Department of Medical Physics, Medical School, National and Kapodistrian University of Athens, 75 MikrasAsias str., Athens 115 27, Greece.
Hell J Nucl Med. 2021 Sep-Dec;24(3):214-221. doi: 10.1967/s002449912405. Epub 2021 Dec 17.
Stress-only myocardial perfusion imaging protocol has a prognostic value similar to that of a stress-rest protocol. The aim of the study was to assess stress myocardial perfusion by gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (GSMPI) in patients who had a normal stress-only study 4.9 years (mean time) before and assess the possible influence of various factors on the results.
Three hundred and forty patients who had a normal stress-only study in the past, were reexamined with GSMPI after a mean period of 4.9 years.
Thirty out of 340 patients (8.8%) had an ischemic result on stress and were therefore submitted to a rest study. Differences between normal and pathological results across levels of potential prognostic factors (age, gender, diabetes mellitus, dyslipidemia, arterial hypertension, smoking and family history), symptoms,left ventricular ejection fraction (LVEF) on ultrasound (U/S), coronary angiography and pre-test probability did not prove statistically significant. On multivariable analysis patients with the combination of family history, diabetes mellitus and hypertension had a 10.7 times higher risk of a pathological scan than the patients without.
The information delivered by stress-only GSMPI proved to be a prognostically reliable method for follow-up of low and intermediate pretest probability coronary artery disease (CAD) patients.
The 91.2% of the patients with an initial normal stress-only GSMPI had a repeat normal stress-only GSMPI after a mean period of 4.9 years. The combination of family history, diabetes mellitus and hypertension increases the risk of a pathological scan significantly.
仅压力心肌灌注成像方案具有与应激-休息方案相似的预后价值。本研究旨在评估 4.9 年前进行过正常仅压力研究的患者的门控单光子发射计算机断层扫描(SPECT)心肌灌注成像(GSMPI)的应激心肌灌注,并评估各种因素对结果的可能影响。
340 例患者在过去有正常的仅压力研究,在平均 4.9 年后用 GSMPI 重新检查。
340 例患者中有 30 例(8.8%)在应激时有缺血结果,因此进行了休息研究。在潜在预后因素(年龄、性别、糖尿病、血脂异常、动脉高血压、吸烟和家族史)、症状、超声心动图(U/S)的左心室射血分数(LVEF)、冠状动脉造影和术前概率的水平上,正常和病理结果之间的差异没有统计学意义。多变量分析显示,同时患有家族史、糖尿病和高血压的患者发生病理性扫描的风险比无这些病史的患者高 10.7 倍。
仅压力 GSMPI 提供的信息被证明是一种对低和中等术前概率冠心病(CAD)患者进行随访的预后可靠方法。
在最初正常的仅压力 GSMPI 后,91.2%的患者在平均 4.9 年后再次进行正常的仅压力 GSMPI。家族史、糖尿病和高血压的结合显著增加了病理性扫描的风险。