Warranty periods for normal myocardial perfusion stress SPECT

Romero-Farina, Guillermo; Candell‐Riera, Jaume; Aguadé-Bruix, Santiago; Ferreira‐González, Ignacio; Cuberas-Borrós, Gemma; Pizzi, M.N.; Garcı́a-Dorado, David

doi:10.1007/s12350-014-9957-6

Cited by 35 publications

(15 citation statements)

References 28 publications

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“…The specificity although modest at 45%, is a reflection of the negative downstream testing that would otherwise not have been performed in the MRPP > 25 group. This could therefore be considered extraneous, as clinical advantage has already been established due to the high sensitivity and warranty periods on EST are not clearly established [14,15].…”

Section: Discussionmentioning

confidence: 99%

Is downstream cardiac testing required in patients with reduced functional capacity and otherwise negative exercise stress test? A single center observational study

et al. 2020

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Background: Exercise stress testing (EST) in patients with poor functional capacity measured by time on treadmill is typically deemed inconclusive and usually leads to further downstream testing. The aim of this study was firstly to evaluate the maximum rate pressure product (MRPP) during initial EST to assessthe need for follow-up testing; and secondly to investigate if MRPP is better than age predicted maximum heart rate (APMHR) for diagnostic outcome based on follow up cardiovascular (CV) events in patients with inconclusive EST due to poor functional capacity. Methods: From a total of 2761 tests performed, 236 tests were considered inconclusive due to poor functional capacity which were available for analysis. From receiver operating characteristic (ROC) analysis, a cutoff value for MRPP of 25000 was chosen using CV events as the outcome measure (sensitivity 97%, specificity 45%). Cases were then categorised into those with an MRPP > 25000 and < 25000. Results: Regardless of treadmill time, any patient attaining an MRPP > 25000 had no abnormal downstream testing or CV events at 2 years follow-up. On ROC analysis MRPP outperformed APMHR for sensitivity and specificity (area under curve 0.76 vs. 0.59, respectively). Conclusions: The results suggest that regardless of functional capacity, individuals whose EST is terminated at maximal fatigue, with no electrocardiogram evidence or symptoms of myocardial ischemia and yields an MRPP > 25000, do not require further downstream testing. Furthermore, this group of patients, while not immune to future CV events, have significantly better outcomes than those not attaining a

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Section: Discussionmentioning

confidence: 99%

Is downstream cardiac testing required in patients with reduced functional capacity and otherwise negative exercise stress test? A single center observational study

et al. 2020

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“…MPS is a robustly validated risk stratification method in different populations, and a normal MPS is associated with ≤1%/year combined mortality and nonfatal infarction rate [24]. It is a noninvasive functional test that depends not only on the presence of epicardial coronary stenosis (macrovascular disease) but also on the endothelial function, including in the small vessels territories (microvascular disease), which may be early affected during disease development and can be modulated by the inflammatory state.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Perfusion in Rheumatoid Arthritis Patients: Associations with Traditional Risk Factors and Novel Biomarkers

Bernardes

Vieira

Martins

et al. 2017

BioMed Research International

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Introduction. Cardiovascular (CV) diseases are a major cause of death in rheumatoid arthritis (RA) patients. Novel biomarkers [B-type natriuretic peptide (BNP); osteoprotegerin (OPG)/receptor activator of nuclear factor-kappa B ligand (RANKL) ratio; and dickkopf-1 (DKK-1)] have been used in CV risk assessment. We analysed, in established RA patients, the presence of silent myocardial ischemia and its association with clinical variables, BNP, and bone and atheroma biomarkers. Methods. From a single-center tertiary referral hospital, RA patients asymptomatic for CV disease were submitted to myocardial perfusion scintigraphy (MPS) under adenosine stress and biomarkers measurements. Logistic regression was used to estimate crude odds ratios (OR) and 95% confidence intervals (CI). Results. In 189 patients, perfusion defects were frequent (25%) and associated with BNP ≥ 100 pg/mL (OR = 5.68; 95% CI: 2.038–15.830), fourth log OPG/RANKL ratio quartile (OR = 2.88; 95% CI: 1.091–7.622), and DKK-1 ≥ 133 pmol/L (OR = 2.69; 95% CI: 1.058–6.840). Similar associations were confirmed in those with C-reactive protein > or ≤ 3 mg/L. No relationship was found with the majority of traditional CV factors nor with disease variables. Conclusions. Our results corroborated the hypothesis that MPS could reveal subclinical CV dysfunction, supported the utility of BNP measurements as a screening tool, and put in perspective the potential usefulness of complementary approaches in CV risk assessment in RA patients.

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“…In this respect, the event rate recorded during follow-up in patients with good functional capacity and absence of myocardial perfusion defects is low. 2 Noninvasive computed tomography (CT) coronary angiography has been introduced more recently. However, as a result of the progressive technical advances made in scanners in recent years, this modality has gained widespread clinical acceptance.…”

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confidence: 99%

Nuclear Cardiology: Role in the World of Multimodality Cardiac Imaging

Rodríguez-Palomares

Aguadé-Bruix

2015

Revista Española de Cardiología (English Edition)

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Warranty periods for normal myocardial perfusion stress SPECT

Abstract: The warranty period for a normal stress-rest SPECT is highly variable since it is primarily determined by the type of stress, the patient's clinical characteristics and LVEF.

Cited by 35 publications

References 28 publications

Is downstream cardiac testing required in patients with reduced functional capacity and otherwise negative exercise stress test? A single center observational study

Is downstream cardiac testing required in patients with reduced functional capacity and otherwise negative exercise stress test? A single center observational study

Myocardial Perfusion in Rheumatoid Arthritis Patients: Associations with Traditional Risk Factors and Novel Biomarkers

Nuclear Cardiology: Role in the World of Multimodality Cardiac Imaging

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