Influence of Race on the Prediction of Cardiac Events With Stress Technetium-99M Sestamibi Tomographic Imaging in Patients With Stable Angina Pectoris

Alkeylani, Abdul; Miller, D. Douglas; Shaw, Leslee J.; Travin, Mark I.; Stratmann, Henry G.; Jenkins, Rhonda; Heller, Gary V.

doi:10.1016/s0002-9149(97)00896-5

Cited by 28 publications

(12 citation statements)

References 17 publications

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“…Synthesizing this evidence suggests that physiologic abnormalities may play a greater role in risk assessment than does obstructive disease burden for ethnic minority patients. Prior evidence on racial differences in cardiac stress testing is limited to very small series of patients (1,2). The majority of prognostic data are largely based on Caucasian non-Hispanic populations.…”

Section: Discussionmentioning

confidence: 99%

“…Despite an ever-increasingly ethnically diverse U.S. population, our current understanding of the predictive accuracy of cardiac testing in African-American and other ethnic minority populations is limited (1,2). Current epidemiologic data are greatest for African Americans and notable for having a higher mortality associated with coronary artery disease (3,4).…”

mentioning

confidence: 99%

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Ethnic Differences in the Prognostic Value of Stress Technetium-99m Tetrofosmin Gated Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging

Shaw

Hendel²,

Cerquiera

et al. 2005

Journal of the American College of Cardiology

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The current results from a large observational registry reveal that exercise and pharmacologic stress SPECT effectively predicts major cardiovascular events in a large cohort of African-American and Hispanic patients evaluated for suspected myocardial ischemia. These results provide further evidence that ethnic minority patient populations have a worsening outcome related to cardiovascular disease.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Ethnic Differences in the Prognostic Value of Stress Technetium-99m Tetrofosmin Gated Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging

Shaw

Hendel²,

Cerquiera

et al. 2005

Journal of the American College of Cardiology

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“…Even in our patients without congestive heart failure, diabetes mellitus, and coronary artery disease, however, the HRV measures were significantly lower than those of the controls; therefore, the reduction cannot be ascribed to these disorders. On the other hand, our patient population included patients with hypertension which may be associated with cardiac autonomic nervous system abnormalities [27, 28]. The reduction of HRV in our CRF patients, however, cannot be ascribed to hypertension, since the HRV measures were similar between those with and those without hypertension.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Autonomic Neuropathy in Patients with Chronic Renal Failure on Hemodialysis

Kurata¹,

Uehara²,

Sugi³

et al. 2000

Nephron

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To characterize uremic cardiac autonomic neuropathy, we measured plasma catecholamines, analyzed the 24-hour heart rate variability (HRV), and acquired serial images with ¹²³I-metaiodobenzylguanidine (MIBG) in 44 patients with chronic renal failure on hemodialysis and in 14 controls. Time-domain measures were calculated using the Marquette HRV program. MIBG clearance rates from the heart and lung were evaluated on planar images, and the regional MIBG uptake in the left ventricular myocardium was evaluated with single-photon emission computed tomography. Compared with controls, plasma dopamine and norepinephrine levels were elevated (p < 0.001 and p = 0.03, respectively), and all the time-domain measures of HRV were reduced in the patients (p < 0.001). The MIBG clearance rate from the heart was higher (p < 0.001), that from the lung was lower (p < 0.001), and the myocardial MIBG distribution was more heterogeneous in patients than in controls (total uptake score p ≤ 0.03). These variables were similar between 26 patients without and 18 patients with hypertension. Uremic cardiac autonomic neuropathy may be characterized by high plasma levels of dopamine and norepinephrine, reduced HRV, and abnormal MIBG kinetics in the heart with heterogeneous myocardial MIBG distribution, suggesting cardiac sympathetic overactivity and parasympathetic deterioration. In addition, abnormal MIBG kinetics in the lung may imply pulmonary sympathetic nervous dysfunction and/or endothelial dysfunction in uremic patients.

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“…Normal rest and stress SPECT perfusion studies have been associated with higher rates of AMI and/or cardiac death in African Americans than in other populations, 19,20 but included higher than usual cardiac risk patients and did not account for the incidence of LV hypertrophy (LVH). 21 …”

Section: African Americansmentioning

confidence: 99%

ACC/AHA/ASNC Guidelines for the Clinical Use of Cardiac Radionuclide Imaging—Executive Summary

Klocke¹,

Baird²,

Lorell³

et al. 2003

Circulation

612

227

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Influence of Race on the Prediction of Cardiac Events With Stress Technetium-99M Sestamibi Tomographic Imaging in Patients With Stable Angina Pectoris

Cited by 28 publications

References 17 publications

Ethnic Differences in the Prognostic Value of Stress Technetium-99m Tetrofosmin Gated Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging

Ethnic Differences in the Prognostic Value of Stress Technetium-99m Tetrofosmin Gated Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging

Cardiac Autonomic Neuropathy in Patients with Chronic Renal Failure on Hemodialysis

ACC/AHA/ASNC Guidelines for the Clinical Use of Cardiac Radionuclide Imaging—Executive Summary

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