW - pharmacological stress test
UR - http://www.scopus.com/inward/record.url?scp=84925627727&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84925627727&partnerID=8YFLogxK
U2 - 10.1007/s12350-015-0101-z
DO - 10.1007/s12350-015-0101-z
M3 - Article
AN - SCOPUS:84925627727
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
SN - 1071-3581
ER -