Donghee Han1, Alan Rozanski2, Robert J H Miller3, Tali Sharir4,5, Andrew J Einstein6, Mathews B Fish7, Terrence D Ruddy8, Philipp A Kaufmann9, Albert J Sinusas10, Edward J Miller10, Timothy M Bateman11, Sharmila Dorbala12, Marcelo Di Carli12, Joanna X Liang1, Damini Dey1, Daniel S Berman1, Piotr J Slomka1. 1. Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA. 2. Department of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, 1111 Amsterdam Avenue, New York, NY, 10025, USA. alanrozanski@mountsinai.org. 3. Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada. 4. Department of Nuclear Cardiology, Assuta Medical Centers, Tel Aviv, Israel. 5. Ben Gurion University of the Negev, Beer Sheba, Israel. 6. Division of Cardiology, Departments of Medicine and Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA. 7. Oregon Heart and Vascular Institute, Sacred Heart Medical Center, Springfield, OR, USA. 8. Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada. 9. Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland. 10. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. 11. Cardiovascular Imaging Technologies LLC, Kansas, MO, USA. 12. Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, Boston, MA, USA.
Abstract
BACKGROUND: The utility of cardiac stress testing depends on the prevalence of myocardial ischemia within candidate populations. However, a comprehensive assessment of the factors influencing frequency of myocardial ischemia within contemporary populations referred for stress testing has not been performed. METHODS: We assessed 19,690 patients undergoing nuclear stress testing from a multicenter registry. The chi-square test was used to assess the relative importance of features for predicting myocardial ischemia. RESULTS: In the overall cohort, LVEF, male gender, and rest total perfusion deficit (TPD) were the top three predictors of ischemia, followed by CAD status, age, typical angina, and CAD risk factors. Myocardial ischemia was observed in 13.6 % of patients with LVEF > 55 %, in 26.2 % of patients with LVEF 45 %-54 %, and in 48.3% among patients with LVEF < 45 % (P < 0.001). A similar pattern was noted for rest TPD (P < 0.001). Men had a threefold higher frequency of ischemia versus women (25.8 % vs. 8.4%, P < 0.001). Although the relative ranking of ischemia predictors varied among centers, LVEF and/or rest TPD were among the two most potent predictors of myocardial ischemia within each center. CONCLUSION: The prevalence of myocardial ischemia varied markedly according to clinical and imaging characteristics. LVEF and rest TPD are robust predictors of myocardial ischemia.
BACKGROUND: The utility of cardiac stress testing depends on the prevalence of myocardial ischemia within candidate populations. However, a comprehensive assessment of the factors influencing frequency of myocardial ischemia within contemporary populations referred for stress testing has not been performed. METHODS: We assessed 19,690 patients undergoing nuclear stress testing from a multicenter registry. The chi-square test was used to assess the relative importance of features for predicting myocardial ischemia. RESULTS: In the overall cohort, LVEF, male gender, and rest total perfusion deficit (TPD) were the top three predictors of ischemia, followed by CAD status, age, typical angina, and CAD risk factors. Myocardial ischemia was observed in 13.6 % of patients with LVEF > 55 %, in 26.2 % of patients with LVEF 45 %-54 %, and in 48.3% among patients with LVEF < 45 % (P < 0.001). A similar pattern was noted for rest TPD (P < 0.001). Men had a threefold higher frequency of ischemia versus women (25.8 % vs. 8.4%, P < 0.001). Although the relative ranking of ischemia predictors varied among centers, LVEF and/or rest TPD were among the two most potent predictors of myocardial ischemia within each center. CONCLUSION: The prevalence of myocardial ischemia varied markedly according to clinical and imaging characteristics. LVEF and rest TPD are robust predictors of myocardial ischemia.
Authors: W Lane Duvall; Mridula Rai; Alan W Ahlberg; David M O'Sullivan; Milena J Henzlova Journal: J Nucl Cardiol Date: 2015-02-05 Impact factor: 5.952
Authors: Thomas H Schindler; Timothy M Bateman; Daniel S Berman; Panithaya Chareonthaitawee; Lorraine E De Blanche; Vasken Dilsizian; Sharmila Dorbala; Robert J Gropler; Leslee Shaw; Prem Soman; David E Winchester; Hein Verberne; Sukhjeet Ahuja; Rob S Beanlands; Marcelo F Di Carli; Venkatesh L Murthy; Terrence D Ruddy; Ronald G Schwartz Journal: J Nucl Med Date: 2020-08 Impact factor: 10.057
Authors: Alan Rozanski; Heidi Gransar; Nathan D Wong; Leslee J Shaw; Romalisa Miranda-Peats; Sean W Hayes; John D Friedman; Daniel S Berman Journal: J Nucl Cardiol Date: 2007 Sep-Oct Impact factor: 5.952
Authors: Alan Rozanski; Heidi Gransar; Sean W Hayes; James Min; John D Friedman; Louise E J Thomson; Daniel S Berman Journal: J Am Coll Cardiol Date: 2013-03-12 Impact factor: 24.094
Authors: Su Min Chang; Faisal Nabi; Jiaqiong Xu; Leif E Peterson; Arup Achari; Craig M Pratt; John J Mahmarian Journal: J Am Coll Cardiol Date: 2009-11-10 Impact factor: 24.094
Authors: David J Maron; Judith S Hochman; Harmony R Reynolds; Sripal Bangalore; Sean M O'Brien; William E Boden; Bernard R Chaitman; Roxy Senior; Jose López-Sendón; Karen P Alexander; Renato D Lopes; Leslee J Shaw; Jeffrey S Berger; Jonathan D Newman; Mandeep S Sidhu; Shaun G Goodman; Witold Ruzyllo; Gilbert Gosselin; Aldo P Maggioni; Harvey D White; Balram Bhargava; James K Min; G B John Mancini; Daniel S Berman; Michael H Picard; Raymond Y Kwong; Ziad A Ali; Daniel B Mark; John A Spertus; Mangalath N Krishnan; Ahmed Elghamaz; Nagaraja Moorthy; Whady A Hueb; Marcin Demkow; Kreton Mavromatis; Olga Bockeria; Jesus Peteiro; Todd D Miller; Hanna Szwed; Rolf Doerr; Matyas Keltai; Joseph B Selvanayagam; P Gabriel Steg; Claes Held; Shun Kohsaka; Stavroula Mavromichalis; Ruth Kirby; Neal O Jeffries; Frank E Harrell; Frank W Rockhold; Samuel Broderick; T Bruce Ferguson; David O Williams; Robert A Harrington; Gregg W Stone; Yves Rosenberg Journal: N Engl J Med Date: 2020-03-30 Impact factor: 91.245