Left ventricular cavity size determined by preoperative dipyridamole thallium scintigraphy as a predictor of late cardiac events in vascular surgery patients.
We hypothesized that left ventricular (LV) cavity size measured on dipyridamole thallium scintigraphy identifies patients at risk for late nonfatal myocardial infarction and cardiovascular death. Accordingly, we retrospectively evaluated the predictive value of clinical and scintigraphic variables, including transendocardial LV cavity measurement performed on formatted images, in 335 vascular surgery patients. A nonhomogeneous perfusion pattern and enlarged LV cavity size were the most significant predictors of late events, and the interaction between these two variables was more predictive than was either variable alone. Life-table analysis demonstrated that patients with normal perfusion patterns had the lowest incidence of late events regardless of cavity size (p < 0.0005). Conversely, patients with a nonhomogeneous perfusion pattern and the largest LV cavity measurements were at the highest risk for late cardiac events (p < 0.0001). Therefore, this study demonstrated that a measurement of LV scintigraphic cavity size can provide important risk stratification for late cardiac events.
Emlein
G
G
University of Massachusetts Medical Center, Department of Nuclear Medicine, Worcester 01655, USA.
Villegas
B
B
Dahlberg
S
S
Leppo
J
J
D000368:Aged; D000704:Analysis of Variance; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D004176:Dipyridamole; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D016016:Proportional Hazards Models; D015635:Radionuclide Ventriculography; D013794:Thallium Radioisotopes; D014656:Vascular Surgical Procedures / Q000401:mortality; D016277:Ventricular Function, Left
D013794:Thallium Radioisotopes; D004176:Dipyridamole