Etiology and pathophysiology of new-onset heart failure: Evaluation by myocardial perfusion imaging
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- 作者：Prem Soman MD ; PhD ; FRCP (1)
Avijit Lahiri MD (2)
Jennifer H. Mieres MD (3)
Dennis A. Calnon MD (4)
David Wolinsky MD (5)
George A. Beller MD (6)
Tina Sias MD (7)
Kenneth Burnham MD (8)
Laurence Conway MD (9)
Peter A. McCullough MD (10)
Edouard Daher MD (11)
Mary N. Walsh MD (12)
Joseph Wight MD (13)
Gary V. Heller MD ; PhD (14)
James E. Udelson MD (15) - 关键词：Heart failure ; myocardial perfusion imaging ; SPECT ; sestamibi ; gated SPECT
- 刊名：Journal of Nuclear Cardiology
- 出版年：2009
- 出版时间：February 2009
- 年：2009
- 卷：16
- 期：1
- 页码：82-91
- 全文大小：438KB
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20. Uretsky BF, Thygesen K, Armstrong PW, Cleland JG, Horowitz JD, Massie BM, et al. Acute coronary findings at autopsy in heart failure patients with sudden death: Results from the Assessment of Treatment with Lisinopril and Survival (ATLAS) trial. Circulation 2000;102:611-6. - 作者单位：Prem Soman MD, PhD, FRCP (1)
Avijit Lahiri MD (2)
Jennifer H. Mieres MD (3)
Dennis A. Calnon MD (4)
David Wolinsky MD (5)
George A. Beller MD (6)
Tina Sias MD (7)
Kenneth Burnham MD (8)
Laurence Conway MD (9)
Peter A. McCullough MD (10)
Edouard Daher MD (11)
Mary N. Walsh MD (12)
Joseph Wight MD (13)
Gary V. Heller MD, PhD (14)
James E. Udelson MD (15)
1. Nuclear Cardiology, University of Pittsburgh Medical Center, Presbyterian University Hospital, A-429 Scaife Hall, 200 Lothrop Street, Pittsburgh, PA, 15213, USA
2. The Wellington Hospital, London, United Kingdom
3. New York University School of Medicine, New York, NY, USA
4. Mid Ohio Cardiology Research Foundation, Columbus, OH, USA
5. Albany Associates in Cardiology, Albany, NY, USA
6. University of Virginia, Charlottesville, VA, USA
7. Marshall University School of Medicine, Huntington, WV, USA
8. Cardiology Associates of Mobile, Mobile, AL, USA
9. Lawrence Memorial Hospital, Tufts University, Boston, MA, USA
10. William Beaumont Hospital, Royal Oak, MI, USA
11. Wayne State University School of Medicine, Detroit, MI, USA
12. The Care Group, Indianapolis, IN, USA
13. Maine Cardiology Associates, South Portland, ME, USA
14. Hartford Hospital, University of Connecticut, Hartford, CT, USA
15. Tufts Medical Center, Boston, MA, USA
文摘
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.