The value of exercise radionuclide ventriculography in risk stratification in patients with known or suspected coronary artery disease
Conference
·
· J. Nucl. Med.; (United States)
OSTI ID:6855144
This study examined the value of rest and exercise (EX) radionuclide ventriculography (RNV) in risk stratification in 392 pts with suspected or known coronary artery disease who were being evaluated for anginal symptoms. There were 289 men and 203 women, aged 55 +- 12 years (mean +- SD). There were 20 cardiac events in the followup period of up to 4 years (19 +- 10 months): 14 pts died of cardiac causes and 6 had non-fatal acute myocardial infarctions. The pts with and without events did not differ in age, clinical presentation, risk factors, and rest and EX ECGs. However, pts with events had lower EX systolic blood pressure (p < 0.02); lower EX duration; (5.5 +- 2.5 vs 7.6 +- 3.7 minutes, p < 0.0l), lower resting left ventricular (LV) ejection fraction (EF) (p = 0.001), and lower EX EF (35 +- 17% vs 56 +- 15%, p = 0.0001). The change in EF from rest to EX was not significantly different (-0.1 +- 6.1 vs 3 +- 9.9). Univariate survival analysis (Cox model) showed several descriptors related to prognosis: EX EF, rest EF, wall motion and EX duration. Multivariate analysis, however, identified the EX EF as the only significant predictor (X/sup 2/ = 19.9). None of the other variables added independent information to that provided by the EX EF. Actuarial lie table analysis showed that the risk increased as the EX EF decreased, when pts were grouped into those with EXEF greater than or equal to 50%, 30-49%, and <30%., (p = 0.001, Mantel-Cox). Thus, the EX RNV is useful in risk stratification; the EX EF is the best descriptor that categorizes pts into different risk groups.
- Research Organization:
- Cardiovascular Institute, Hahnemann Univ., Philadelphia, PA
- OSTI ID:
- 6855144
- 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
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Related Subjects
550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
550901 -- Pathology-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BIOLOGICAL RECOVERY
BIOLOGICAL STRESS
BODY
CARDIOGRAPHY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
DISEASE INCIDENCE
DISEASES
DYNAMIC FUNCTION STUDIES
EVALUATION
EXERCISE
HAZARDS
HEALING
HEALTH HAZARDS
HEART
ORGANS
PUBLIC HEALTH
RECOVERY
RISK ASSESSMENT
THERAPY
550901 -- Pathology-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BIOLOGICAL RECOVERY
BIOLOGICAL STRESS
BODY
CARDIOGRAPHY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
DISEASE INCIDENCE
DISEASES
DYNAMIC FUNCTION STUDIES
EVALUATION
EXERCISE
HAZARDS
HEALING
HEALTH HAZARDS
HEART
ORGANS
PUBLIC HEALTH
RECOVERY
RISK ASSESSMENT
THERAPY