ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
Prognostic significance of ischemic electrocardiographic changes during vasodilator stress testing in patients with normal SPECT images.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 94 citations in OpenAlex.
- Stress protocols and tracers.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2006Guideline
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- The chest pain guidelines revisited: cherry picking from the frequentist tree.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Gated SPECT beyond myocardial perfusion: assessment of mechanical left ventricular synchrony.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Abnormal vasodilator stress electrocardiogram with normal myocardial perfusion: Clinical decision-making and review of literature.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Review
- Prognostic significance of ischemic electrocardiographic changes with regadenoson stress myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- Examining a novel threshold for defining electrocardiographic ischemia with vasodilator stress.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- Myocardial perfusion imaging in women for the evaluation of stable ischemic heart disease-state-of-the-evidence and clinical recommendations.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- The role of pharmacological stress testing in women.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Review
- The prognostic value of non-perfusion variables obtained during vasodilator stress myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Review
- Diagnostic and prognostic significance of ischemic electrocardiographic changes with regadenoson-stress myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015Article
- Normal Myocardial Perfusion Gated SPECT and Positive Stress Test: Different Prognoses in Women and Men.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015Article
- Electrocardiographic profile of adenosine pharmacological stress testing.Experimental and therapeutic medicine · 2015Article
- Warranty periods for normal myocardial perfusion stress SPECT.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015Article
- The Significance of ST Depression in a Postmenopausal Woman on Estrogen Therapy during Regadenoson Myocardial SPECT Imaging.Case reports in cardiology · 2015Article
- Assessing clinical impact of myocardial perfusion studies: ischemia or other prognostic indicators?Current cardiology reports · 2014Review
- Predictive variables for hard cardiac events and coronary revascularization in patients with normal left ventricular myocardial perfusion and systolic function.European journal of nuclear medicine and molecular imaging · 2013Article
- ST-segment depression during vasodilator stress is of minor clinical importance in women with normal myocardial perfusion imaging and low or intermediate risk of coronary artery disease.European journal of nuclear medicine and molecular imaging · 2012Article
- Electrocardiographic changes during vasodilator SPECT myocardial perfusion imaging: does it affect diagnosis or prognosis?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2012Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with ischemic electrocardiographic (ECG) findings during exercise stress testing but normal perfusion images generally have a low risk of cardiac death or myocardial infarction (<1% per year). During vasodilator stress testing, however, the prognostic significance of the combination of normal perfusion images and ischemic ECG changes is unknown. METHODS AND
resultsAmong 5526 patients who underwent vasodilator stress single photon emission computed tomography (SPECT), 49 (0.9%) had normal images but ischemic ECG changes. A unique feature of this population was that 43 (88%) were women with a mean age of 67 +/- 10 years. Ischemic ECG changes occurred at a mean heart rate of 101 +/- 15 beats per minute and persisted for 6.8 +/- 4.7 minutes after termination of drug infusion. During follow-up of 28 +/- 20 months, cardiac death occurred in 2 patients and nonfatal myocardial infarction in 4 patients. The rate of cardiac death or nonfatal myocardial infarction was 4% at 1 year, 10% at 2 years, and 14% at 3 years. Of the 12 patients who underwent coronary angiography or autopsy during follow-up, 11 had multivessel coronary artery disease, indicating that these patients likely had false-negative SPECT image results. Eight patients required coronary revascularization.
conclusionsThe finding of ischemic ECG changes with normal SPECT images during vasodilator infusion is uncommon, occurs primarily in older women, and is associated with a higher subsequent cardiac event rate than is customarily associated with normal images.
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