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Mortality risk associated with ejection fraction differs across resting nuclear perfusion findings.
- Source :
-
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2007 Apr; Vol. 14 (2), pp. 165-73. - Publication Year :
- 2007
-
Abstract
- Background: Left ventricular ejection fraction (LVEF) is a significant predictor of morbidity and death. The nuclear summed rest score (SRS) measures myocardial perfusion defects and provides prognostic information, but its effects on long-term outcomes are not fully established. Moreover, information regarding the potential interaction between these 2 covariates is limited. The purpose of this study was to determine whether the mortality risk associated with LVEF is the same across all values of SRS in a population undergoing evaluation for ischemic heart disease.<br />Methods and Results: We examined 3,187 patients who underwent cardiac catheterization and perfusion single photon emission computed tomography imaging with a maximum follow-up of 8.1 years and median follow-up of 3.1 years. Cox proportional hazards modeling showed that increasing nuclear SRS and decreasing LVEF were independently associated with a higher long-term mortality rate, with a clinically significant interaction between them (P = .032). Patients with a normal LVEF and a high SRS (greater perfusion abnormality) have a prognosis similar to those with a reduced LVEF.<br />Conclusions: Resting perfusion studies provide prognostic information for long-term survival and significantly impact the interpretation of mortality risk associated with changes in LVEF. Patient prognostication, risk stratification, and future research using these variables should take this interaction into account.
- Subjects :
- Aged
Cohort Studies
Comorbidity
Female
Humans
Male
Middle Aged
North Carolina epidemiology
Perfusion methods
Radionuclide Imaging
Risk Assessment methods
Risk Factors
Statistics as Topic
Survival Analysis
Survival Rate
Coronary Artery Disease diagnostic imaging
Coronary Artery Disease mortality
Myocardial Ischemia diagnostic imaging
Myocardial Ischemia mortality
Stroke Volume
Ventricular Dysfunction, Left diagnostic imaging
Ventricular Dysfunction, Left mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1532-6551
- Volume :
- 14
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 17386378
- Full Text :
- https://doi.org/10.1016/j.nuclcard.2006.11.011