Relationship of myocardial perfusion imaging findings to outcome of patients with heart failure and suspected ischemic heart disease.
BACKGROUND
We retrospectively identified heart failure patients with suspected ischemic heart disease who underwent myocardial perfusion imaging (MPI) to examine the relationship of MPI findings to subsequent patient outcomes.


METHODS
The study group consisted of 336 patients with heart failure, left ventricular ejection fraction <45%, and suspected ischemic heart disease who underwent MPI during the period of January 1991 to December 31, 1997. Patients were divided in 3 subgroups: group A (n = 137), large fixed perfusion defects; group B (n = 77), large reversible perfusion defects; and group C (n=122), absence of a large reversible or fixed perfusion defect.


RESULTS
Overall, the 5-year mortality rate was high at 49.2% +/- 3.1%. Mortality was significantly different (P =.009) among the 3 subgroups. Groups A and B had a similar 5-year mortality rates >50%. Group C had a relatively better, but still substantial 5-year mortality rate of 40%. The overall revascularization rate was low (9.7% in 5 years).


CONCLUSIONS
These results indicate a high 5-year mortality rate in patients with large myocardial perfusion defects (fixed or reversible) and presumably an ischemic etiology for their heart failure. Patients with no large or absent perfusion defects had more favorable survival outcomes.
Miller
Wayne L
WL
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA. miller.wayne@mayo.edu
Hodge
David O
DO
Tointon
Susan K
SK
Rodeheffer
Richard J
RJ
Nelson
Susan M
SM
Gibbons
Raymond J
RJ
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D009204:Myocardial Revascularization; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013318:Stroke Volume; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging
D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi