title: [Follow-up of patients with good exercise capacity in stress test with myocardial single-photon emission computed tomography (SPECT)].
abstract: BACKGROUND
  The evaluation of coronary artery disease (CAD) can be performed with stress test and myocardial SPECT tomography.
  
  
  OBJECTIVE
  To assess the predictive value of myocardial SPECT using stress test for cardiovascular events in patients with good exercise capacity.
  
  
  METHODS
  We included 102 males aged 56 ± 10 years and 19 females aged 52 ± 10 years, all able to achieve 10 METs and ≥ 85% of the theoretical maximum heart rate and at least 8 min in their stress test with gated 99mTc-sestamibi SPECT. Eighty two percent of patients were followed clinically for 33 ± 17 months.
  
  
  RESULTS
  Sixty seven percent of patients were studied for CAD screening and the rest for known disease assessment. Treadmill stress test was negative in 75.4%; 37% of patients with moderate to severe Duke Score presented ischemia. Normal myocardial perfusion SPECT was observed in 70.2%. Reversible defects appeared in 24.8% of cases, which were of moderate or severe degree (> 10% left ventricular extension) in 56.6%. Only seven cases had coronary events after the SPECT. Two major (myocardial infarction and emergency coronary revascularization) and 5 minor events (elective revascularization) ere observed in the follow-up. In a multivariate analysis, SPECT ischemia was the only statistically significant parameter that increased the probability of having a major or minor event.
  
  
  CONCLUSIONS
  Nearly a quarter of our patients with good exercise capacity demonstrated reversible defects in their myocardial perfusion SPECT. In the intermediate-term follow-up, a low rate of cardiac events was observed, being the isotopic ischemia the only significant predictive parameter.
authors.forename: Javiera
authors.initials: J
authors.lastname: González
authors.forename: Hernán
authors.initials: H
authors.lastname: Prat
authors.forename: Eduardo
authors.initials: E
authors.lastname: Swett
authors.forename: Isabel
authors.initials: I
authors.lastname: Berrocal
authors.forename: René
authors.initials: R
authors.lastname: Fernández
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Zhindon
authors.forename: Ariel
authors.initials: A
authors.lastname: Castro
authors.forename: Teresa
authors.initials: T
authors.lastname: Massardo
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055686:Metabolic Equivalent / Q000502:physiology; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D017256:Technetium Tc 99m Sestamibi