Erschienen in:
01.02.2009 | Original Article
Etiology and pathophysiology of new-onset heart failure: Evaluation by myocardial perfusion imaging
verfasst von:
Prem Soman, MD, PhD, FRCP, Avijit Lahiri, MD, Jennifer H. Mieres, MD, Dennis A. Calnon, MD, David Wolinsky, MD, George A. Beller, MD, Tina Sias, MD, Kenneth Burnham, MD, Laurence Conway, MD, Peter A. McCullough, MD, Edouard Daher, MD, Mary N. Walsh, MD, Joseph Wight, MD, Gary V. Heller, MD, PhD, James E. Udelson, MD
Erschienen in:
Journal of Nuclear Cardiology
|
Ausgabe 1/2009
Einloggen, um Zugang zu erhalten
Abstract
Objective
The IMAGING in Heart Failure study was a prospective, multi-national trial designed to explore the role of single-photon emission computed tomographic (SPECT) myocardial perfusion imaging (MPI) as an initial investigative strategy in patients hospitalized with new-onset heart failure.
Methods
We recruited 201 patients (age 65.3 ± 14.5 years, 43% women) hospitalized with their first episode of heart failure. Rest/stress gated SPECT Tc-99m sestamibi MPI was performed during or within 2 weeks of the index hospitalization, in addition to standard care.
Results
SPECT MPI revealed a broad range of ejection fractions with preserved systolic function in 36% of patients. Forty-one percent of patients had normal perfusion. In the remaining patients, perfusion abnormalities were predominantly due to prior myocardial infarction, with extensive ischemia seen only in 6%. Among patients who underwent coronary angiography, SPECT performance characteristics revealed excellent negative predictive value (96%) for extensive coronary artery disease (CAD). In multivariable analyses, the extent of perfusion abnormality and advancing age predicted the presence of extensive CAD.
Conclusions
These preliminary data derived from a non-randomized observational cohort suggest potential diagnostic utility of MPI for ischemic LV dysfunction in new-onset HF, and sets the stage for a prospective randomized study to confirm these findings.