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- Title
Etiology and pathophysiology of new-onset heart failure: Evaluation by myocardial perfusion imaging.
- Authors
Soman, Prem; Lahiri, Avijit; Mieres, Jennifer H.; Calnon, Dennis A.; Wolinsky, David; Beller, George A.; Sias, Tina; Burnham, Kenneth; Conway, Laurence; McCullough, Peter A.; Daher, Edouard; Walsh, Mary N.; Wight, Joseph; Heller, Gary V.; Udelson, James E.
- Abstract
Objective: The IMAGING in Heart Failure study was a prospective, multi-national trial designed to explore the role of single-photon emission computed tomographic (SPECT) myocardial perfusion imaging (MPI) as an initial investigative strategy in patients hospitalized with new-onset heart failure. Methods: We recruited 201 patients (age 65.3 ± 14.5 years, 43% women) hospitalized with their first episode of heart failure. Rest/stress gated SPECT Tc-99m sestamibi MPI was performed during or within 2 weeks of the index hospitalization, in addition to standard care. Results: SPECT MPI revealed a broad range of ejection fractions with preserved systolic function in 36% of patients. Forty-one percent of patients had normal perfusion. In the remaining patients, perfusion abnormalities were predominantly due to prior myocardial infarction, with extensive ischemia seen only in 6%. Among patients who underwent coronary angiography, SPECT performance characteristics revealed excellent negative predictive value (96%) for extensive coronary artery disease (CAD). In multivariable analyses, the extent of perfusion abnormality and advancing age predicted the presence of extensive CAD. Conclusions: These preliminary data derived from a non-randomized observational cohort suggest potential diagnostic utility of MPI for ischemic LV dysfunction in new-onset HF, and sets the stage for a prospective randomized study to confirm these findings.
- Subjects
HEART failure; HEART diseases; CARDIAC arrest; MYOCARDIAL infarction; CORONARY disease
- Publication
Journal of Nuclear Cardiology, 2009, Vol 16, Issue 1, p82
- ISSN
1071-3581
- Publication type
Article
- DOI
10.1007/s12350-008-9010-8