Nuclear Medicine and Molecular Imaging

The Korean Society of Nuclear Medicine (대한핵의학회)
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Assessment of Prognosis and Risk Stratification in Coronary Artery Disease

관상동맥질환의 예후 및 위험도 평가

  • Lim, Seok-Tae (Department of Nuclear Medicine, Research Institute of Clinical Medicine, and Cyclotron Research Center, Chonbuk National University Medical School and Hospital)
  • 임석태 (전북대학교 의학전문대학원 핵의학교실, 임상의학연구소, 사이클로트론연구소)
  • Published : 2009.06.30
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Abstract

Risk stratification and assessment of prognosis in patients with known or suspected CAD is of crucial important for the practice of contemporary medicine. Noninvasive testing such as myocardial perfusion scintigraphy, coronary artery calcium scoring or CT coronary angiography is increasingly being used to determine the need for aggressive medical therapy and to select patients for catheterization. The integrated anatomic and functional information may provide more additional information for the cardiologist or other clinician by the improved risk stratification and diagnostic accuracy of integrated techniques. The development of SPECT/CT or PET/CT hybrid systems is therefore of important value for the nuclear cardiology.

Keywords

References

  1. Gimelli A, Rossi G, Landi P, Marzullo P, Iervasi G, L'abbate A, et al. Stress/rest myocardial perfusion abnormalities by gated SPECT: still the best predictor of cardiac events in stable ischemic heart disease. J Nul Med 2009;50:546-53 https://doi.org/10.2967/jnumed.108.055954
  2. Ueda T, Toyama T, Seki R, Hoshizaki H, Oshima S, Taniquchi K, et al. Prediction of functional outcome in stunned myocardium after myocardial infarction using BMIPP and tetrofosmin imaging. J Int Med Res 2009;37:367-77 https://doi.org/10.1177/147323000903700211
  3. Shaw LJ, Hendel RC, Heller GV, Borqes-Neto S, Cerqueira M, Berman DS. Prognostic estimation of coronary artery disease risk with resting perfusion abnormalities and stress ischemia on myocardial perfusion SPECT. J Nucl Cardiol 2008;15:762-73 https://doi.org/10.1016/j.nuclcard.2008.07.005
  4. van Werkhoven JM, Schuijf JD, Gaemperli O, Jukema JW, Boersma E, Wijns W, et al. Prognostic value of multislice computed tomography and gated single-photon emission computed tomography in patients with suspected coronary artery disease. J Am Coll Cardiol 2009;53:623-32 https://doi.org/10.1016/j.jacc.2008.10.043
  5. Lin F, Shaw LJ, Berman DS, Callister TO, Weisaft JW, Wong FJ, et al. Multidetector computed tomography coronary artery plaque predictors of stress-induced myocardial ischemia by SPECT. Atherosclerosis 2008;197:700-9 https://doi.org/10.1016/j.atherosclerosis.2007.07.002
  6. Berman DS, Hachamovitch R, Shaw LJ, Friedman JD, Hayes SW, Thomson LET, et al. Roles of nuclear cardiology, cardiac computed tomography, and cardiac magnetic resonance: noninvasive risk stratification and a conceptual framework for the selection of noninvasive imaging tests in patients with known or suspected coronary artery disease. J Nucl Med 2006;47:1107-118
  7. Menon M, Lesser JR, Hara H, Birkett R, Knickelbine T, Longe T, et al. Multidetector CT coronary angiography for patient triage to invasive coronary angiography: performance and cost in ambulatory patients with equivocal or suspected inaccurate noninvasive stress tests. Catheter Cardiovasc Interv 2009;73:497-502 https://doi.org/10.1002/ccd.21816
  8. Doukky R, Hendel RC. Practical guide to risk stratification using myocardial perfusion imaging. In: Heller GV, Hendel RC. Nuclear cardiology: practical applications. Neu York : Mc Graw Hill; 2004. p. 259-74
  9. Sabharwal NK, Stoykova B, Taneja AK, Lahiri A. A radomized trial of exercise treadmill ECG versus stress SPECT myocardial perfusion imaging as an initial diagnostic strategy in stable patients with chest pain and suspected CAD: cost analysis. J Nucl Cardiol 2007;14:174-86 https://doi.org/10.1016/j.nuclcard.2006.12.324
  10. Hachamovitch R, Berman DS, Kiat H, Cohen I, Cabico JA, Friedman J, et al. Exercise myocardial perfusion SPECT in patients without known coronary artery disease: incremental prognostic value and use in risk stratification. Circulation 1996;93:905-14 https://doi.org/10.1161/01.CIR.93.5.905
  11. Rajagopalan N, Miller TD, Hodge DO, Frye RL, Gibbons RJ. Identifying high-risk asymptomatic diabetic patients who are candidates for screeing stress single-photon emission computed tomography imaging. J Am Coll Cardiol 2005;45:43-9 https://doi.org/10.1016/j.jacc.2004.06.078
  12. Ahlberq AW, Baqhdasarian SB, Athar H, Thompsen JP, Katten DM, Noble GL, et al. Symptom-limited exercise combined with dipyridamole stress: prognostic value in assessment of known or suspected coronary artery disease by use of gated SPECT imaging. J Nucl Cardiol 2008;15:42-56 https://doi.org/10.1016/j.nuclcard.2007.09.025
