Prognostic importance of scintigraphic left ventricular cavity dilation during intravenous dipyridamole technetium-99m sestamibi myocardial tomographic imaging in predicting coronary events

Joseph R. McClellan, Mark I. Travin, Steven D. Herman, John I. Baron, Robert J. Golub, James J. Gallagher, David Waters, Gary V. Heller

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Left ventricular (LV) cavity dilation during stress myocardial perfusion imaging has been associated with multivessel disease, and may be an independent prognostic marker in addition to perfusion defects. The present study examines the predictive value for future cardiac events of transient or fixed LV dilation during dipyridamole technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) imaging. The study included 512 consecutive patients who underwent SPECT imaging with Tc-99m sestamibi after dipyridamole infusion. Transient LV dilation was seen in 70 patients (14%) and 74 had fixed cavity dilation (14%); cavity size was normal in 368 patients (72%). Each perfusion scan was classified as normal or abnormal, and if abnormal, defects were categorized as transient or fixed, and as small, medium, or large (depending upon the number of abnormal vascular territories). Events during a mean follow-up of 12.8 ± 6.8 months were tabulated by direct review of hospital charts and death certificates. The cardiac event rate (cardiac death or nonfatal infarction) was 1.9% in patients with normal cavity size, 11.4% with transient LV dilation, and 13.5% with fixed LV dilation (p <0.01). Compared with patients with normal cavity size, those with transient LV dilation were more likely to sustain a myocardial infarction (p <0.01) and those with fixed dilation more frequently suffered cardiac death (p <0.01) and hospitalization far heart failure (p <0.01). The group with the highest risk had both a large perfusion defect and cavity dilation. By Cox proportional hazard regression analysis, both transient and fixed LV dilation were strong independent predictors of cardiac events. Transient or fixed LV dilation are commonly seen during dipyridamole Tc-99m sestamibi SPECT imaging (14% incidence for each) and are useful predictors of cardiac events.

Original languageEnglish (US)
Pages (from-to)600-605
Number of pages6
JournalAmerican Journal of Cardiology
Volume79
Issue number5
DOIs
StatePublished - Mar 1 1997
Externally publishedYes

Fingerprint

Technetium Tc 99m Sestamibi
Dipyridamole
Dilatation
Single-Photon Emission-Computed Tomography
Perfusion
Myocardial Perfusion Imaging
Death Certificates
Infarction
Blood Vessels
Hospitalization
Heart Failure
Myocardial Infarction
Regression Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic importance of scintigraphic left ventricular cavity dilation during intravenous dipyridamole technetium-99m sestamibi myocardial tomographic imaging in predicting coronary events. / McClellan, Joseph R.; Travin, Mark I.; Herman, Steven D.; Baron, John I.; Golub, Robert J.; Gallagher, James J.; Waters, David; Heller, Gary V.

In: American Journal of Cardiology, Vol. 79, No. 5, 01.03.1997, p. 600-605.

Research output: Contribution to journalArticle

McClellan, Joseph R. ; Travin, Mark I. ; Herman, Steven D. ; Baron, John I. ; Golub, Robert J. ; Gallagher, James J. ; Waters, David ; Heller, Gary V. / Prognostic importance of scintigraphic left ventricular cavity dilation during intravenous dipyridamole technetium-99m sestamibi myocardial tomographic imaging in predicting coronary events. In: American Journal of Cardiology. 1997 ; Vol. 79, No. 5. pp. 600-605.
@article{93f067d90bd34c95b72e280ad7e21f4f,
title = "Prognostic importance of scintigraphic left ventricular cavity dilation during intravenous dipyridamole technetium-99m sestamibi myocardial tomographic imaging in predicting coronary events",
abstract = "Left ventricular (LV) cavity dilation during stress myocardial perfusion imaging has been associated with multivessel disease, and may be an independent prognostic marker in addition to perfusion defects. The present study examines the predictive value for future cardiac events of transient or fixed LV dilation during dipyridamole technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) imaging. The study included 512 consecutive patients who underwent SPECT imaging with Tc-99m sestamibi after dipyridamole infusion. Transient LV dilation was seen in 70 patients (14{\%}) and 74 had fixed cavity dilation (14{\%}); cavity size was normal in 368 patients (72{\%}). Each perfusion scan was classified as normal or abnormal, and if abnormal, defects were categorized as transient or fixed, and as small, medium, or large (depending upon the number of abnormal vascular territories). Events during a mean follow-up of 12.8 ± 6.8 months were tabulated by direct review of hospital charts and death certificates. The cardiac event rate (cardiac death or nonfatal infarction) was 1.9{\%} in patients with normal cavity size, 11.4{\%} with transient LV dilation, and 13.5{\%} with fixed LV dilation (p <0.01). Compared with patients with normal cavity size, those with transient LV dilation were more likely to sustain a myocardial infarction (p <0.01) and those with fixed dilation more frequently suffered cardiac death (p <0.01) and hospitalization far heart failure (p <0.01). The group with the highest risk had both a large perfusion defect and cavity dilation. By Cox proportional hazard regression analysis, both transient and fixed LV dilation were strong independent predictors of cardiac events. Transient or fixed LV dilation are commonly seen during dipyridamole Tc-99m sestamibi SPECT imaging (14{\%} incidence for each) and are useful predictors of cardiac events.",
author = "McClellan, {Joseph R.} and Travin, {Mark I.} and Herman, {Steven D.} and Baron, {John I.} and Golub, {Robert J.} and Gallagher, {James J.} and David Waters and Heller, {Gary V.}",
year = "1997",
month = "3",
day = "1",
doi = "10.1016/S0002-9149(96)00823-5",
language = "English (US)",
volume = "79",
pages = "600--605",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Prognostic importance of scintigraphic left ventricular cavity dilation during intravenous dipyridamole technetium-99m sestamibi myocardial tomographic imaging in predicting coronary events

