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01.12.2012 | Original Article

Prognostic value of quantitative high-speed myocardial perfusion imaging

verfasst von: Ryo Nakazato, MD, PhD, Daniel S. Berman, MD, Heidi Gransar, MSc, Mark Hyun, CNMT, Romalisa Miranda-Peats, MPH, Faith C. Kite, CNMT, Sean W. Hayes, MD, Louise E. J. Thomson, MBChB, John D. Friedman, MD, Alan Rozanski, MD, Piotr J. Slomka, PhD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 6/2012

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Abstract

Background

We studied the prognostic value of fully automated quantitative analysis software applied to new solid-state, high-speed (HS) SPECT-myocardial perfusion imaging (MPI).

Methods

1,613 consecutive patients undergoing exercise or adenosine HS-MPI were followed for 2.6 ± 0.5 years for all-cause mortality (ACM). Automated quantitative software was used to compute stress total perfusion deficit (sTPD) and was compared to semi-quantitative visual analysis. MPI was characterized as 0% (normal), 1%-4% (minimal perfusion defect), 5%-10% (mildly abnormal), and >10% (moderately/severely abnormal).

Results

During follow-up, 79 patients died (4.9%). Annualized ACM increased with progressively increasing sTPD; 0% (0.87%), 1%-4% (1.94%), 5%-10% (3.10%), and >10% (5.33%) (log-rank P < .0001). While similar overall findings were observed with visual analysis, only sTPD demonstrated increased risk in patients with minimal perfusion defects. In multivariable analysis, sTPD > 10% was a mortality predictor (HR 3.03, 95% CI 1.30-7.09, P = .01). Adjusted mortality rate was substantial in adenosine MPI, but low in exercise MPI (9.0% vs 1.0%, P < .0001).

Conclusions

By quantitative analysis, ACM increases with increasing perfusion abnormality among patients undergoing stress HS-MPI. These findings confirm previous results obtained with visual analysis using conventional Anger camera imaging systems.

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Titel: Prognostic value of quantitative high-speed myocardial perfusion imaging
verfasst von: Ryo Nakazato, MD, PhD
Daniel S. Berman, MD
Heidi Gransar, MSc
Mark Hyun, CNMT
Romalisa Miranda-Peats, MPH
Faith C. Kite, CNMT
Sean W. Hayes, MD
Louise E. J. Thomson, MBChB
John D. Friedman, MD
Alan Rozanski, MD
Piotr J. Slomka, PhD
Publikationsdatum: 01.12.2012
Verlag: Springer-Verlag
Erschienen in: Journal of Nuclear Cardiology / Ausgabe 6/2012
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-012-9619-5

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Prognostic value of quantitative high-speed myocardial perfusion imaging