Prognostic Value of Myocardial Perfusion Imaging with a Cadmium-Zinc-Telluride SPECT Camera in Patients Suspected of Having Coronary Artery Disease

被引:27
作者
Engbers, Elsemiek M. [1 ,2 ]
Timmer, Jorik R. [1 ]
Mouden, Mohamed [1 ,2 ]
Knollema, Siert [2 ]
Jager, Pieter L. [2 ]
Ottervanger, Jan Paul [1 ]
机构
[1] Isala, Dept Cardiol, Dokter van Heesweg 2, NL-8025 AB Zwolle, Netherlands
[2] Isala, Dept Nucl Med, Zwolle, Netherlands
关键词
prognosis; suspected coronary artery disease; SPECT; cadmium zinc telluride; AMERICAN-HEART-ASSOCIATION; OF-CARDIOLOGY FOUNDATION; NUCLEAR CARDIOLOGY; COMPUTED-TOMOGRAPHY; COLLEGE; SOCIETY; RECOMMENDATIONS; SCINTIGRAPHY; DIAGNOSIS;
D O I
10.2967/jnumed.116.188516
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The prognostic value of myocardial perfusion imaging (MPI) with the cadmium-zinc-telluride (CZT) SPECT camera is not well established. Therefore, the aim of the current study was to evaluate the prognostic value of MPI performed with a CZT SPECT camera in a large cohort of patients suspected of having coronary artery disease. Methods: Consecutive symptomatic stable patients (n = 4,057) without a history of coronary artery disease underwent CZT SPECT MPI. During a median follow-up of 2.4 y (25th-75th percentile, 1.7-3.4), patients were monitored for primary (nonfatal myocardial infarction and cardiac mortality) and secondary outcomes (late revascularization [>90 d after scanning] and primary outcome). Results: Patients with normal perfusion demonstrated low annual event rates (primary outcome, 0.2%; secondary outcome, 0.6%). Annual event rates increased with the extent of abnormality of myocardial perfusion. In patients with small ischemic perfusion defects, annual event rates were 0.7% and 2.8% for the primary and secondary outcome, respectively. In patients with moderate or large ischemic perfusion defects, these event rates were 1.2% and 4.3%, respectively. After multivariate analysis, the risk for events was significantly associated with the extent of ischemia (hazard ratio for small ischemic defects: 2.2, 95% confidence interval [CI], 0.9-5.9 and 4.6, 95% CI, 2.8-7.6, for primary and secondary outcomes, respectively; hazard ratio for moderate or large ischemic defects: 4.0, 95% CI, 1.5-10.5 and 12.1, 95% CI, 7.2-20.2, for primary and secondary outcomes, respectively). Conclusion: Our findings show that MPI acquired with a CZT SPECT camera provides excellent prognostic information, with low event rates in patients with normal myocardial perfusion. In patients with abnormal SPECT MPI, the extent of abnormality is independently associated with an increased risk of events.
引用
收藏
页码:1459 / 1463
页数:5
相关论文
共 30 条
  • [1] [Anonymous], 1998, Ann ICRP, V28, P1
  • [2] Prognostic validation of a 17-segment score derived from a 20-segment score for myocardial perfusion SPECT interpretation
    Berman, DS
    Abidov, A
    Kang, XP
    Hayes, SW
    Friedman, JD
    Sciammarella, MG
    Cohen, I
    Gerlach, J
    Waechter, PB
    Germano, G
    Hachamovitch, R
    [J]. JOURNAL OF NUCLEAR CARDIOLOGY, 2004, 11 (04) : 414 - 423
  • [3] INCREMENTAL VALUE OF PROGNOSTIC TESTING IN PATIENTS WITH KNOWN OR SUSPECTED ISCHEMIC-HEART-DISEASE - A BASIS FOR OPTIMAL UTILIZATION OF EXERCISE TC-99M SESTAMIBI MYOCARDIAL PERFUSION SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY
    BERMAN, DS
    HACHAMOVITCH, R
    KIAT, H
    COHEN, I
    CABICO, JA
    WANG, FP
    FRIEDMAN, JD
    GERMANO, G
    VANTRAIN, K
    DIAMOND, GA
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1995, 26 (03) : 639 - 647
  • [4] Recommendations for reducing radiation exposure in myocardial perfusion imaging
    Cerqueira, Manuel D.
    Allman, Kevin C.
    Ficaro, Edward P.
    Hansen, Christopher L.
    Nichols, Kenneth J.
    Thompson, Randall C.
    Van Decker, William A.
    Yakovlevitch, Marko
    [J]. JOURNAL OF NUCLEAR CARDIOLOGY, 2010, 17 (04) : 709 - 718
  • [5] Rapid-acquisition myocardial perfusion scintigraphy (MPS) on a novel gamma camera using multipinhole collimation and miniaturized cadmiumzinctelluride (CZT) detectors: prognostic value and diagnostic accuracy in a real-world nuclear cardiology service
    Chowdhury, F. U.
    Vaidyanathan, S.
    Bould, M.
    Marsh, J.
    Trickett, C.
    Dodds, K.
    Clark, T. P. R.
    Sapsford, R. J.
    Dickinson, C. J.
    Patel, C. N.
    Thorley, P. J.
    [J]. EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, 2014, 15 (03) : 275 - 283
  • [6] Prognostic evaluation in obese patients using a dedicated multipinhole cadmium-zinc telluride SPECT camera
    De Lorenzo, Andrea
    Peclat, Thais
    Amaral, Ana Carolina
    Lima, Ronaldo S. L.
    [J]. INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 2016, 32 (02) : 355 - 361
  • [7] ANALYSIS OF PROBABILITY AS AN AID IN THE CLINICAL-DIAGNOSIS OF CORONARY-ARTERY DISEASE
    DIAMOND, GA
    FORRESTER, JS
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1979, 300 (24) : 1350 - 1358
  • [8] High-efficiency SPECT MPI: Comparison of automated quantification, visual interpretation, and coronary angiography
    Duvall, W. Lane
    Slomka, Piotr J.
    Gerlach, Jim R.
    Sweeny, Joseph M.
    Baber, Usman
    Croft, Lori B.
    Guma, Krista A.
    George, Titus
    Henzlova, Milena J.
    [J]. JOURNAL OF NUCLEAR CARDIOLOGY, 2013, 20 (05) : 763 - 773
  • [9] Reduced isotope dose with rapid SPECT MPI imaging: Initial experience with a CZT SPECT camera
    Duvall, W. Lane
    Croft, Lori B.
    Godiwala, Tapan
    Ginsberg, Eric
    George, Titus
    Henzlova, Milena J.
    [J]. JOURNAL OF NUCLEAR CARDIOLOGY, 2010, 17 (06) : 1009 - 1014
  • [10] Nuclear myocardial perfusion imaging with a novel cadmium-zinc-telluride detector SPECT/CT device: first validation versus invasive coronary angiography
    Fiechter, Michael
    Ghadri, Jelena R.
    Kuest, Silke M.
    Pazhenkottil, Aju P.
    Wolfrum, Mathias
    Nkoulou, Rene N.
    Goetti, Robert
    Gaemperli, Oliver
    Kaufmann, Philipp A.
    [J]. EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2011, 38 (11) : 2025 - 2030