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Titolo:
PROGNOSTIC VALUE OF DOBUTAMINE-ATROPINE STRESS TC-99M SESTAMIBI PERFUSION SCINTIGRAPHY IN PATIENTS WITH CHEST PAIN
Autore:
GELEIJNSE ML; ELHENDY A; VANDOMBURG RT; CORNEL JH; REIJS AEM; ROELANDT JRTC; KRENNING EP; FIORETTI PM;
Indirizzi:
THORAX CTR ROTTERDAM,BA 302,DR MOLEWATERPLEIN 40 NL-3015 GD ROTTERDAMNETHERLANDS THORAX CTR ROTTERDAM NL-3015 GD ROTTERDAM NETHERLANDS UNIV ROTTERDAM HOSP,DEPT NUCL MED ROTTERDAM NETHERLANDS ERASMUS UNIV ROTTERDAM ROTTERDAM NETHERLANDS
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 2, volume: 28, anno: 1996,
pagine: 447 - 454
SICI:
0735-1097(1996)28:2<447:PVODST>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; EMISSION COMPUTED-TOMOGRAPHY; ECHOCARDIOGRAPHY; SPECT; SAFETY; EXTENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
32
Recensione:
Indirizzi per estratti:
Citazione:
M.L. Geleijnse et al., "PROGNOSTIC VALUE OF DOBUTAMINE-ATROPINE STRESS TC-99M SESTAMIBI PERFUSION SCINTIGRAPHY IN PATIENTS WITH CHEST PAIN", Journal of the American College of Cardiology, 28(2), 1996, pp. 447-454

Abstract

Objectives. This study investigated the prognostic value of dobutamine-atropine technetium-99m (Tc-99m) sestamibi single photon emission computed tomographic (SPECT) myocardial perfusion imaging. Background Dobutamine atropine Tc-99m sestamibi SPECT imaging is an accurate methodfor the detection of coronary disease, However, the prognostic value of this stress modality has not been assessed. Methods. Three hundred ninety-two consecutive patients with chest pain (mean [+/-SD] age 60 +/- 12 years; 220 men, 190 with a previous myocardial infarction) underwent a dobutamine-atropine Tc-99m sestamibi SPECT scintigraphic study. Patients were followed up for 22 +/- 13 months to determine the univariate and multivariate variables associated with hard cardiac events (cardiac death, nonfatal myocardial infarction), to define their event-free survival and to determine whether the extent and severity of reversible perfusion defects correlated with events. Results. Forty-four patients (11%) had hard cardiac events. Multivariate models demonstrated that older age (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.0 to 4.4), history of heart failure (OR 2.6, 95% CI 1.3 to 5.2), abnormal sestamibi scan results (OR 10.0, 95% CI 2.3 to 43.0) and reversible perfusion defects (OR 3.2, 95% CI 1.6 to 6.4) had independent predictive value. Patients without perfusion defects, with fixed defects alone, reversible defects alone and fixed plus reversible defects had annual hard cardiac event rates of 0.8%, 6.8%, 8.1% and 11.6%, respectively. Patients with increasing reversible defect scores had increasing annual event rates of 2.1%, 5.0%, 5.5%, 13.0% and 14.6%, respectively. Conclusions. Dobutamine atropine stress Tc-99m sestamibi SPECT imagingprovides excellent prognostic information. The single most important independent predictor for future hard cardiac events is an abnormal pattern, and a reversible defect provides additional, independent prognostic information. Moreover, the extent and severity of reversible defects are major determinants for prognosis.

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Documento generato il 19/01/20 alle ore 06:05:40