title: Prognostic value of one millisievert exercise myocardial perfusion imaging in patients without known coronary artery disease.
abstract: The aim of this study was to assess the prognostic value of normal ultra-low-dose exercise MPI with a CZT camera.
  
  
  
  1901 consecutive patients without known CAD referred for exercise MPI with 1.8 MBq/kg (0.05 mCi) of Tc99m sestamibi or tetrofosmin and a CZT camera were included prospectively. Patients with an abnormal scan requiring an additional resting image (230) or a submaximal exercise test (271) were excluded. The 1400 remaining patients were followed for 39 months. The primary end-point was cardiac events (cardiac death, nonfatal myocardial infarction, and revascularization). The secondary end-point was noncardiac death.
  
  
  
  The mean injected activity was 145 ± 37 MBq (3.9 ± 1 mCi), the mean acquisition duration was 10 ± 0.7 minutes, and the mean effective dose was 0.91 ± 0.13 mSv. 1288 patients (92%) achieved full follow-up. We observed 22 cardiac events and 16 noncardiac deaths. The annualized rates were equivalent to 0.55% for cardiac events and 0.37% for noncardiac mortality.
  
  
  
  Normal ultra-low-dose exercise MPI with a CZT camera has a high negative predictive value. The effective dose was less than 1 mSv, and the study thus allays concerns about radiation burden.
authors: Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France. b.songy@ccn.fr.
authors: Bernard
authors: B
authors: Songy
authors: Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France.
authors: Mohamed
authors: M
authors: Guernou
authors: Cardiology, Centre Cardiologique du Nord (CCN), Paris, France.
authors: Daniel
authors: D
authors: Hivoux
authors: Cardiology, Centre Cardiologique du Nord (CCN), Paris, France.
authors: David
authors: D
authors: Attias
authors: Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France.
authors: David
authors: D
authors: Lussato
authors: Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France.
authors: Mathieu
authors: M
authors: Queneau
authors: Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France.
authors: Gerald
authors: G
authors: Bonardel
authors: Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France.
authors: Marc
authors: M
authors: Bertaux
mesh_terms: D000368:Aged; D002104:Cadmium; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D017256:Technetium Tc 99m Sestamibi; D013691:Tellurium; D016896:Treatment Outcome; D015032:Zinc
chemical_list: C474490:CdZnTe; D002104:Cadmium; D017256:Technetium Tc 99m Sestamibi; D015032:Zinc; D013691:Tellurium
keywords: CZT camera; Myocardial perfusion imaging; effective dose; prognosis; ultra-low-dose