Dipyridamole administration at the end of an insufficient exercise Tc-99m MIBI SPECT improves detection of multivessel coronary artery disease in patients with previous myocardial infarction

Candell‐Riera, Jaume; Santana-Boado, César; Castell‐Conesa, Joan; Aguadé-Bruix, Santiago; Bermejo-Fraile, Begoña; Soler‐Soler, Jordi

doi:10.1016/s0002-9149(99)00806-1

Cited by 15 publications

(8 citation statements)

References 22 publications

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“…Of these patients, 941 (16.6%) were given intravenous dipyridamole during exercise because they failed to attain 80% of maximum heart rate (HR) in the absence of symptoms or ST-segment depression. 20 Exercise duration, peak oxygen consumption estimated on METS, HR at baseline and peak exercise, HR percentage reached over expected, systolic blood pressure at baseline and peak exercise, magnitude of horizontal or downsloping ST-segment depression, and angina were recorded.…”

Section: Exercise Mpgs Protocolmentioning

confidence: 99%

Usefulness of Exercise Test and Myocardial Perfusion–Gated Single Photon Emission Computed Tomography to Improve the Prediction of Major Events

Candell‐Riera

Ferreira‐González

Marsal

et al. 2013

Circ: Cardiovascular Imaging

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Background-The incremental prognostic value of myocardial perfusion-gated single photon emission computed tomography (MPGS) compared with exercise test has not yet been properly evaluated. Methods and Results-Five thousand six hundred seventy-two consecutive patients with known or suspected coronary disease undergoing exercise MPGS between 1997 and 2007 were included. Three-year predictive models for total death and death from cardiovascular causes or acute myocardial infarction (ie, major cardiovascular events [MCE]) were built using Cox-regression modeling, including only the clinical information. Then the exercise and MPGS information was sequentially added. The added discriminative ability of exercise test information and MPGS was assessed by net reclassification improvement and integrated discrimination improvement. The increase in predictive ability of exercise information for death and MCE was high as assessed by net reclassification improvement (0.199 and 0.263) and integrated discrimination improvement (0.042 and 0.021). The only variable of MPGS associated with total death was ejection fraction (hazard ratio, 0.84; 95% confidence interval, 0.79-0.89; P<0.001). Global stress ischemic score emerged as an additional variable associated with MCE (hazard ratio, 1.07; 95% confidence interval, 1.02-1.12; P=0.007). Adding MPGS information barely improved the prognostic value for total death (net reclassification improvement, 0.017; integrated discrimination improvement, 0.013), but it increased for MCE (net reclassification improvement, 0.122; integrated discrimination improvement, 0.033). Conclusions-Adding

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Section: Exercise Mpgs Protocolmentioning

confidence: 99%

Usefulness of Exercise Test and Myocardial Perfusion–Gated Single Photon Emission Computed Tomography to Improve the Prediction of Major Events

Candell‐Riera

Ferreira‐González

Marsal

et al. 2013

Circ: Cardiovascular Imaging

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“…Of these 128 patients, 4 (7%) were given intravenous dipyridamole during exercise because they failed to attain 80% of maximum heart rate in the absence of symptoms or ST segment depression. 9 Nine of 137 patients (6.6%) underwent only dipyridamole study. The starting load was 50 W, and load was increased by 25 W every 3 minutes until exhaustion, appearance of symptoms, horizontal or downsloping ST segment depression [2 mm, appearance of ventricular or supraventricular arrythmias, and/or failure of systemic blood pressure to rise.…”

Section: Myocardial Perfusion-gated Spectmentioning

confidence: 99%

Prognostic value of myocardial perfusion-gated SPECT in patients with ischemic cardiomyopathy

Candell‐Riera

Romero-Farina

Aguadé-Bruix

et al. 2009

Journal of Nuclear Cardiology

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“…Single photon emission computed tomography (SPECT) with Tc99m sestamibi can increase both the sensitivity and specificity to 90% and 93%, respectively (6). It is a well-known phenomenon that the sensitivity of a nuclear stress test is limited by motion artifact, diaphragmatic attenuation, and "balanced" 3-vessel disease or left main disease (7,8). This is due to the inability of a SPECT scan to detect subendocardial blood flow (10).…”

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confidence: 99%

“…This is due to the inability of a SPECT scan to detect subendocardial blood flow (10). The overall sensitivity of a standard Tc-99 MIBI SPECT is approximately 60 -70% in patients with multivessel disease (7,9). Additional modalities added to the standard SPECT study, such as echocardiogram or adding pharmacologic agents like dipyridamole, can increase the sensitivity to 82% and 76%, respectively (7,9).…”

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confidence: 99%

Chest pain

Osborne

Brown

Nadel³

2004

The Journal of Emergency Medicine

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Dipyridamole administration at the end of an insufficient exercise Tc-99m MIBI SPECT improves detection of multivessel coronary artery disease in patients with previous myocardial infarction

Cited by 15 publications

References 22 publications

Usefulness of Exercise Test and Myocardial Perfusion–Gated Single Photon Emission Computed Tomography to Improve the Prediction of Major Events

Usefulness of Exercise Test and Myocardial Perfusion–Gated Single Photon Emission Computed Tomography to Improve the Prediction of Major Events

Prognostic value of myocardial perfusion-gated SPECT in patients with ischemic cardiomyopathy

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