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Electrocardiographic changes during vasodilator SPECT myocardial perfusion imaging: Does it affect diagnosis or prognosis?

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Significance of electrocardiographic (ECG) changes during vasodilator stress myocardial perfusion imaging (MPI) is controversial. We examined the diagnostic and prognostic significance of ECG changes during vasodilator single photon emission computerized tomography (SPECT) MPI.

Methods

We studied consecutive patients who underwent vasodilator SPECT MPI from 1995 to 2009. Patients with baseline ECG abnormalities, previous history of coronary artery bypass graft surgery or myocardial infarction (MI) were excluded. Significant coronary artery disease (CAD) was defined as >70% stenosis of any vessel or ≥50% stenosis of left main. Mean follow-up was 2.4 ± 1.5 years for cardiac events (cardiac death and non-fatal MI).

Results

Of patients in the diagnostic cohort, ST depression was associated with increased incidence of CAD with abnormal (P = .020 and P <.001) but not in those with normal perfusion (P = .342). Of 3,566 patients with follow-up in the prognostic cohort, including 130 (5.0%) with ST depression and normal perfusion, the presence of ST depression ≥1 mm did not affect the outcomes in any summed stress score category.

Conclusions

ST depression ≥1 mm during vasodilator SPECT MPI is associated with CAD in patients with abnormal perfusion, but provides no additional risk stratification beyond concomitant perfusion imaging, including those with normal studies.

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Authors and Affiliations

  1. Nuclear Cardiology Laboratory, Henry Low Heart Center, Division of Cardiology, Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA

    Talhat Azemi MD, Mridula Rai MD, Purvi Parwani MD, Fawad Kazi MD, Alan W. Ahlberg MA, Giselle Cyr RN, BSN, Deborah Katten RN, MPH, David O’Sullivan PhD, Daniel Fram MD & Gary V. Heller MD, PhD, FACC

  2. University of Connecticut School of Medicine, Farmington, CT, USA

    Mridula Rai MD & Purvi Parwani MD

  3. University of California, San Francisco School of Medicine, San Francisco, CA, USA

    Sarkis Baghdasarian MD

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  1. Talhat Azemi MD
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  2. Mridula Rai MD
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  3. Purvi Parwani MD
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Correspondence to Talhat Azemi MD.

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Supported by a grant from the Department of Research Administration, Hartford Hospital, Hartford, CT, USA.

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Azemi, T., Rai, M., Parwani, P. et al. Electrocardiographic changes during vasodilator SPECT myocardial perfusion imaging: Does it affect diagnosis or prognosis?. J. Nucl. Cardiol. 19, 84–91 (2012). https://doi.org/10.1007/s12350-011-9457-x

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  • DOI: https://doi.org/10.1007/s12350-011-9457-x

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