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Prognostic implications of post-stress ejection fraction decrease detected by gated SPECT in the absence of stress-induced perfusion abnormalities

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Abstract

Purpose

The prognostic meaning of a post-stress ejection fraction (EF) decrease detected by perfusion gated SPECT is still unclear. We therefore followed up patients with post-stress EF decrease in the absence of stress-induced perfusion abnormalities.

Methods

We prospectively enrolled 57 consecutive patients with post-stress EF drop ≥ 5 EF units and summed difference score (SDS) ≤ 1. They were followed up for more than 1 year and their outcome was compared with a group of sex- and age-matched controls with the same SDS but without EF decrease.

Results

During follow-up there were 13 events (1 cardiac death, 1 non-fatal myocardial infarction, 1 congestive heart failure and 10 late revascularizations). In the control group we registered six events. There was a significant difference (p < 0.0001) between the event-free survival curves of the two groups.

Conclusion

The event rate of patients with post-stress EF decrease ≥ 5 EF units is relatively high and is significantly worse than that of a control group of patients with similarly normal SDS but without EF changes. Therefore, a post-stress EF decrease without stress-induced perfusion abnormalities should be cautiously interpreted.

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Authors and Affiliations

  1. Nuclear Medicine Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy

    Manjola Dona, Lucia Massi, Leonardo Settimo, Matteo Bartolini, Gianluca Giannì, Alberto Pupi & Roberto Sciagrà

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  1. Manjola Dona
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  2. Lucia Massi
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  3. Leonardo Settimo
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  4. Matteo Bartolini
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  5. Gianluca Giannì
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  6. Alberto Pupi
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  7. Roberto Sciagrà
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Correspondence to Roberto Sciagrà.

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Dona, M., Massi, L., Settimo, L. et al. Prognostic implications of post-stress ejection fraction decrease detected by gated SPECT in the absence of stress-induced perfusion abnormalities. Eur J Nucl Med Mol Imaging 38, 485–490 (2011). https://doi.org/10.1007/s00259-010-1643-6

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  • DOI: https://doi.org/10.1007/s00259-010-1643-6

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