Seguimiento clínico en pacientes con buena capacidad metabólica en la prueba de esfuerzo con SPECT miocárdico / Follow-up of patients with good exercise capacity in stress test with myocardial single-photon emission computed tomography (SPECT)
Rev. méd. Chile
;
143(11): 1426-1434, nov. 2015. ilus, graf, tab
Article
Dans Espagnol
| LILACS
| ID: lil-771732
ABSTRACT
Background:
The evaluation of coronary artery disease (CAD) can be performed with stress test and myocardial SPECT tomography.Aim:
To assess the predictive value of myocardial SPECT using stress test for cardiovascular events in patients with good exercise capacity. Material andMethods:
We included 102 males aged 56 ± 10 years and 19 females aged 52 ± 10 years, all able to achieve 10 METs and ≥ 85% of the theoretical maximum heart rate and at least 8 min in their stress test with gated 99mTc-sestamibi SPECT. Eighty two percent of patients were followed clinically for 33 ± 17 months.Results:
Sixty seven percent of patients were studied for CAD screening and the rest for known disease assessment. Treadmill stress test was negative in 75.4%; 37% of patients with moderate to severe Duke Score presented ischemia. Normal myocardial perfusion SPECT was observed in 70.2%. Reversible defects appeared in 24.8% of cases, which were of moderate or severe degree (> 10% left ventricular extension) in 56.6%. Only seven cases had coronary events after the SPECT. Two major (myocardial infarction and emergency coronary revascularization) and 5 minor events (elective revascularization) ere observed in the follow-up. In a multivariate analysis, SPECT ischemia was the only statistically significant parameter that increased the probability of having a major or minor event.Conclusions:
Nearly a quarter of our patients with good exercise capacity demonstrated reversible defects in their myocardial perfusion SPECT. In the intermediate-term follow-up, a low rate of cardiac events was observed, being the isotopic ischemia the only significant predictive parameter.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Maladie des artères coronaires
/
Tomographie par émission monophotonique
/
Tolérance à l'effort
/
Épreuve d'effort
Type d'étude:
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Adulte
/
Adulte très âgé
/
Femelle
/
Humains
/
Mâle
langue:
Espagnol
Texte intégral:
Rev. méd. Chile
Thème du journal:
Médicament
Année:
2015
Type:
Article
Pays d'affiliation:
Chili
Institution/Pays d'affiliation:
Universidad de Chile/CL
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