Long-Term Prognostic Value of Appropriate Myocardial Perfusion Imaging

Background:The goal of this study was to evaluate the prevalence of depression and anxiety in patients subjected to myocardial perfusion imaging (MPI) with 99m Tc tetrofosmin stress-rest single-photon emission computer tomography (SPECT), and their impact on their cardiological events or disease. material and methods: Patients referred to the Nuclear Medicine Department for 99m Tc tetrofosmin myocardial MPI-SPECT were asked to fulfill the Zung Self-Rating Depression Scale (ZDS) and Hamilton anxiety questionnaire (HAQ). Among 213 patients who completed the ZDS and HAQ, 80 patients (59 males and 21 females) were selected for this study because they had no known psychological disease, other disease that could influence psychological status, or use of narcotic drugs. Collected data from MPI and psychological status were subsequently analyzed. results: Among all 80 patients, 52 patients (65%) had abnormal MPI of whom 28/52 (53.8%) exhibited either depression, anxiety or both, and 28 (35%) patients had normal MPI of whom 10/28 (35.7%) had abnormal psychological status. The higher number of patients with abnormal psychological status in association with abnormal MPI was noted predominantly in patients with previously established coronary artery disease. A correlation was also noted between obesity, cardiac heredity and depression or anxiety in patients with abnormal MPI. conclusions: Patients that exhibit depression, anxiety, or both, have high rates of myocardial ischemia, and thus are at risk for subsequent cardiological events.

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“…The MPI grading may be able to provide an excellent tool to monitor response to treatment, follow-up status and long term prognosis [11,12].…”

Section: Introductionmentioning

confidence: 99%

The impact of depression and anxiety in prognosis of patients undergoing myocardial perfusion imaging with 99mTc tetrofosmin SPECT for evaluation of possible myocardial ischemia

et al. 2020

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“…Interestingly, in a prospective study, Koh et al investigated the long-term prognostic value of MPI classified as appropriate, according to the appropriate use criteria [21]. The researchers found that appropriate MPI was associated with long-term prognostic value for adverse events, despite a high proportion of low-risk patients (SSS ≤ 3).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Prognostic Value of Automated Measurements in Nuclear Cardiology: Comparisons with Expert Scoring

Angelidis,

Giannakou,

Valotassiou

et al. 2023

Medicina

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Background and Objectives: Automated methods for the analysis of myocardial perfusion studies have been incorporated into clinical practice, but they are currently used as adjuncts to the visual interpretation. We aimed to investigate the role of automated measurements of summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) as long-term prognostic markers of morbidity and mortality, in comparison to the prognostic value of expert reading. Materials and Methods: The study was conducted at the Nuclear Medicine Laboratory of the University of Thessaly, in Larissa, Greece. A total of 378 consecutive patients with known or suspected coronary artery disease were enrolled in the study. All participants were referred to our laboratory for the performance of stress/rest myocardial perfusion single photon emission computed tomography. Automated measurements of SSS, SRS, and SDS were obtained by Emory Cardiac Toolbox (ECTb (Version 3.0), Emory University, Atlanta, GA, USA), Myovation (MYO, Xeleris version 3.05, GE Healthcare, Chicago, IL, USA), and Quantitative Perfusion SPECT (QPS (Version 4.0), Cedars-Sinai Medical Center, Los Angeles, CA, USA) software packages. Follow-up data were recorded after phone contacts, as well as through review of hospital records. Results: Expert scoring of SSS and SDS had significantly greater prognostic ability in comparison to all software packages (p < 0.001 for all comparisons). Similarly, ECTb-obtained SRS measurements had significantly lower prognostic ability in comparison to expert scoring (p < 0.001), while expert scoring of SRS showed significantly higher prognostic ability compared to MYO (p = 0.018) and QPS (p < 0.001). Conclusions: Despite the useful contribution of automated analyses in the interpretation of myocardial perfusion studies, expert reading should continue to have a crucial role, not only in clinical decision making, but also in the assessment of prognosis.

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“…In recent years, a large body of literature has established the prognostic significance of MPI in general population [7,16,17]. It was shown that patients with normal stress MPI studies had remarkably low cardiac event rates ( < 1% per year) and the event rate was proportional to the extent of stress-induced hypoperfusion.…”

Section: Discussionmentioning

confidence: 99%

Correlation between myocardial perfusion imaging findings and future cardiac events in patients with type 2 diabetes mellitus

et al. 2021

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Introduction/Objective. Myocardial perfusion imaging (MPI) is clinically useful for the evaluation of coronary artery disease (CAD) in patients with diabetes mellitus (DM). However, the prevalence of ischemia and its ability to predict future cardiac events is less clear. The aim was to determine the incidence of cardiac events in diabetic patients and relationship between them and MPI findings. Methods. Two cohorts of patients, 98 diabetics and 100 non-diabetics, with medium- to high-risk of CAD without previous coronary revascularization were studied prospectively. All of them were outpatients underwent 99mTc-sestamibi MPI with dipyridamole. The data about cardiac events were collected during follow-up period of two years. Results. Cardiac events occurred in 17.3% diabetics and in 8% non-diabetics (p = 0.048). Diabetics had shorter estimated event-free time 24.7 months (95% CI 23.2-26.2) versus non-diabetics 28.5 months (95% CI 27.4-29.5) (p = 0.046). The independent predictors of cardiac events were male sex (p = 0.010), previous myocardial infarction (p < 0.001), presence of the symptoms of angina (p = 0.014) and all variables derived from MPI findings. After adjustment for variables derived from MPI findings, the significant predictors in diabetics were size of stress perfusion defect (p = 0.022), summed stress score (p = 0.011) and summed difference score (p = 0.044). Conclusion. In diabetic patients, the cumulative rate of cardiac events was higher and the event-free survival was worse. MPI could help in prediction of cardiac events in diabetics and the most important predictors were size of stress perfusion defect, summed stress score and summed difference score.

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Long-Term Prognostic Value of Appropriate Myocardial Perfusion Imaging

Cited by 9 publications

References 15 publications

The impact of depression and anxiety in prognosis of patients undergoing myocardial perfusion imaging with 99mTc tetrofosmin SPECT for evaluation of possible myocardial ischemia

The impact of depression and anxiety in prognosis of patients undergoing myocardial perfusion imaging with 99mTc tetrofosmin SPECT for evaluation of possible myocardial ischemia

Long-Term Prognostic Value of Automated Measurements in Nuclear Cardiology: Comparisons with Expert Scoring

Correlation between myocardial perfusion imaging findings and future cardiac events in patients with type 2 diabetes mellitus

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