Yield and diagnostic value of stress myocardial perfusion imaging in patients without known coronary artery disease presenting with syncope.
نویسندگان
چکیده
BACKGROUND American College of Cardiology/American Heart Association appropriate use criteria recommend performing stress myocardial perfusion imaging (MPI) for intermediate- to high-risk patients presenting with syncope but not for low-risk patients. However, there are limited data to support these recommendations. We investigated the yield of stress MPI for the evaluation of syncope in patients at risk but without known coronary artery disease. METHODS AND RESULTS Using the Cleveland Clinic Institutional Review Board-approved MPI database, we identified consecutive patients without known coronary artery disease who underwent stress MPI between 2006 and 2012 for diagnostic workup of syncope. Patients were stratified into low-, intermediate-, and high-risk groups using the Framingham risk score. For patients with abnormal MPI, left heart catheterization were reviewed if performed. There were 700 patients (mean age, 62±15 years; 55% female) who had undergone stress MPI for syncope; 659 patients (94%) had normal perfusion. Of the 41 patients with abnormal MPI, 18 had left heart catheterization (9 were false-positive); there were 23 remaining patients with abnormal MPI (16 having moderate to severe perfusion defect size) but who did not have a left-side angiogram and could have undiagnosed significant coronary artery disease. The diagnostic yield of stress MPI was similarly low among all cardiovascular risk categories. CONCLUSIONS Stress MPI for evaluation of syncope in patients without known coronary artery disease has a low-diagnostic yield among all risk categories; thus, reaffirmation and revision of the appropriateness criteria should be considered.
منابع مشابه
Yield and Diagnostic Value of Stress Myocardial Perfusion Imaging in Patients Without Known Coronary Artery Disease Presenting with Syncope AlJaroudi et al: Role of Stress MPI in Syncope
Background—ACC/AHA Appropriate Use Criteria recommend performing stress MPI for intermediate to high-risk patients presenting with syncope, but not for low-risk patients. However, there are limited data to support these recommendations. We investigated the yield of stress MPI for the evaluation of syncope in patients at risk but without known CAD Methods and Results—From the Cleveland Clinic IR...
متن کاملComparison of dipyridamole – induced electrocardiographic changes and myocardial perfusion imaging in diagnosis of coronary artery disease [Persian]
Introduction: This study evaluated the diagnostic value of the dipyridamole induced electrocardiuogram (ECG) cahnges, comparing with myocardial perfusion imaging. Materials and Methods: 222 patinets were studied with dipyridamole infusion (based on ECG criteria) as well as Dipyridamole-myocardial perfusion imaging (MPI). Results: Abnormal dipyridamole test and abnormal MPI were noted in 1...
متن کاملDiagnostic Accuracy of Gated-SPECT Myocardial Perfusion Imaging and Exercise Stress Test for Diagnosis of Coronary Artery Disease
Background and Objective:Accurate diagnosis of CAD using noninvasive procedures is of great importance. The aim of the study is to assess diagnostic accuracy of myocardial perfusion imaging and compare it with exercise stress test in order to decipher a more accurate and cost-effective method for CAD detection. Materials and Methods:Of 430 consecutive patients suspected with CAD, 104 performed...
متن کاملMyocardial perfusion scan accuracy in detection of coronary artery disease - Comparison with exercise stress test [Persian]
Introduction: In patients with coronary artery disease (CAD) noninvasive evaluation for detection of ischemia is important to avoid invasive interventions like angiography. Exercise stress test is conventionally the first study used in evaluation of CAD. Considering the noninvasive nature of the myocardial perfusion scan, we decided to compare its accuracy with stress test. Methods: Patie...
متن کاملThe prognostic value of stress/rest gated myocardial perfusion SPECT in patients with known or suspected coronary artery disease
Introduction:Gated myocardial perfusion SPECT has diagnostic and prognostic values in coronary artery disease (CAD). We tried to determine prognostic values of the left ventricular perfusion & functional indices as well as transient left ventricular dilation (TID) derived from gated myocardial perfusion SPECT. Methods: 1820patients who underwent gated myo...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Circulation. Cardiovascular imaging
دوره 6 3 شماره
صفحات -
تاریخ انتشار 2013