[Value of gated-SPECT in defining the post-revascularization prognosis of patients with ischemic cardiomyopathy].
OBJECTIVE
Gated-SPECT simultaneously evaluates perfusion and ventricular function and could provide important prognostic information in ischemic cardiomyopathy. Our aim was to study the value of gated-SPECT performed before revascularization in a cardioischemic population to predict the outcome of revascularization.


METHODS
One hundred and ten patients who had undergone percutaneous (n = 100) or surgical revascularization were included. Patients underwent sestamibi gated-SPECT before revascularization. After revascularization, they were followed-up for at least 12 months (mean 23.7 months, maximum 44 months). We recorded deaths and a combined clinical event of death, non-fatal infarction, and hospital re-admission for cardiac reasons. We analyzed the prognostic value of clinical, angiographic, and gated-SPECT variables.


RESULTS
During follow-up, there were 14 deaths (6.4%/ year) and 36 cases of combined events (16.5%/year). Multivariate analysis showed that depressed gated-SPECT ejection fraction (threshold 0.30) was the only variable independently related to death (OR = 4.8; 95%CI, 1.6-14.6) and combined event (OR = 2.5; 95%CI, 1.2-4.8). Survival analysis showed that patients with ejection fraction < or = 0.30% had a significantly shorter period of time free of death (33 months [28-38] versus 42 months [40-44]; p = 0.002) and combined events (28 months [23-32] versus 36 months [33-39]; p = 0.007).


CONCLUSIONS
Gated-SPECT, due to the information it provides about left ventricular function, predicts the prognosis of patients after coronary revascularization.
Ruiz-Salmerón
Rafael J
RJ
Unidades de Cardiología Intervencionista. Instituto Gallego de Medicina Técnica. Hospital Meixoeiro. Vigo (Pontevedra). España. rafael.ruiz.salmeron@sergas.es
de Araujo Martins-Romeo
Daniela
D
López
Ana
A
Sanmartín
Marcelo
M
del Campo
Víctor
V
Mantilla
Ramón
R
Castellanos
Raúl
R
Ocaranza
Raymundo
R
Saa
Teresa
T
Guitián
Ramón
R
Goicolea
Javier
J
D000367:Age Factors; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D009204:Myocardial Revascularization / Q000379:methods*; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D016019:Survival Analysis; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016277:Ventricular Function, Left
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi