TY - JOUR
T1 - Rest-redistribution 201-Thallium single photon emission computed tomography predicts myocardial infarction and cardiac death in patients with ischemic left ventricular dysfunction
AU - Perrone-Filardi, Pasquale
AU - Pace, Leonardo
AU - Dellegrottaglie, Santo
AU - Corrado, Luigi
AU - Prastaro, Maria
AU - Cafiero, Maria
AU - Caiazzo, Gianluca
AU - Marzano, Antonio
AU - Cesarano, Paolo
AU - Gargiulo, Paola
AU - Paolillo, Stefania
AU - Maglione, Antonio
AU - Petretta, Andrea
AU - Chiariello, Massimo
PY - 2009/2
Y1 - 2009/2
N2 - The prognostic role of rest-redistribution 201-Thallium imaging has not been extensively investigated in patients with left ventricular ischemic dysfunction. OBJECTIVE: The aim of this study was to evaluate the ability of rest-redistribution 201-Thallium single photon emission computed tomography to predict cardiac death and occurrence of acute myocardial infarction in patients with ischemic mild-to-moderate left ventricular dysfunction. METHODS: One-hundred and twenty-six patients with chronic coronary artery disease and mean left ventricular ejection fraction 39 ± 11% were followed-up for 30 ± 17 months after a rest-redistribution 201-Thallium imaging single photon emission computed tomography. Cardiac death and acute myocardial infarction were considered as major cardiac events. RESULTS: During the follow up, 11 (9%) cardiac deaths and 9 (7%) acute myocardial infarctions occurred. The only variable showing significant difference between patients with and without events was the number of severe irreversible defects (1.7 ± 1.9 versus 0.9 ± 1.2, respectively; P = 0.02). By Kaplan-Meier analysis, the presence of three or less, or more than three severe defects was selected as the best cutoff to identify patients with longer event-free survival from cardiac death or acute myocardial infarction (log rank 19.84; P <0.0001). When only cardiac death was considered as clinical event, the presence of at least two severe defects best separated patients who died from those who survived (log rank 8.68; P = 0.0032). CONCLUSION: Rest-redistribution 201-Thallium single photon emission computed tomography provides prognostic information in coronary patients with mild-to-moderate left ventricular dysfunction. The number of severe irreversible defects per patient is a powerful predictor of prognosis.
AB - The prognostic role of rest-redistribution 201-Thallium imaging has not been extensively investigated in patients with left ventricular ischemic dysfunction. OBJECTIVE: The aim of this study was to evaluate the ability of rest-redistribution 201-Thallium single photon emission computed tomography to predict cardiac death and occurrence of acute myocardial infarction in patients with ischemic mild-to-moderate left ventricular dysfunction. METHODS: One-hundred and twenty-six patients with chronic coronary artery disease and mean left ventricular ejection fraction 39 ± 11% were followed-up for 30 ± 17 months after a rest-redistribution 201-Thallium imaging single photon emission computed tomography. Cardiac death and acute myocardial infarction were considered as major cardiac events. RESULTS: During the follow up, 11 (9%) cardiac deaths and 9 (7%) acute myocardial infarctions occurred. The only variable showing significant difference between patients with and without events was the number of severe irreversible defects (1.7 ± 1.9 versus 0.9 ± 1.2, respectively; P = 0.02). By Kaplan-Meier analysis, the presence of three or less, or more than three severe defects was selected as the best cutoff to identify patients with longer event-free survival from cardiac death or acute myocardial infarction (log rank 19.84; P <0.0001). When only cardiac death was considered as clinical event, the presence of at least two severe defects best separated patients who died from those who survived (log rank 8.68; P = 0.0032). CONCLUSION: Rest-redistribution 201-Thallium single photon emission computed tomography provides prognostic information in coronary patients with mild-to-moderate left ventricular dysfunction. The number of severe irreversible defects per patient is a powerful predictor of prognosis.
KW - Chronic coronary artery disease
KW - Left ventricular dysfunction
KW - Myocardial perfusion scintigraphy
KW - Myocardial viability
KW - Nuclear cardiology
KW - Prognosis
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U2 - 10.2459/JCM.0b013e32831a0ea8
DO - 10.2459/JCM.0b013e32831a0ea8
M3 - Article
C2 - 19377379
AN - SCOPUS:65549167916
VL - 10
SP - 122
EP - 128
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 2
ER -