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Myocardial stress perfusion scintigraphy for outcome prediction in patients with severe left ventricular systolic dysfunction
by
Gimelli Alessia
, Shaw, Leslee J
, Emdin Michele
, Coceani, Michele Alessandro
, Aimo Alberto
, Pasanisi, Emilio Maria
, Clemente, Alberto
in
Acute coronary syndromes
/ Angiography
/ Blood vessels
/ Cardiovascular disease
/ Coronary artery
/ Coronary artery disease
/ Ejection fraction
/ Fatalities
/ Heart
/ Heart diseases
/ Ischemia
/ Myocardial infarction
/ Perfusion
/ Predictions
/ Regression analysis
/ Regression models
/ Scintigraphy
/ Subgroups
/ Ventricle
2021
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Myocardial stress perfusion scintigraphy for outcome prediction in patients with severe left ventricular systolic dysfunction
by
Gimelli Alessia
, Shaw, Leslee J
, Emdin Michele
, Coceani, Michele Alessandro
, Aimo Alberto
, Pasanisi, Emilio Maria
, Clemente, Alberto
in
Acute coronary syndromes
/ Angiography
/ Blood vessels
/ Cardiovascular disease
/ Coronary artery
/ Coronary artery disease
/ Ejection fraction
/ Fatalities
/ Heart
/ Heart diseases
/ Ischemia
/ Myocardial infarction
/ Perfusion
/ Predictions
/ Regression analysis
/ Regression models
/ Scintigraphy
/ Subgroups
/ Ventricle
2021
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Do you wish to request the book?
Myocardial stress perfusion scintigraphy for outcome prediction in patients with severe left ventricular systolic dysfunction
by
Gimelli Alessia
, Shaw, Leslee J
, Emdin Michele
, Coceani, Michele Alessandro
, Aimo Alberto
, Pasanisi, Emilio Maria
, Clemente, Alberto
in
Acute coronary syndromes
/ Angiography
/ Blood vessels
/ Cardiovascular disease
/ Coronary artery
/ Coronary artery disease
/ Ejection fraction
/ Fatalities
/ Heart
/ Heart diseases
/ Ischemia
/ Myocardial infarction
/ Perfusion
/ Predictions
/ Regression analysis
/ Regression models
/ Scintigraphy
/ Subgroups
/ Ventricle
2021
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Myocardial stress perfusion scintigraphy for outcome prediction in patients with severe left ventricular systolic dysfunction
Journal Article
Myocardial stress perfusion scintigraphy for outcome prediction in patients with severe left ventricular systolic dysfunction
2021
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Overview
Coronary angiography has been recommended in all patients with suspected chronic coronary syndrome and left ventricular ejection fraction (LVEF) ≤35%. The role of ischemia testing, for example, through stress-rest myocardial perfusion scintigraphy (MPS), for risk prediction is not well established.MethodsWe evaluated 1576 consecutive patients referred to MPS and stratified into 3 LV ejection fraction (LVEF) categories: ≤35%, 36–49%, and ≥ 50%.ResultsPatients with LVEF ≤35% were oldest, most often men, and with the highest likelihood of prior early (elective or urgent) coronary revascularization. They had also the highest values or summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS), as well as the highest frequency of significant coronary artery disease, and a greater number of diseased vessels. Follow-up: In this subgroup, 32 cardiovascular death or non-fatal myocardial infarction (MI) (21%), 35 all-cause deaths (22%), and 37 cardiovascular deaths, non-fatal MI, or late revascularizations (27%) were recorded with the shortest survival among all LVEF classes. SRS, SSS, and SDS had very low area under the curve values for the prediction of the 3 endpoints, with very high cut-offs, respectively. SRS and SSS cut-offs predicted a worse outcome in Cox regression models including the number of diseased vessels and early revascularization.ConclusionsIn patients with LVEF ≤35%, SRS and SSS are less predictive of outcome than in patients with better preserved systolic dysfunction, but their cut-offs retain independent prognostic significance from the number of vessels with significant stenoses and from early revascularization.
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