ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
Prognostic significance of ischemic electrocardiographic changes during adenosine infusion in patients with normal myocardial perfusion imaging.
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 33 papers, 1 of them a synthesis that pooled it.
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33 citing papers in PubMed, 1 synthesis or guideline pooled it, 114 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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- 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
- 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
- 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
- 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 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
- New SPECT and PET radiopharmaceuticals for imaging cardiovascular disease.BioMed research international · 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
- Gender differences in myocardial perfusion defect in asymptomatic postmenopausal women and men with and without diabetes mellitus.Journal of women's health (2002) · 2013Article
- Prevalence and significance of electrocardiographic changes and side effect profile of regadenoson compared with adenosine during myocardial perfusion imaging.Journal of cardiovascular disease research · 2013Article
- Comparison and effectiveness of regadenoson versus dipyridamole on stress electrocardiographic changes during positron emission tomography evaluation of patients with hypertrophic cardiomyopathy.The American journal of cardiology · 2012Article
- 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
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4 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe development of ST-segment depression during adenosine myocardial perfusion imaging (MPI) has been shown to be an independent predictor of subsequent cardiac events and worse outcome, particularly in association with ischemic defects. However, the prognostic significance of ST-segment depression with adenosine in patients with normal MPI is not known. METHODS AND
resultsWe performed a retrospective analysis of 3231 patients undergoing adenosine MPI. Patients with baseline electrocardiographic (ECG) abnormalities were excluded. Overall, 228 patients (7%) had ischemic ECG changes develop during adenosine infusion. Of these, 66 (29% [2% of all patients]) had normal MPI (+ECG group). An age- and sex-matched group of 200 patients with normal MPI without ECG changes served as control subjects (-ECG group). During a mean follow-up of 29 +/- 12 months, patients in the +ECG group had significantly more adverse cardiac events than those in the -ECG group (nonfatal myocardial infarction, 7.6% vs 0.5%, respectively, P = .004; subsequent revascularization, 13.6% vs 2.5%, respectively, P = .0015). Although cardiac death alone did not differ between the 2 groups (+ECG, 3.0%, vs -ECG, 1.0%; P = .25), cumulative survival free from cardiac death and nonfatal myocardial infarction was worse in patients with ST-segment depression during adenosine infusion and normal MPI (+ECG, 10.6%, vs -ECG, 1.5%; log-rank chi(2) = 11.82; P = .0006).
conclusionsPatients with normal myocardial perfusion images in whom ST-segment depression develops during adenosine administration appear to be at increased risk for future cardiac events compared with similar patients without ECG evidence of ischemia. Ischemic ECG changes during adenosine MPI should warrant further evaluation, even when perfusion images are reassuring.
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