Rest-redistribution 201-Thallium single photon emission computed tomography predicts myocardial infarction and cardiac death in patients with ischemic left ventricular dysfunction

Pasquale Perrone-Filardi, Leonardo Pace, Santo Dellegrottaglie, Luigi Corrado, Maria Prastaro, Maria Cafiero, Gianluca Caiazzo, Antonio Marzano, Paolo Cesarano, Paola Gargiulo, Stefania Paolillo, Antonio Maglione, Andrea Petretta, Massimo Chiariello

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)122-128
Number of pages7
JournalJournal of Cardiovascular Medicine
Volume10
Issue number2
DOIs
Publication statusPublished - Feb 2009

Keywords

  • Chronic coronary artery disease
  • Left ventricular dysfunction
  • Myocardial perfusion scintigraphy
  • Myocardial viability
  • Nuclear cardiology
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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