ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2016
Effect of changes in perfusion defect size during serial regadenoson myocardial perfusion imaging on cardiovascular outcomes in high-risk patients.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Quality metrics for single-photon emission computed tomography myocardial perfusion imaging: an ASNC information statement.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Review
- Comparison of left ventricle mechanical dyssynchrony parameters in ischemic and non-ischemic patients usingJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Myocardial Blood Flow and Flow Reserve in Patients With Acute Myocardial Infarction and Obstructive and Non-Obstructive Coronary Arteries: CZT SPECT Study.Frontiers in nuclear medicine · 2022Article
- The prognostic value of myocardial perfusion imaging in patients with type 2 myocardial infarction.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- What is this image? 2021: Image 5 result : Progression of myocardial ischemia to scar on serialJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- My warranty has expired: I need to be retested.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Myocardial perfusion imaging prior to coronary revascularization: From risk stratification to procedure guidance.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Detection and quantitation of right ventricular reversible perfusion defects by stress SPECT myocardial perfusion imaging: A proof-of-principle study.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Adverse effects associated with regadenoson myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Review of cardiovascular imaging in the Journal of Nuclear Cardiology in 2017. Part 2 of 2: Myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Review
- Impact of coronary revascularization vs medical therapy on ischemia among stable patients with or suspected coronary artery disease undergoing serial myocardial perfusion scintigraphy.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- Review of cardiovascular imaging in the journal of nuclear cardiology in 2016: Part 2 of 2-myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Review
- Stress SPECT Myocardial Perfusion Imaging in End-Stage Renal Disease.Current cardiovascular imaging reports · 2017Article
- Serial cardiac SPECT studies: Technical issues and clinical implications.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Article
- The reproducibility and prognostic value of serial measurements of heart rate response to regadenoson during myocardial perfusion imaging.European journal of nuclear medicine and molecular imaging · 2016Article
- Uncontrolled risk factors and worsening perfusion pattern on SPECT myocardial perfusion imaging in medically treated patients with stable chronic ischaemic heart disease.European journal of nuclear medicine and molecular imaging · 2016Article
- Heart rate response to regadenoson: Making the case for its value in clinical practice.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Article
- Review of Cardiovascular Imaging in the Journal of Nuclear Cardiology in 2015-Part 2 of 2: Myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Article
- Immortality time and serial myocardial perfusion imaging: Only those who do not die may repeat the exam.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Article
- Serial imaging and outcome prediction.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Review
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7 authors.
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Abstract
backgroundThe prognostic value of single-photon emission computed tomography myocardial perfusion imaging (MPI) is well established. There is a paucity of data on the prognostic value of changes in perfusion defect size (PDS) on serial MPIs.
methodsFrom the MPI database at the University of Alabama at Birmingham, consecutive patients who underwent two regadenoson stress MPIs between July 2008 and March 2013 were identified. The MPIs were analyzed side-by-side using an automated software program for presence and change in PDS. Improvement in PDS was defined as a reduction ≥5% of left ventricle. A drop in left ventricular ejection fraction (LVEF) was defined as a decrease ≥5%. The primary outcome was a composite of death, myocardial infarction (MI), and coronary revascularization (CR).
resultsThere were 698 patients (61 ± 11 years, 53% male, 48% diabetes, 25% prior MI, 49% prior CR) who underwent two regadenoson MPIs within 16 ± 9 months for clinical indications. The primary outcome occurred in 167 (24%) patients (8% death, 9% MI, 15% CR) during 24 ± 16 months of follow-up after the second MPI. The MPIs were normal in both studies in 399 (57%, Group 1), showed improvement in 94 (14%, Group 2, PDS 15% ± 16% vs 28% ± 18%, P < .001) and no change or worsening in 205 patients (29%, Group 3, 28% ± 17% vs 20% ± 17%, P < .001). The best outcomes were seen in Group 1 and the worst in Group 3 (log-rank P < .001). Similar trends were seen for the components of the primary outcome (P = .04 for death, P < .001 for MI, P < .001 for CR). In a Cox-regression model that adjusted for baseline factors including PDS and LVEF on initial MPI, the hazard ratios for primary outcome were 2.0 (P = .02) and 3.9 (P < .001) for Groups 2 and 3 compared to Group 1, respectively. In addition, an LVEF drop ≥5% was independently associated with the primary outcome (HR 1.5, P = .01).
conclusionChanges in PDS and LVEF on serial MPIs provide incremental prognostic information to initial and follow-up MPI findings. Lack of improvement or an increase in PDS and a drop in LVEF identify high-risk patients.
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