1. Prognostic assessment of uncomplicated first myocardial infarction by exercise echocardiography and Tc-99m tetrofosmin gated SPECT
- Author
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Joan Llevadot, Begoña Bermejo, Herminio Garcı́a-del-Castillo, Marina Soler-Peter, Joan Castell, Lluís Armadans, Cesar A. Santana, Jordi Soler-Soler, Jaume Candell-Riera, Guillermo Oller, and Santiago Aguadé
- Subjects
Male ,medicine.medical_specialty ,Gated SPECT ,Myocardial Infarction ,Myocardial Ischemia ,Single-photon emission computed tomography ,Scintigraphy ,Angina ,Organophosphorus Compounds ,Internal medicine ,Odds Ratio ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Myocardial infarction ,Heart Failure ,Tomography, Emission-Computed, Single-Photon ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Electrocardiography in myocardial infarction ,Stroke Volume ,Organotechnetium Compounds ,Middle Aged ,Prognosis ,medicine.disease ,Echocardiography ,Heart failure ,Multivariate Analysis ,Exercise Test ,Cardiology ,Female ,Radiology ,Radiopharmaceuticals ,Cardiology and Cardiovascular Medicine ,business - Abstract
We evaluate the prognostic value of stress echo and gated single photon emission computed tomography (SPECT) after a first uncomplicated acute myocardial infarction. We used predischarge maximal subjective exercise echocardiography and gated SPECT with technetium 99m tetrofosmin to prospectively study 103 patients younger than 70 years with a first acute myocardial infarction. During a 12-month follow-up period, 2 patients died, 9 had heart failure, and 29 had ischemic complications (4 reinfarction and 25 angina). Predictive variables for heart failure in multivariate analysis were ejection fraction evaluated by echocardiography (odds ratio [OR]8.5, P =.016) or by gated SPECT (OR 10.7, P =.009). Predictive variables for ischemic complications in multivariate analysis were less than 5 metabolic equivalents (METS) in exercise test (OR 5.2, P =.007) and greater than 15% ischemic extent in the polar map (OR 3.6, P =.04) of SPECT. Exercise echocardiography and Tc-99m tetrofosmin gated SPECT were predictive for heart failure, but exercise SPECT was the only test with predictive power for ischemic complications.
- Published
- 2001
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