Prognostic value of stress myocardial perfusion imaging in patients with mildly impaired systolic left ventricular function or left ventricular asynergy without chest pain but with suspected coronary artery disease.
BACKGROUND
The prognostic value of myocardial perfusion imaging (MPI) was investigated in patients with mildly impaired left ventricular (LV) function who had no chest pain but were suspected to have coronary artery disease (CAD).


RESULTS
Consecutive patients (n=72, mean age =67) who had no chest pain but with mildly impaired systolic LV function (mean LV ejection fraction =52%) or LV asynergy and suspected to have CAD were followed up for 4.9 years after stress MPI. The follow-up time was censored at the occurrence of cardiac death, hospitalization for congestive heart failure (CHF), acute coronary syndromes (ACS), or revascularization. Images were scored using a 20-segment model and a 0-4 scale, and then the summed stress, rest, and difference scores (SDS) were calculated. During follow-up, there were 2 cases of cardiac death, 8 of hospitalization for CHF, 4 of ACS and 2 of revascularization. Cox regression demonstrated that SDS >or=4 was an excellent predictor of cardiac events in all patients (hazard ratio =4.2, p=0.01), and especially in diabetic patients (hazard ratio =28.4, p=0.01).


CONCLUSIONS
Stress MPI is useful for predicting cardiac events and may be performed in patients without chest pain if they have mildly impaired systolic LV function or LV asynergy.
Nakazato
Ryo
R
Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. ryo3@oha.toho-u.ac.jp
Moroi
Masao
M
D000208:Acute Disease; D000368:Aged; D002637:Chest Pain; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality; D048909:Diabetes Complications / Q000000981:diagnostic imaging; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D016277:Ventricular Function, Left