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03.01.2021 | ORIGINAL ARTICLE

Prognostic value of early left ventricular ejection fraction reserve during regadenoson stress solid-state SPECT-MPI

verfasst von: Yuka Otaki, Mathews B. Fish, Robert J. H. Miller, Mark Lemley, Piotr J. Slomka

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 3/2022

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Abstract

Background

We hypothesized early post-stress left ventricular ejection fraction reserve (EFR) on solid-state-SPECT is associated with major cardiac adverse events (MACE).

Methods

151 patients (70 ± 12 years, male 50%) undergoing same-day rest/regadenoson stress 99mTc-sestamibi solid-state SPECT were followed for MACE. Rest imaging was performed in the upright and supine positions. Early stress imaging was started 2 minutes after the regadenoson injection in the supine position and followed by late stress acquisition in the upright position. Total perfusion deficit (TPD) and functional parameters were quantified automatically. EFR, ∆end-diastolic volume (EDV), and end-systolic volume (ESV) were calculated as the difference between stress and rest values in the same position. EFR < 0%, ∆EDV ≥ 5 ml, or ∆ESV ≥ 5 ml was defined as abnormal.

Results

During the follow-up (mean 3.2 years), 28 MACE occurred (19%). In Kaplan–Meier analysis, there was a significantly decreased event-free survival in patients with early EFR < 0% (P = 0.004). Similarly, there was a decreased event-free survival in patients with ∆ESV ≥ 5 ml at early stress (P = 0.003). However, EFR, ∆EDV, and ∆ESV at late stress were not associated with MACE-free survival. Cox proportional hazards model adjusting for clinical information and stress TPD demonstrated that EFR, ∆EDV, and ∆ESV at early stress were significantly associated with MACE (P < 0.05 for all).

Conclusions

Reduced early post-stress EFR on vasodilator stress solid-state SPECT is associated with MACE.
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Metadaten
Titel
Prognostic value of early left ventricular ejection fraction reserve during regadenoson stress solid-state SPECT-MPI
verfasst von
Yuka Otaki
Mathews B. Fish
Robert J. H. Miller
Mark Lemley
Piotr J. Slomka
Publikationsdatum
03.01.2021
Verlag
Springer International Publishing
Erschienen in
Journal of Nuclear Cardiology / Ausgabe 3/2022
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-020-02420-w

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