The value of exercise radionuclide ventriculography in risk stratification after coronary arterial bypass grafting

Conference · Wed May 01 04:00:00 EDT 1985 · J. Nucl. Med.; (United States)

OSTI ID:6794397

Iskandrian, A S; Hakki, A H; Goel, I P; Mundth, E D; Kane, S; Schenk, C

Cardiac events after coronary artery bypass surgery (CABG) may be related to left ventricular (LV) function, residual coronary artery diseases (CAD), graft occlusion, and progression of CAD. This study examined the value of rest and exercise (EX) radionuclide ventriculography (RNV) done 3-6 mos after CABG in risk stratification in 212 pts. There were 185 men and 27 women, aged 57 +- 8 years (mean +- SD). During a followup period of up to 4 years, (15 +- 10 months), there were 23 cardiac events; 13 pts died of cardiac causes and 20 had non-fatal acute myocardial infarctions. The pts with and without events did not differ in: clinical presentation after CABG (most were asymptomatic), medications and ECG findings at rest and EX. The pts with events had lower EX systolic blood pressure (p < 0.01); resting LV ejection fraction (EF) (p = 0.002), and EX EF (40 +- 18% vs 54 +- 16%, p = 0.002). The change in EF (rest to EX) was not significantly different (l.6 +- 8.2%, vs 2.1 +- 9.2%). Survival analysis (Cox model) identified the EX EF as the best predictor of death and total events (X/sup 2/ = 4.3 and 2.4, p = 0.04 and 0.07 respectively). Actuarial life table analysis showed that the risk increased as the EX EF decreased when pts were grouped into EX EF greater than or equal to 50, 30-49, and <30%, (p < 0.001, Mantel-Cox). Thus, EX RNA is useful in risk stratification after CABG. The EX LVEF is an important descriptor that categorizes pts into different risks groups. The pts at high risk probably require more aggressive followup and continued medical therapy.

• Research Organization: Cardiovascular Institute, Hahnemann Univ., Philadelphia, PA
• OSTI ID: 6794397
• Report Number(s): CONF-850611-
• Conference Information: Journal Name: J. Nucl. Med.; (United States) Journal Volume: 26:5
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
550901 -- Pathology-- Tracer Techniques
551000 -- Physiological Systems
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BIOLOGICAL RECOVERY
BIOLOGICAL STRESS
BLOOD PRESSURE
BLOOD VESSELS
BODY
CARDIOGRAPHY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CORONARIES
DIAGNOSTIC TECHNIQUES
DISEASE INCIDENCE
DISEASES
DYNAMIC FUNCTION STUDIES
EXERCISE
GRAFTS
HAZARDS
HEALING
HEALTH HAZARDS
HEART
MEDICINE
MONITORING
MYOCARDIAL INFARCTION
ORGANS
PUBLIC HEALTH
RADIONUCLIDE KINETICS
RECOVERY
SURGERY
THERAPY
TRANSPLANTS