AU - McClellan, Joseph R.

AU - Travin, Mark I.

AU - Herman, Steven D.

AU - Baron, John I.

AU - Golub, Robert J.

AU - Gallagher, James J.

AU - Waters, David

AU - Heller, Gary V.

PY - 1997/3/1

Y1 - 1997/3/1

N2 - Left ventricular (LV) cavity dilation during stress myocardial perfusion imaging has been associated with multivessel disease, and may be an independent prognostic marker in addition to perfusion defects. The present study examines the predictive value for future cardiac events of transient or fixed LV dilation during dipyridamole technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) imaging. The study included 512 consecutive patients who underwent SPECT imaging with Tc-99m sestamibi after dipyridamole infusion. Transient LV dilation was seen in 70 patients (14%) and 74 had fixed cavity dilation (14%); cavity size was normal in 368 patients (72%). Each perfusion scan was classified as normal or abnormal, and if abnormal, defects were categorized as transient or fixed, and as small, medium, or large (depending upon the number of abnormal vascular territories). Events during a mean follow-up of 12.8 ± 6.8 months were tabulated by direct review of hospital charts and death certificates. The cardiac event rate (cardiac death or nonfatal infarction) was 1.9% in patients with normal cavity size, 11.4% with transient LV dilation, and 13.5% with fixed LV dilation (p <0.01). Compared with patients with normal cavity size, those with transient LV dilation were more likely to sustain a myocardial infarction (p <0.01) and those with fixed dilation more frequently suffered cardiac death (p <0.01) and hospitalization far heart failure (p <0.01). The group with the highest risk had both a large perfusion defect and cavity dilation. By Cox proportional hazard regression analysis, both transient and fixed LV dilation were strong independent predictors of cardiac events. Transient or fixed LV dilation are commonly seen during dipyridamole Tc-99m sestamibi SPECT imaging (14% incidence for each) and are useful predictors of cardiac events.

AB - Left ventricular (LV) cavity dilation during stress myocardial perfusion imaging has been associated with multivessel disease, and may be an independent prognostic marker in addition to perfusion defects. The present study examines the predictive value for future cardiac events of transient or fixed LV dilation during dipyridamole technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) imaging. The study included 512 consecutive patients who underwent SPECT imaging with Tc-99m sestamibi after dipyridamole infusion. Transient LV dilation was seen in 70 patients (14%) and 74 had fixed cavity dilation (14%); cavity size was normal in 368 patients (72%). Each perfusion scan was classified as normal or abnormal, and if abnormal, defects were categorized as transient or fixed, and as small, medium, or large (depending upon the number of abnormal vascular territories). Events during a mean follow-up of 12.8 ± 6.8 months were tabulated by direct review of hospital charts and death certificates. The cardiac event rate (cardiac death or nonfatal infarction) was 1.9% in patients with normal cavity size, 11.4% with transient LV dilation, and 13.5% with fixed LV dilation (p <0.01). Compared with patients with normal cavity size, those with transient LV dilation were more likely to sustain a myocardial infarction (p <0.01) and those with fixed dilation more frequently suffered cardiac death (p <0.01) and hospitalization far heart failure (p <0.01). The group with the highest risk had both a large perfusion defect and cavity dilation. By Cox proportional hazard regression analysis, both transient and fixed LV dilation were strong independent predictors of cardiac events. Transient or fixed LV dilation are commonly seen during dipyridamole Tc-99m sestamibi SPECT imaging (14% incidence for each) and are useful predictors of cardiac events.

UR - http://www.scopus.com/inward/record.url?scp=0030903106&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030903106&partnerID=8YFLogxK

U2 - 10.1016/S0002-9149(96)00823-5

DO - 10.1016/S0002-9149(96)00823-5

M3 - Article

VL - 79

SP - 600

EP - 605

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 5

ER -