Incremental Prognostic Value of Rest-Redistribution
            <sup>201</sup>
            Tl Single-Photon Emission Computed Tomography

Sharir, Tali; Berman, Daniel S.; Lewin, Howard C.; Friedman, John D.; Cohen, Ishac; Miranda, Romalisa; Agafitei, Raluca D.; Germano, Guido

doi:10.1161/01.cir.100.19.1964

Cited by 40 publications

(11 citation statements)

References 37 publications

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“…With respect to the prognostic complementarity of LGE and perfusion, the authors found that reversible perfusion defects and the presence of LGE were both associated with the end point of CD/MI in both univariate analyses and after adjustment for patient sex and age in a model inclusive of both of these CMR variables. This finding extends results from previous studies reporting the complementary nature of stress perfusion and viability 7 to CMR, justifying the acquisition and reporting of both of these data elements.…”

Section: Article See P 1390supporting

confidence: 88%

Assessing the Prognostic Value of Cardiovascular Imaging

Hachamovitch¹

2009

Circulation

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Section: Article See P 1390supporting

confidence: 88%

Assessing the Prognostic Value of Cardiovascular Imaging

Hachamovitch¹

2009

Circulation

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“…Although single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has been shown to identify patients at high risk of cardiovascular events and cardiovascular mortality, [11][12][13] including those resuscitated from SCD, 14 it remains unknown whether it can identify patients with CAD at risk for de novo SCD. The goal of this study is to determine whether SPECT MPI can identify patients with CAD at increased risk of SCD.…”

Section: Editorial See P 175 Clinical Perspective See P 188mentioning

confidence: 99%

Single-Photon Emission Computed Tomography Myocardial Perfusion Defects Are Associated With an Increased Risk of All-Cause Death, Cardiovascular Death, and Sudden Cardiac Death

Piccini

Horton

Shaw

et al. 2008

Circ: Cardiovascular Imaging

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Background— Single-photon emission computed tomography myocardial perfusion imaging defects are associated with increased all-cause mortality and cardiovascular death. However, it is unknown whether single-photon emission computed tomography myocardial perfusion imaging can identify patients at increased risk of sudden cardiac death (SCD). Methods and Results— We analyzed a cohort of 6383 patients with angiographically documented coronary artery disease who underwent single-photon emission computed tomography imaging. Cox proportional hazards modeling was used to examine the relationship between patient characteristics and SCD. Among patients who died, the median time to SCD was 2.7 years (25 th , 75 th percentiles 0.9, 4.9, respectively). The incidence of SCD was 3.4% (n=215) over 6.1 years (25 th , 75 th percentiles 3.7, 9.2, respectively) of follow-up. Patients with SCD had more severe heart failure symptoms, greater comorbidity (Charlson index), and higher summed stress perfusion scores (all P <0.001). After adjusting for left ventricular ejection fraction and other clinical factors in the multivariable model, the summed stress perfusion score (fixed plus reversible defects) remained significantly associated with the occurrence of SCD: summed stress perfusion score (hazard ratios per 3 U: 1.16 [95% CI, 1.08 to 1.25], P <0.001), left ventricular ejection fraction (hazard ratios per 5 U: 0.90 [95% CI, 0.85 to 0.95], P <0.001), and Charlson index (hazard ratios 1.35 [95% CI, 1.23 to 1.49], P <0.001). Conclusions— Myocardial perfusion imaging is a significant predictor of SCD and provides information independent of clinical history and left ventricular ejection fraction. Gated single-photon emission computed tomography imaging, which evaluates both myocardial perfusion and function, may represent a more effective means of risk stratification than solitary left ventricular ejection fraction determination and should be evaluated in prospective trials.

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“…Recent data by Hachamovitch et al 25 also demonstrated an increasing event rate that paralleled the increasing abnormalities on perfusion imaging. In addition, Sharir et al 26 have recently emphasized again the strong prognostic value of LVEF (in that study derived from gated SPECT data).…”

Section: Ischemia Viability and Scar Tissue Versus Treatment And Prmentioning

confidence: 86%

Impact of Viability, Ischemia, Scar Tissue, and Revascularization on Outcome After Aborted Sudden Death

et al. 2003

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Background-Survivors of aborted sudden death attributable to ventricular arrhythmias in the presence of coronary artery disease are at risk for recurrences. The substrate underlying these arrhythmias is not clear, and therefore the relation between ischemia, viability, scar tissue (and revascularization), and the incidence of ventricular arrhythmias (and survival) was studied over up to 3 years. Methods and Results-One hundred fifty-three survivors of sudden death underwent stress-rest perfusion imaging.Patients with ischemic/viable myocardium (nϭ73) were revascularized if possible. Final antiarrhythmic therapy was based on the outcome of electrophysiological testing or left ventricular ejection fraction (LVEF). Implantation of a defibrillator was performed in 112 (72%) patients. During 3-year follow-up, 15 cardiac deaths occurred and 42 (29%) patients had recurrent ventricular arrhythmias. Patients with events (death or recurrence) exhibited more often a severely depressed LVEF (Յ30%), more extensive scar tissue, and less ischemic/viable myocardium on perfusion imaging and less frequently underwent revascularization. Multivariate analysis identified extensive scar tissue and LVEF Յ30% as the only predictors of death/recurrent ventricular arrhythmias. Conclusions-In patients with aborted sudden death, extensive scar tissue and severely depressed LVEF are the only predictors of death or recurrent ventricular arrhythmias. These patients should be considered for implantation of a defibrillator.

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Incremental Prognostic Value of Rest-Redistribution ²⁰¹ Tl Single-Photon Emission Computed Tomography

Cited by 40 publications

References 37 publications

Assessing the Prognostic Value of Cardiovascular Imaging

Assessing the Prognostic Value of Cardiovascular Imaging

Single-Photon Emission Computed Tomography Myocardial Perfusion Defects Are Associated With an Increased Risk of All-Cause Death, Cardiovascular Death, and Sudden Cardiac Death

Impact of Viability, Ischemia, Scar Tissue, and Revascularization on Outcome After Aborted Sudden Death

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Incremental Prognostic Value of Rest-Redistribution 201 Tl Single-Photon Emission Computed Tomography

Cited by 40 publications

References 37 publications

Assessing the Prognostic Value of Cardiovascular Imaging

Assessing the Prognostic Value of Cardiovascular Imaging

Single-Photon Emission Computed Tomography Myocardial Perfusion Defects Are Associated With an Increased Risk of All-Cause Death, Cardiovascular Death, and Sudden Cardiac Death

Impact of Viability, Ischemia, Scar Tissue, and Revascularization on Outcome After Aborted Sudden Death

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Incremental Prognostic Value of Rest-Redistribution ²⁰¹ Tl Single-Photon Emission Computed Tomography