ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2020
Prognostic significance of ischemic electrocardiographic changes with regadenoson stress myocardial perfusion imaging.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Primary versus iatrogenic (post-PCI) coronary microvascular dysfunction: a wire-based multimodal comparison.Open heart · 2023Trial
- Myocardial ischemia in patients with large prior infarction: Clinical decision making and review of literature.Radiology case reports · 2023Article
- The diagnostic and prognostic value of near-normal perfusion or borderline ischemia on stress myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- The prognostic implications of ST-segment and T-wave abnormalities in patients undergoing regadenoson stress SPECT myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- The prognostic utility of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease: The largest cohort to date.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- The Prognostic Value of MPI in CKD: Can we do better?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- The evolution of the prognostic value of regadenoson SPECT myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- The prognostic value of regadenoson SPECT myocardial perfusion imaging: The largest cohort to date.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Myocardial perfusion imaging and coronary calcium score: A marriage made in heaven.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Prognostic value of regadenoson stress myocardial perfusion imaging in patients with left bundle branch block or ventricular paced rhythm.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- An opportunity to improve exercise test accuracy by incorporating high frequency QRS (HFQRS) waveform assessment.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
- Ischemia and Viability Testing in New-Onset Heart Failure.Current cardiology reports · 2020Review
- Cardiac pharmacologic stress: does the gender matters?European journal of nuclear medicine and molecular imaging · 2019Article
- Aminophylline shortage and current recommendations for reversal of vasodilator stress: An ASNC information statement endorsed by SCMR.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Review
- Aminophylline shortage and current recommendations for reversal of vasodilator stress: an ASNC information statement endorsed by SCMR.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2018Review
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Abstract
backgroundIn patients undergoing regadenoson SPECT myocardial perfusion imaging (MPI), the prognostic value of ischemic ST-segment depression (ST↓) and the optimal ST↓ threshold have not been studied.
methodsA retrospective cohort study of consecutive patients referred for regadenoson stress MPI was conducted. Patients with uninterpretable ECG were excluded. Two diagnostic thresholds of horizontal or downsloping ST↓ were studied, ≥ 0.5 mm and ≥ 1.0 mm. The primary endpoint was the composite major adverse cardiac events (MACE) of cardiac death, myocardial infarction, or coronary revascularization.
resultsAmong 8615 subjects (mean age 62 ± 13 years; 55% women), 89 (1.0%) had ST↓ ≥ 1.0 mm and 133 (1.5%) had ST↓ ≥ 0.5 mm. Regadenoson-induced ST↓ was more common in women (P < .001). Mean follow-up was 2.5 ± 2.2 years. After multivariate adjustment, ST↓ ≥ 1.0 mm was associated with a non-significant increase in MACE risk (P = .069), irrespective to whether MPI was abnormal (P = .162) or normal (P = .214). Ischemic ST↓ ≥ 0.5 mm was independently associated with MACE in the entire cohort (HR 2.14; CI 1.38-3.32; P = .001), whether MPI is normal (HR 2.07; CI 1.07-4.04; P = .032) or abnormal (HR 2.24; CI 1.23-4.00; P = .007), after adjusting for clinical and imaging covariates. An ST↓ threshold of ≥ 0.5 mm provided greater incremental prognostic value beyond clinical and imaging parameters (Δχ
conclusionRegadenoson-induced ischemic ST↓ is more common in women and it provides a modest independent prognostic value beyond MPI and clinical parameters. ST↓ ≥ 0.5 mm is a better threshold than ≥ 1.0 mm to define ECG evidence for regadenoson-induced myocardial ischemia.
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