title: What is the value of stress (99m)Tc-tetrofosmin myocardial perfusion imaging for the assessment of very long-term outcome in obese patients?
abstract: OBJECTIVE
  There are no data regarding the long-term prognostic value of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in obese patients. The aim of this study was to examine the value of stress (99m)Tc-tetrofosmin MPI findings for the prediction of very long-term outcome in obese patients.
  
  
  METHODS
  The study population consisted of 261 patients with a body mass index ≥30 kg/m(2) who underwent exercise or pharmacological stress (99m)Tc-tetrofosmin MPI for the assessment of known or suspected coronary artery disease. Endpoints during follow-up were all-cause mortality, cardiac death, nonfatal infarction, and coronary revascularization. Kaplan-Meier survival cures were constructed and univariate and multivariate analyses were performed to identify predictors of very long-term outcome.
  
  
  RESULTS
  The mean age was 59 ± 10 years, 42% of the patients was male, and the body mass index was on average 37 ± 7 kg/m(2). MPI findings were normal in 109 patients (42%). Myocardial perfusion abnormalities were fixed in 62 patients (24%) and reversible in 90 patients (34%). During a median 12-year follow-up, 91 (35%) patients died, and 27 (10%) had a nonfatal myocardial infarction. Survival curves were compared using the log-rank test at subsequent follow-up durations. Obese patients with a normal stress (99m)Tc-tetrofosmin study had a significantly better prognosis as compared with those with an abnormal study, up to 6 years after the test was performed.
  
  
  CONCLUSIONS
  Stress (99m)Tc-tetrofosmin MPI provides valuable prognostic information for the prediction of outcome in obese patients. Obese patients with a normal stress (99m)Tc-tetrofosmin study have a significantly better prognosis as compared with those with an abnormal study, up to 6 years after the test is performed.
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Room Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Korbee
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Boiten
authors.forename: Machiel
authors.initials: M
authors.lastname: Ottenhof
authors.forename: Roelf
authors.initials: R
authors.lastname: Valkema
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Arend F L
authors.initials: AF
authors.lastname: Schinkel
mesh_terms: D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000000981:diagnostic imaging* / Q000401:mortality*; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin