Relationship of technetium-99m tetrofosmin-gated rest single-photon emission computed tomography myocardial perfusion imaging to death and hospitalization in heart failure patients: results from the nuclear ancillary study of the HF-ACTION trial

被引:7
作者
Atchley, Allen E.
Iskandrian, Ami E. [2 ]
Bensimhon, Dan
Ellis, Stephen J.
Kitzman, Dalane W. [3 ]
Shaw, Linda K.
Pagnanelli, Robert A.
Whellan, David J. [4 ]
Gardin, Julius M. [5 ]
Kao, Andrew [6 ]
Abdul-Nour, Khaled [7 ]
Ewald, Greg [8 ]
Walsh, Mary Norine [9 ]
Kraus, William E.
O'Connor, Christopher M.
Borges-Neto, Salvador [1 ]
机构
[1] Duke Univ, Med Ctr, Dept Med & Radiol, Durham, NC 27710 USA
[2] Univ Alabama, Birmingham, AL USA
[3] Wake Forest Univ, Sch Med, Winston Salem, NC 27109 USA
[4] Thomas Jefferson Univ, Jefferson Med Coll, Philadelphia, PA 19107 USA
[5] Hackensack Univ, Med Ctr, Hackensack, NJ USA
[6] St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA
[7] Henry Ford Hosp, Detroit, MI 48202 USA
[8] Washington Univ, St Louis, MO USA
[9] St Vincent Hosp, Indianapolis, IN USA
基金
美国国家卫生研究院;
关键词
CORONARY-ARTERY-DISEASE; INCREMENTAL PROGNOSTIC VALUE; LEFT-VENTRICULAR DYSFUNCTION; IDIOPATHIC DILATED CARDIOMYOPATHY; CARDIAC-RESYNCHRONIZATION THERAPY; PHASE-ANALYSIS; MECHANICAL DYSSYNCHRONY; INVESTIGATING OUTCOMES; RISK STRATIFICATION; SPECT;
D O I
10.1016/j.ahj.2011.02.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background We hypothesized that the severity of resting perfusion abnormalities assessed by the summed rest score (SRS) would be associated with a higher rate of adverse outcomes in patients with heart failure (HF) and reduced left ventricular (LV) ejection fraction (EF). Methods A subset of 240 subjects from HF-ACTION underwent resting technetium-99m tetrofosmin-gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Images were evaluated using a 17-segment model to derive the SRS and additional nuclear variables. Results After adjusting for prespecified covariates, SRS was significantly associated with the primary end point (hazard ratio 0.98, 95% confidence interval [CI] 0.97-1.00, P = .04), with a higher SRS corresponding to lower risk of an event. This association was not present in the unadjusted analysis. The relationship between SRS and the primary outcome was likely due to a higher event ratein patients with ischemic HF and a low SRS. The LV phase SD was not predictive of the primary outcome (hazard ratio 1.00, 95% confidence interval 0.99-1.01, P = .49). In a post hoc analysis, nuclear variables provided incremental prognostic information when added to clinical information (P = .006). Conclusions Gated SPECT MPI provides important information in patients with HF and reduced LVEF. In the adjusted analysis, SRS has an unexpected relationship with the primary end point. Phase SD was not associated with the primary end point. Rest-gated SPECT MPI provides incrementally greater prognostic information than clinical information alone. (Am Heart J 2011;161:1038-45.)
引用
收藏
页码:1038 / 1045
页数:8
相关论文
共 49 条
[1]   Use of phase analysis of gated SPECT perfusion imaging to quantify dyssynchrony in patients with mild-to-moderate left ventricular dysfunction [J].
Atchley, Allen E. ;
Trimble, Mark A. ;
Samad, Zainab ;
Shaw, Linda K. ;
Pagnanelli, Robert ;
Chen, Ji ;
Garcia, Ernest V. ;
Iskandrian, Ami E. ;
Velazquez, Eric J. ;
Borges-Neto, Salvador .
JOURNAL OF NUCLEAR CARDIOLOGY, 2009, 16 (06) :888-894
[2]   Myocardial perfusion, function, and dyssynchrony in patients with heart failure: Baseline results from the single-photon emission computed tomography imaging ancillary study of the Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing (HF-ACTION) Trial [J].
