Potential impact of myocardial perfusion scintigraphy as gatekeeper for invasive examination and treatment in patients with stable angina pectoris: observational study without post-test referral bias

Høilund-Carlsen, Poul Fl.; Johansen, Allan; Christensen, Henrik Wulff; Vach, Werner; Møldrup, Mette; Bartram, Peter; Veje, Annegrete; Haghfelt, Torben

doi:10.1093/eurheartj/ehi503

Cited by 46 publications

(24 citation statements)

References 19 publications

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“…Moreover, the rare occurrence of false negative S-MPI for LMT lesion or 3-vessel disease, with a frequency of around 2% of normal S-MPI, has been reported. 24, 25 Among the 31 patients with normal S-MPI in our study, postischemic stunning was observed in only 1 (3%) patient with 3-vessel disease as identified by CCTA.…”

Section: Discussionmentioning

confidence: 61%

Discordance Between the Morphological and Physiological Information of 64-Slice MSCT Coronary Angiography and Myocardial Perfusion Imaging in Patients With Intermediate to High Probability of Coronary Artery Disease

Kiriyama

Toba

Fukushima

et al. 2011

Circ J

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Section: Discussionmentioning

confidence: 61%

Discordance Between the Morphological and Physiological Information of 64-Slice MSCT Coronary Angiography and Myocardial Perfusion Imaging in Patients With Intermediate to High Probability of Coronary Artery Disease

Kiriyama

Toba

Fukushima

et al. 2011

Circ J

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“…That means that not every patient after myocardial infarction had an evident fi xed perfusion defect on gated-SPECT of myocardium. The above-men-tioned number of patients with a nonviable myocardium is nevertheless larger than for instance the patient group of Hoilund-Carlsen et al (8 % of 168 revascularized patients with a stable angina pectoris) 16 . This fact is in our study caused by a selection of patients with a systolic LV dysfunction with a large number of patients after myocardial infarction.…”

Section: Discussionmentioning

confidence: 70%

Echocardiographic and Cardiac Single Photon Emission Computed Tomography Predictors of Left Ventricle Reverse Remodeling After Surgical Revascularization in Patients With Ischemic Cardiomyopathy and Left Ventricle Systolic Dysfunction

Hutyra¹,

Škála²,

Kamínek³

et al. 2008

BIOMED PAP

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Background:The extent of scar or viable hypocontractile myocardial tissue determines postinfarction left ventricle remodeling. The aim of this pilot study was to evaluate the revascularization eff ect in a group of patients with ischemic cardiomyopathy and LV systolic dysfunction indicated for surgical revascularization, based on evidence for multivessel disease on coronarography and viable myocardium (CMR, SPECT).Aims: To evaluate the revascularization eff ect in patients with ischemic LV systolic dysfunction and to fi nd preoperative predictors of revascularization eff ect.Methods: 33 patients (64±11 years) with baseline LVEF 34.9±9.3 % were included in the study. After a follow-up of 10.7±1.2 months, ECHO and SPECT were performed again. The whole group of patients was divided according to revascularization eff ect (↑LVEF > 5 % and ↓LVESV > 5 % compared with baseline) into revascularization responders (R, n = 22) and nonresponders (NR, n = 11).Results: At baseline there was no diff erence between the subgroups in LVEF (R = 35.7±11.0 % vs. NR = 34.3±8.2 %), EDV (R = 183.6±43.2 vs. NR = 180.2±80.5 ml), ESV (R = 118.5±40.4 vs. NR = 119.7±55.2 ml).The responders showed in a revascularization eff ect subanalysis diff erences in the values of LVEF (+9.8±8.1 %, p < 0.009), reduction of EDV (-39.9±50.9 ml, p = 0.05) and ESV (-35.4±42.6 ml, p = 0,002) compared with baseline.The only preoperative parameters predicting LV reverse remodeling were the T E-Em (R = -10.6±44.1 vs. NR = 29.7±43.7 ms, p = 0.037) and the size of fi xed perfusion defect (FPD) (R = 11.9±13.5 vs. NR = 22.9±15.3 % of LV, p = 0.044).Conclusions: Patients with ischemic LV systolic dysfunction with a preoperatively determined myocardial viability develop LV reverse remodeling. The only preoperative parameters predicting LV reverse remodeling were echocardiographic T E-Em and FPD on SPECT.

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“…Referral patterns may differ too. Thus, in a consecutive series of 972 patients referred for CA for known or stable angina, 40% had normal angiograms (16), ie, approximately twice the rate reported in Canada (38) but lower than the 44% reported a few years earlier in the United States (39).…”

Section: Discussionmentioning

confidence: 88%

High probability of disease in angina pectoris patients: Is clinical estimation reliable?

Høilund-Carlsen¹,

Johansen²,

Vach

et al. 2007

Canadian Journal of Cardiology

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Potential impact of myocardial perfusion scintigraphy as gatekeeper for invasive examination and treatment in patients with stable angina pectoris: observational study without post-test referral bias

Abstract: The use of MPS as gatekeeper appears to make about half of catheterizations and almost one-fifth of revascularizations redundant. Even in high-risk groups, substantial savings are possible, and the risk of overlooking patients with severe disease seems negligible.

Cited by 46 publications

References 19 publications

Discordance Between the Morphological and Physiological Information of 64-Slice MSCT Coronary Angiography and Myocardial Perfusion Imaging in Patients With Intermediate to High Probability of Coronary Artery Disease

Discordance Between the Morphological and Physiological Information of 64-Slice MSCT Coronary Angiography and Myocardial Perfusion Imaging in Patients With Intermediate to High Probability of Coronary Artery Disease

Echocardiographic and Cardiac Single Photon Emission Computed Tomography Predictors of Left Ventricle Reverse Remodeling After Surgical Revascularization in Patients With Ischemic Cardiomyopathy and Left Ventricle Systolic Dysfunction

High probability of disease in angina pectoris patients: Is clinical estimation reliable?

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