BACKGROUND: Left ventricular hypertrophy (LVH) is associated with an increased risk of cardiac death. Data on the prognostic value of myocardial perfusion imaging (MPI) in patients with LVH are limited. The aim of this study is to assess the independent value of stress technetium 99m tetrofosmin MPI in predicting the long-term mortality rate in patients with LVH. METHODS AND RESULTS: We studied 177 patients (mean age, 59 +/- 12 years; 134 men) with LVH by electrocardiographic criteria who underwent dobutamine or exercise stress Tc-99m tetrofosmin MPI. Endpoints during follow-up were cardiac and all-cause death and hard cardiac events. A normal scan was detected in 42 patients (24%). Myocardial perfusion abnormalities were fixed in 59 patients (33%) and reversible in 76 (43%). Perfusion abnormalities were observed in a single-vessel distribution in 79 patients and in a multivessel distribution in 56. During a mean follow-up period of 5.5 +/- 2 years, 60 patients (34%) died. Death was considered cardiac in 42 patients (24%). Nonfatal myocardial infarction occurred in 10 patients (6%). The annual mortality rate was 1.4% in patients with normal perfusion, 3.2% in those with perfusion abnormalities in a single-vessel distribution, and 8% in those with a multivessel distribution. In a multivariate analysis independent predictors of death were age (risk ratio [RR], 1.05; 95% confidence interval [CI], 1.02-1.07), male gender (RR, 1.9; 95% CI, 1.1-3.6), hypercholesterolemia (RR, 1.7; 95% CI, 1.0-2.9), and abnormal perfusion (RR, 2.7; 95% CI, 1.5-4.8). CONCLUSION: In patients referred for stress MPI, LVH is associated with a high mortality rate, with approximately one third of patients dying over a period of 5 years. Stress Tc-99m tetrofosmin MPI provides independent information for predicting death in these patients.
BACKGROUND:Left ventricular hypertrophy (LVH) is associated with an increased risk of cardiac death. Data on the prognostic value of myocardial perfusion imaging (MPI) in patients with LVH are limited. The aim of this study is to assess the independent value of stress technetium 99m tetrofosmin MPI in predicting the long-term mortality rate in patients with LVH. METHODS AND RESULTS: We studied 177 patients (mean age, 59 +/- 12 years; 134 men) with LVH by electrocardiographic criteria who underwent dobutamine or exercise stress Tc-99mtetrofosmin MPI. Endpoints during follow-up were cardiac and all-cause death and hard cardiac events. A normal scan was detected in 42 patients (24%). Myocardial perfusion abnormalities were fixed in 59 patients (33%) and reversible in 76 (43%). Perfusion abnormalities were observed in a single-vessel distribution in 79 patients and in a multivessel distribution in 56. During a mean follow-up period of 5.5 +/- 2 years, 60 patients (34%) died. Death was considered cardiac in 42 patients (24%). Nonfatal myocardial infarction occurred in 10 patients (6%). The annual mortality rate was 1.4% in patients with normal perfusion, 3.2% in those with perfusion abnormalities in a single-vessel distribution, and 8% in those with a multivessel distribution. In a multivariate analysis independent predictors of death were age (risk ratio [RR], 1.05; 95% confidence interval [CI], 1.02-1.07), male gender (RR, 1.9; 95% CI, 1.1-3.6), hypercholesterolemia (RR, 1.7; 95% CI, 1.0-2.9), and abnormal perfusion (RR, 2.7; 95% CI, 1.5-4.8). CONCLUSION: In patients referred for stress MPI, LVH is associated with a high mortality rate, with approximately one third of patients dying over a period of 5 years. Stress Tc-99mtetrofosmin MPI provides independent information for predicting death in these patients.
Authors: Francis J Klocke; Michael G Baird; Beverly H Lorell; Timothy M Bateman; Joseph V Messer; Daniel S Berman; Patrick T O'Gara; Blase A Carabello; Richard O Russell; Manuel D Cerqueira; Martin G St John Sutton; Anthony N DeMaria; James E Udelson; J Ward Kennedy; Mario S Verani; Kim Allan Williams; Elliott M Antman; Sidney C Smith; Joseph S Alpert; Gabriel Gregoratos; Jeffrey L Anderson; Loren F Hiratzka; David P Faxon; Sharon Ann Hunt; Valentin Fuster; Alice K Jacobs; Raymond J Gibbons; Richard O Russell Journal: J Am Coll Cardiol Date: 2003-10-01 Impact factor: 24.094
Authors: Ralph G Brindis; Pamela S Douglas; Robert C Hendel; Eric D Peterson; Michael J Wolk; Joseph M Allen; Manesh R Patel; Ira E Raskin; Robert C Hendel; Timothy M Bateman; Manuel D Cerqueira; Raymond J Gibbons; Linda D Gillam; John A Gillespie; Robert C Hendel; Ami E Iskandrian; Scott D Jerome; Harlan M Krumholz; Joseph V Messer; John A Spertus; Stephen A Stowers Journal: J Am Coll Cardiol Date: 2005-10-18 Impact factor: 24.094
Authors: Abdou Elhendy; Arend F L Schinkel; Ron T van Domburg; Jeroen J Bax; Roelf Valkema; Don Poldermans Journal: J Nucl Cardiol Date: 2004 Nov-Dec Impact factor: 5.952
Authors: E G DePuey; E Guertler-Krawczynska; J V Perkins; W L Robbins; J D Whelchel; S D Clements Journal: Am J Cardiol Date: 1988-08-01 Impact factor: 2.778
Authors: Abdou Elhendy; Arend F L Schinkel; Ron T van Domburg; Jeroen J Bax; Roelf Valkema; Elena Biagini; Don Poldermans Journal: Eur J Nucl Med Mol Imaging Date: 2006-06-09 Impact factor: 9.236