Atchley, Allen E. ;
Kitzman, Dalane W. ;
Whellan, David J. ;
Iskandrian, Ami E. ;
Ellis, Stephen J. ;
Pagnanelli, Robert A. ;
Kao, Andrew ;
Abdul-Nour, Khaled ;
O'Connor, Christopher M. ;
Ewald, Greg ;
Kraus, William E. ;
Borges-Neto, Salvador .
AMERICAN HEART JOURNAL, 2009, 158 (04) :S53-S63
[3]   Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure [J].
Bardy, GH ;
Lee, KL ;
Mark, DB ;
Poole, JE ;
Packer, DL ;
Boineau, R ;
Domanski, M ;
Troutman, C ;
Anderson, J ;
Johnson, G ;
McNulty, SE ;
Clapp-Channing, N ;
Davidson-Ray, LD ;
Fraulo, ES ;
Fishbein, DP ;
Luceri, RM ;
Ip, JH .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 352 (03) :225-237
[4]   Effect of exercise training on ventricular function dyssynchrony, resting myocardial perfusion, and clinical outcomes in patients with heart failure: A nuclear ancillary study of Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION); Design and rationale [J].
Bensimhon, Daniel R. ;
Adams, George L. ;
Whellan, David J. ;
Pagnanelli, Robert A. ;
Trimble, Mark ;
Lee, Benjamin A. ;
Lee, Kerry L. ;
Ellis, Stephen J. ;
Kraus, William E. ;
Rendall, David S. ;
Iskandrian, Ami E. ;
O'Connor, Christopher M. ;
Borges-Neto, Salvador .
AMERICAN HEART JOURNAL, 2007, 154 (01) :46-53
[5]   Incremental prognostic power of single-photon emission computed tomographic myocardial perfusion imaging in patients with known or suspected coronary artery disease [J].
Borges-Neto, S ;
Shaw, LK ;
Tuttle, RH ;
Alexander, JH ;
Smith, WT ;
Chambless, M ;
Coleman, RE ;
Harrington, RA ;
Califf, RM .
AMERICAN JOURNAL OF CARDIOLOGY, 2005, 95 (02) :182-188
[6]   Prediction of Mortality and Major Cardiac Events by Exercise Echocardiography in Patients With Normal Exercise Electrocardiographic Testing [J].
Bouzas-Mosquera, Alberto ;
Peteiro, Jesus ;
Alvarez-Garcia, Nemesio ;
Broullon, Francisco J. ;
Mosquera, Victor X. ;
Garcia-Bueno, Lourdes ;
Ferro, Luis ;
Castro-Beiras, Alfonso .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2009, 53 (21) :1981-1990
[7]   Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure [J].
Bristow, MR ;
Saxon, LA ;
Boehmer, J ;
Krueger, S ;
Kass, DA ;
De Marco, T ;
Carson, P ;
DiCarlo, L ;
DeMets, D ;
White, BG ;
DeVries, DW ;
Feldman, AM .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (21) :2140-2150
[8]   TL-201 IMAGING AND GATED CARDIAC BLOOD POOL SCANS IN PATIENTS WITH ISCHEMIC AND IDIOPATHIC CONGESTIVE CARDIOMYOPATHY - CLINICAL AND PATHOLOGIC-STUDY [J].
BULKLEY, BH ;
HUTCHINS, GM ;
BAILEY, I ;
STRAUSS, HW ;
PITT, B .
CIRCULATION, 1977, 55 (05) :753-760
[9]   Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: Development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony [J].
Chen, J ;
Garcia, EV ;
Folks, RD ;
Cooke, CD ;
Faber, TL ;
Tauxe, L ;
Iskandrian, AE .
JOURNAL OF NUCLEAR CARDIOLOGY, 2005, 12 (06) :687-695
[10]   Left Ventricular Mechanical Dyssynchrony as Assessed by Phase Analysis of ECG-Gated SPECT Myocardial Perfusion Imaging [J].
Chen, Ji ;
Garcia, Ernest V. ;
Lerakis, Stamatios ;
Henneman, Maureen M. ;
Bax, Jeroen J. ;
Trimble, Mark A. ;
Borges-Neto, Salvador ;
Velazquez, Eric J. ;
Iskandrian, Ami E. .
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2008, 25 (10) :1186-1194