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Journal of Nuclear Cardiology

, Volume 16, Issue 1, pp 82–91 | Cite as

Etiology and pathophysiology of new-onset heart failure: Evaluation by myocardial perfusion imaging

  • Prem Soman
  • Avijit Lahiri
  • Jennifer H. Mieres
  • Dennis A. Calnon
  • David Wolinsky
  • George A. Beller
  • Tina Sias
  • Kenneth Burnham
  • Laurence Conway
  • Peter A. McCullough
  • Edouard Daher
  • Mary N. Walsh
  • Joseph Wight
  • Gary V. Heller
  • James E. Udelson
Original Article

Abstract

Objective

The IMAGING in Heart Failure study was a prospective, multi-national trial designed to explore the role of single-photon emission computed tomographic (SPECT) myocardial perfusion imaging (MPI) as an initial investigative strategy in patients hospitalized with new-onset heart failure.

Methods

We recruited 201 patients (age 65.3 ± 14.5 years, 43% women) hospitalized with their first episode of heart failure. Rest/stress gated SPECT Tc-99m sestamibi MPI was performed during or within 2 weeks of the index hospitalization, in addition to standard care.

Results

SPECT MPI revealed a broad range of ejection fractions with preserved systolic function in 36% of patients. Forty-one percent of patients had normal perfusion. In the remaining patients, perfusion abnormalities were predominantly due to prior myocardial infarction, with extensive ischemia seen only in 6%. Among patients who underwent coronary angiography, SPECT performance characteristics revealed excellent negative predictive value (96%) for extensive coronary artery disease (CAD). In multivariable analyses, the extent of perfusion abnormality and advancing age predicted the presence of extensive CAD.

Conclusions

These preliminary data derived from a non-randomized observational cohort suggest potential diagnostic utility of MPI for ischemic LV dysfunction in new-onset HF, and sets the stage for a prospective randomized study to confirm these findings.

Keywords

Heart failure myocardial perfusion imaging: SPECT sestamibi gated SPECT 

Notes

Acknowledgment

This study was funded by an unrestricted educational grant from BMS-Medical Imaging, Billerica, MA.

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Copyright information

© American Society of Nuclear Cardiology 2008

Authors and Affiliations

  • Prem Soman
    • 1
  • Avijit Lahiri
    • 2
  • Jennifer H. Mieres
    • 3
  • Dennis A. Calnon
    • 4
  • David Wolinsky
    • 5
  • George A. Beller
    • 6
  • Tina Sias
    • 7
  • Kenneth Burnham
    • 8
  • Laurence Conway
    • 9
  • Peter A. McCullough
    • 10
  • Edouard Daher
    • 11
  • Mary N. Walsh
    • 12
  • Joseph Wight
    • 13
  • Gary V. Heller
    • 14
  • James E. Udelson
    • 15
  1. 1.Nuclear CardiologyUniversity of Pittsburgh Medical Center, Presbyterian University HospitalPittsburghUSA
  2. 2.The Wellington HospitalLondonUnited Kingdom
  3. 3.New York University School of MedicineNew YorkUSA
  4. 4.Mid Ohio Cardiology Research FoundationColumbusUSA
  5. 5.Albany Associates in CardiologyAlbanyUSA
  6. 6.University of VirginiaCharlottesvilleUSA
  7. 7.Marshall University School of MedicineHuntingtonUSA
  8. 8.Cardiology Associates of MobileMobileUSA
  9. 9.Lawrence Memorial HospitalTufts UniversityBostonUSA
  10. 10.William Beaumont HospitalRoyal OakUSA
  11. 11.Wayne State University School of MedicineDetroitUSA
  12. 12.The Care GroupIndianapolisUSA
  13. 13.Maine Cardiology AssociatesSouth PortlandUSA
  14. 14.Hartford HospitalUniversity of ConnecticutHartfordUSA
  15. 15.Tufts Medical CenterBostonUSA

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