Prognostic value of myocardial ischemia in patients with uncomplicated acute myocardial infarction: Direct comparison of stress echocardiography and myocardial perfusion imaging
Prognostic value of myocardial ischemia in patients with uncomplicated acute myocardial infarction: Direct comparison of stress echocardiography and myocardial perfusion imaging(300 views) Acampa W, Spinelli L, Petretta M, De Lauro F, Ibello F, Cuocolo A
Department of Biomorphological and Functional Sciences, University Federico II, Napoli, Italy
Institute of Biostructure and Bioimages, National Council of Research, Napoli, Italy
Neuromed, Pozzilli, Italy
Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University Federico II, Napoli, Italy
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Marwick, T. H., Mehta, R., Arheart, K., Lauer, M. S., Use of exercise echocardiography for prognostic evaluation of patients with known or suspected coronary artery disease (1997) J Am Coll Cardiol, 30, pp. 83-90
Olmos, L. I., Dakik, H., Gordon, R., Long-term prognostic value of exercise echocardiography compared with exercise Tl-201, ECG, and clinical variables in patients evaluated for coronary artery disease (1998) Circulation, 98, pp. 2679-2686
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Schinkel, A. F., Bax, J. J., Elhendy, A., Long-term prognostic value of dobutamine stress echocardiography compared with myocardial perfusion scanning in patients unable to perform exercise tests (2004) Am J Med, 117, pp. 1-9
Van Daele, M. E., McNeill, A. J., Fioretti, P. M., Prognostic value of dipyridamole sestamibi single-photon emission computed tomography and dipyridamole stress echocardiography for new cardiac events after an uncomplicated myocardial infarction (1994) J Am Soc Echocardiogr, 7, pp. 370-380
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Prognostic value of myocardial ischemia in patients with uncomplicated acute myocardial infarction: Direct comparison of stress echocardiography and myocardial perfusion imaging
This study directly compared the prognostic value of predischarge dobutamine stress echocardiography (DSE) and dobutamine myocardial SPECT perfusion imaging in patients with prior myocardial infarction. Methods: The study population consisted of 146 consecutive patients who underwent predischarge DSE and SPECT with 99mTc-sestamibi after a first acute uncomplicated myocardial infarction treated with thrombolysis. Fifty patients who underwent revascularization within 90 d from the imaging studies were excluded. Cardiac death and nonfatal myocardial infarction were considered events. Follow-up was 98% complete in a mean period of 44 ± 19 mo. Results: Myocardial ischemia was detectable in 55 (58%) patients at SPECT and in 63 (67%) patients at DSE. Concordance between SPECT and DSE in detecting ischemia was observed in 68 (72%) of the 94 patients (κ value, 0.41). During the follow-up, there were 20 cardiac events (9 deaths and 11 nonfatal myocardial infarctions). Ischemia at SPECT was a significant predictor of events (hazards ratio = 4.8; 95% confidence interval, 1.4-16.3; P < 0.01). However, ischemia at DSE (biphasic or worsening patterns) was not associated with events, whereas biphasic pattern alone was associated with a poor outcome compared with direct worsening (P < 0.05). Finally, at Cox multivariate analysis, ischemia at SPECT but not biphasic pattern at DSE was a significant independent predictor of events (P < 0.01). Conclusion: These results indicate that, after uncomplicated myocardial infarction, ischemia at SPECT is associated with an increased risk of cardiac events at long-term follow-up. However, ischemia at DSE was unable to stratify patients after myocardial infarction.
Prognostic value of myocardial ischemia in patients with uncomplicated acute myocardial infarction: Direct comparison of stress echocardiography and myocardial perfusion imaging
Prognostic value of myocardial ischemia in patients with uncomplicated acute myocardial infarction: Direct comparison of stress echocardiography and myocardial perfusion imaging
Santulli G, Cipolletta E, Sorriento D, Del Giudice C, Anastasio A, Monaco S, Maione AS, Condorelli G, Puca A, Trimarco B, Illario M, Iaccarino G * CaMK4 gene deletion induces hypertension(349 views) J Am Heart Assoc Journal Of The American Heart Association (ISSN: 2047-9980), 2012; 1(4): N/D-N/D. Impact Factor:2.882 ViewExport to BibTeXExport to EndNote