title: Prognostic role of myocardial single photon emission computed tomography in the elderly.
abstract: The increase in average life expectancy will move the burden of coronary artery disease (CAD) to older patients. Myocardial perfusion imaging by single photon emission computed tomography (SPECT) has been extensively validated for diagnosis and prognostic evaluation in large population series. Yet, its use is usually limited in elderly patients in whom, despite increased absolute cardiovascular risk, diagnostic and therapeutic work-up is often underperformed. American College of Cardiology/American Heart Association guidelines recommend exercise ECG testing as the initial noninvasive method for assessment of CAD in patients with a normal or near-normal resting ECG, regardless of age. However, a considerable proportion of elderly patients is unable to reach an adequate workload during the exercise test and the majority of those undergoing for standard exercise treadmill score are classified as intermediate risk. In elderly patients, SPECT imaging may provide valuable diagnostic and prognostic information for clinical management. In particular, normal or near normal SPECT identifies elderly patients at low risk of major adverse cardiac events at the short-term follow-up.
authors.affiliation: Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, Via S. Pansini 5, Naples, 80131, Italy. fpperron@unina.it
authors.forename: Pasquale
authors.initials: P
authors.lastname: Perrone-Filardi
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Costanzo
authors.forename: Santo
authors.initials: S
authors.lastname: Dellegrottaglie
authors.forename: Paola
authors.initials: P
authors.lastname: Gargiulo
authors.forename: Donatella
authors.initials: D
authors.lastname: Ruggiero
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Savarese
authors.forename: Antonio
authors.initials: A
authors.lastname: Parente
authors.forename: Carmen
authors.initials: C
authors.lastname: D'Amore
authors.forename: Alberto
authors.initials: A
authors.lastname: Cuocolo
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiariello
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002309:Cardiology / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012306:Risk; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*