SPECT-MPI may be useful in new onset HF

SPECT-MPI may be useful in ruling out coronary artery disease in patients with new onset heart failure, according to a non-randomized, observational, cohort study published in the Journal of Nuclear Cardiology.

Click here to read the press release from Lantheus Medical, which makes Cardiolite.

Here is the study abstract:

1: J Nucl Cardiol. 2009 Jan-Feb;16(1):82-91. Epub 2009 Jan 20.

Etiology and pathophysiology of new-onset heart failure: Evaluation by myocardial
perfusion imaging.

Soman P, Lahiri A, Mieres JH, Calnon DA, Wolinsky D, Beller GA, Sias T, Burnham
K, Conway L, McCullough PA, Daher E, Walsh MN, Wight J, Heller GV, Udelson JE.

Nuclear Cardiology, University of Pittsburgh Medical Center, Presbyterian
University Hospital, A-429 Scaife Hall, 200 Lothrop Street, Pittsburgh, PA,
15213, USA, somanp@upmc.edu.

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.

PMID: 19152132 [PubMed - in process]

Related Links

    Evaluation of myocardial perfusion and function by gated SPECT in patients with
Behçet's disease. [Ann Nucl Med. 2008] PMID:18535879

    Detection of occult left ventricular dysfunction in patients without prior
clinical history of myocardial infarction by technetium-99m sestamibi myocardial
perfusion gated single-photon emission computed tomography. [Clin Cardiol. 2002]

    Treadmill ECG test combined with myocardial perfusion imaging for evaluation of
coronary artery disease: analysis of 340 cases. [J Assoc Physicians India. 2003]

    Underestimation of extent of ischemia by gated SPECT myocardial perfusion imaging
in patients with left main coronary artery disease. [J Nucl Cardiol. 2007]

    [Evaluation of hemodynamic significance of arteriovenous coronary fistulas:
diagnostic integration of coronary angiography and stress/rest myocardial
scintigraphy] [Radiol Med. 2000] PMID:11307506

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