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What is the value of stress 99mTc-tetrofosmin myocardial perfusion imaging for the assessment of very long-term outcome in obese patients?

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Journal of Nuclear Cardiology Aims and scope

Abstract

Objective

There are no data regarding the long-term prognostic value of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in obese patients. The aim of this study was to examine the value of stress 99mTc-tetrofosmin MPI findings for the prediction of very long-term outcome in obese patients.

Methods

The study population consisted of 261 patients with a body mass index ≥30 kg/m2 who underwent exercise or pharmacological stress 99mTc-tetrofosmin MPI for the assessment of known or suspected coronary artery disease. Endpoints during follow-up were all-cause mortality, cardiac death, nonfatal infarction, and coronary revascularization. Kaplan-Meier survival cures were constructed and univariate and multivariate analyses were performed to identify predictors of very long-term outcome.

Results

The mean age was 59 ± 10 years, 42% of the patients was male, and the body mass index was on average 37 ± 7 kg/m2. MPI findings were normal in 109 patients (42%). Myocardial perfusion abnormalities were fixed in 62 patients (24%) and reversible in 90 patients (34%). During a median 12-year follow-up, 91 (35%) patients died, and 27 (10%) had a nonfatal myocardial infarction. Survival curves were compared using the log-rank test at subsequent follow-up durations. Obese patients with a normal stress 99mTc-tetrofosmin study had a significantly better prognosis as compared with those with an abnormal study, up to 6 years after the test was performed.

Conclusion

Stress 99mTc-tetrofosmin MPI provides valuable prognostic information for the prediction of outcome in obese patients. Obese patients with a normal stress 99mTc-tetrofosmin study have a significantly better prognosis as compared with those with an abnormal study, up to 6 years after the test is performed.

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Authors and Affiliations

  1. Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Room Ba304, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    Rebecca S. Korbee BSc, Henk J. Boiten BSc, Machiel Ottenhof BSc, Ron T. van Domburg PhD & Arend F. L. Schinkel MD, PhD

  2. Department of Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

    Roelf Valkema MD, PhD

Authors
  1. Rebecca S. Korbee BSc
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  2. Henk J. Boiten BSc
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  3. Machiel Ottenhof BSc
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  4. Roelf Valkema MD, PhD
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  5. Ron T. van Domburg PhD
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  6. Arend F. L. Schinkel MD, PhD
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Corresponding author

Correspondence to Arend F. L. Schinkel MD, PhD.

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Korbee, R.S., Boiten, H.J., Ottenhof, M. et al. What is the value of stress 99mTc-tetrofosmin myocardial perfusion imaging for the assessment of very long-term outcome in obese patients?. J. Nucl. Cardiol. 20, 227–233 (2013). https://doi.org/10.1007/s12350-012-9657-z

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  • DOI: https://doi.org/10.1007/s12350-012-9657-z

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