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
Artigo
em Espanhol
| 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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Doença da Artéria Coronariana
/
Tomografia Computadorizada de Emissão de Fóton Único
/
Tolerância ao Exercício
/
Teste de Esforço
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2015
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Universidad de Chile/CL
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