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Titolo:
Serial changes on quantitative myocardial perfusion SPECT in patients undergoing revascularization or conservative therapy
Autore:
Berman, DS; Kang, XP; Schisterman, EF; Gerlach, J; Kavanagh, PB; Areeda, JS; Sharir, T; Hayes, SW; Shaw, LJ; Lewin, HC; Friedman, JD; Miranda, R; Germano, G;
Indirizzi:
Cedars Sinai Med Ctr, Dept Imaging, Div Nucl Med, Los Angeles, CA 90048 USA Cedars Sinai Med Ctr Los Angeles CA USA 90048 , Los Angeles, CA 90048 USA Cedars Sinai Med Ctr, Dept Med, Div Cardiol, Los Angeles, CA 90048 USA Cedars Sinai Med Ctr Los Angeles CA USA 90048 , Los Angeles, CA 90048 USA Cedars Sinai Med Ctr, Burns & Allen Res Inst, Los Angeles, CA 90048 USA Cedars Sinai Med Ctr Los Angeles CA USA 90048 , Los Angeles, CA 90048 USA Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA Univ Calif Los Angeles Los Angeles CA USA 90024 Los Angeles, CA 90024 USA Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA USA Univ Calif Los Angeles Los Angeles CA USA t Biostat, Los Angeles, CA USA Emory Univ, Sch Med, Dept Med, Atlanta, GA USA Emory Univ Atlanta GA USAEmory Univ, Sch Med, Dept Med, Atlanta, GA USA
Titolo Testata:
JOURNAL OF NUCLEAR CARDIOLOGY
fascicolo: 4, volume: 8, anno: 2001,
pagine: 428 - 437
SICI:
1071-3581(200107/08)8:4<428:SCOQMP>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; EMISSION COMPUTED-TOMOGRAPHY; INCREMENTAL PROGNOSTIC VALUE; CONVERTING-ENZYME INHIBITOR; EXERCISE TL-201 TOMOGRAPHY; ISCHEMIC-HEART-DISEASE; INFARCTION; SESTAMIBI; RISK; REPRODUCIBILITY;
Keywords:
quantitative myocardial perfusion single photon emission computed tomography; conservative therapy; coronary revascularization; coronary artery disease;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Berman, DS Cedars Sinai Med Ctr, Dept Imaging, Div Nucl Med, 8700 Beverly Blvd,Room A042, Los Angeles, CA 90048 USA Cedars Sinai Med Ctr 8700 BeverlyBlvd,Room A042 Los Angeles CA USA 90048
Citazione:
D.S. Berman et al., "Serial changes on quantitative myocardial perfusion SPECT in patients undergoing revascularization or conservative therapy", J NUCL CARD, 8(4), 2001, pp. 428-437

Abstract

Background. Little is known about changes of myocardial perfusion in patients undergoing coronary revascularization or medical therapy. The purpose of this observational study was to assess the long-term effects of revascularization or conservative therapy on serial quantitative myocardial perfusion single photon emission computed tomography (SPECT). Methods and Results. The study population consisted of 421 patients who underwent serial rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion SPECT with at least a 1-year interval between the 2studies and who had abnormal quantitative scan results on the first stressSPECT. The mean interval between scans was 32.7 +/- 15.9 months. Patients were divided into 3 groups according to stress defect extent: group I had small stress defects (4%-10%, n = 145), group 2 had intermediate stress defects (>10%-20%, n = 144), and group 3 had extensive stress defects (>20%, n = 132) at baseline. Forty patients in group 1, 44 in group 2, and 54 in group 3 underwent coronary revascularization between 2 SPECT studies; the others had conservative therapy. In group 3 patients with revascularization, stress defect extent and reversible defect extent were remarkably reduced (14.5% +/- 13.6% and 13.1% +/- 12.5%, respectively; both P < .0001), with greater improvement in those patients reporting increased use of cardiac medications; resting defect extent was slightly reduced (1.9% <plus/minus> 6.4%, P < .05). In group 3 patients with conservative therapy, a small reduction in stress defect extent was noted (2.3% <plus/minus> 8.3%, P < .05). In group 2, there were modest, similar reductions in reversible defect extent in both the patients with revascularization (2.7% <plus/minus> 7.7%, P < .05) and those with conservative therapy (1.8% <plus/minus> 7.3%, P < .05), as well as a small but significant reduction in stress defect extent in those with conservative therapy (2.1% <plus/minus> 8.2 %, P < .05). In group 1 patients, no significant changes in stress, rest, or reversible defect extent were found with either therapy. Conclusions. The findings of this study show that improvement in quantitative myocardial perfusion abnormalities over time occurs in some patients with either revascularization or conservative therapy and suggest that, in patients with extensive defects, greater improvement may be seen in those whoundergo revascularization.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/01/20 alle ore 07:30:59