  13. Leoncini M, Sciagra R. Role of perfusion myocardial scintigraphy with gated SPECT technique in the diagnostic and prognostic evaluation of patients with chronic coronary disease. Ital Heart Suppl 2002;3:309-18
  14. Kayano D, Nakajima K, Ohtake H, Kinuya S. Gayed myocardial perfusion SPECT for preoperative risk stratification in patients with noncardiac vascular disease. Ann Nucl Med 2009;23:173-81 https://doi.org/10.1007/s12149-008-0228-y
  15. Berman DS, Germano G. The clinical value of assessing left ventricular function from gated SPECT perfusion studies. Rev Port Cardiol 2000;19:131-7
  16. Nakajima K, Kusuoka H, Nishimura S, Yamashima A, Nishimura T. Prognostic value of myocardial perfusion and ventricular function in a Japanese multicenter cohort study (J-ACCESS): the first-year total events and hard events. Ann Nucl Med 2009;23:373-81 https://doi.org/10.1007/s12149-009-0248-2
  17. Metz LD, Beattie M, Hom R, Redberg RF, Grady D, Fleischmann KE. The prognostic value of normal exercise myocardial perfusion imaging and exercise echocardiography: a meta-analysis. J Am Coll Cardiol 2007;49:227-37 https://doi.org/10.1016/j.jacc.2006.08.048
  18. Elhendy A, Schinkel AF, van Domburg RT, Bax JJ, Valkema R, Huurman A, et al. Risk stratification of patients with angina pectoris by stress Tc-99m tetrofosmin myocardial perfusion imaging. J Nucl Med 2005;46:2003-8
  19. Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. A prognostic score for prediction of cardiac mortality risk after adenosine stress myocardial perfusion scintigraphy. J Am Coll Cardiol 2005;45:722-9 https://doi.org/10.1016/j.jacc.2004.08.069
  20. Travin MI, Heller GV, Johnson LL, Katten D, Ahlberg A W, Isasi CR, et al. The prognostic value of ECG-gated SPECT imaging in patients undergoing stress Tc-99m sestamibi myocardial perfusion imaging. J Nucl Cardiol 2004;11:253-62 https://doi.org/10.1016/j.nuclcard.2004.02.005
  21. Bennan DS, Shaw LJ, Hachamovitch R, Friedman JD, Polk DM, Hayes SW, et al. Comparative use of radionuclide stress testing, coronary artery calcium scanning, and noninvasive coronary angiography for diagnostic and prognostic cardiac assessment. Semin Nucl Med 2007;37:2-16 https://doi.org/10.1053/j.semnuclmed.2006.08.002
  22. Hachamovitch RHS, Friedman JD, Cohen I, et al. Is there a referral bias against revascularization of patients with reduced LV ejection fraction? influence of ejection fraction and inducible ischemia on post-SPECT management of patients without history of CAD. J Am Coll Cardiol 2003;42:1286-94 https://doi.org/10.1016/S0735-1097(03)00991-4
  23. Sharir T, Germano G, Kang X, Lewin HC, Miranda R, Cohen L, et al. Prediction of myocardial infarction versus cardiac death by gated myocardial perfusion SPECT: risk stratification by the amount of stress-induced ischemia and the poststress ejection fraction. J Nucl Med 2001;42:831-7
  24. Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. Stress myocardial perfusion single-photon emission computed tomography is clinically effective and cost effective in risk stratification of patients with a high likelihood of coronary artery disease (CAD) but no known CAD. J Am Coll Cardiol 2004;43:200-8 https://doi.org/10.1016/j.jacc.2003.07.043
  25. Brown KA, Heller GV, Landin RS, Shaw LJ, Beller GA, Pasquale MJ, et al. Early dipyridamole Tc-99m sestamibi single photon emission computed tomographic imaging 2 to 4 days after acute myocardial infarction predicts in -hospital and postdischarge cardiac events: comparison with submaximal exercise imaging. Circulation 1999;100:2060-6 https://doi.org/10.1161/01.CIR.100.20.2060
  26. Brown KA. Prognostic value of thallium-201 myocardial perfusion imaging in patients with unstable angina who respond to medical treatment. J Am Coll Cardiol 1991;17:1053-7 https://doi.org/10.1016/0735-1097(91)90829-X
  27. Lim ST, Lee DS, Kang WJ, Chung JK, Lee Me. The usefulness of myocardial SPECT for the preoperative cardiac risk evaluation in noncardiac surgery. Korean J Nucl Med 1999;33:273-81
  28. Freeman WK, Gibbons RJ. Periopeative cardiovascular assessment of patients undergoing noncardiac surgery. Mayo Clin Proc 2009;84:79-90 https://doi.org/10.4065/84.1.79
  29. Almanaseer Y, Mukherjee D, Kline-Rogers EM, Kesterson SK, Sonnad SS, Roqers B, et al. Implementation of the ACC/AHA guidelines for preoperative cardiac risk assessment in a general medicine preoperative clinic: improving efficiency and preserving outcomes. Cardiology 2005;103:24-9 https://doi.org/10.1159/000081848
  30. Mukherjee D, Eagle KA. Perioperative cardiac assessment for noncardiac surgery: eight steps to the best possible outcome. Circulation 2003;107:2771-4 https://doi.org/10.1161/01.CIR.0000072248.24921.D6
  31. Coley CM, Field TS, Abraham SA, Boucher CA, Eagle KA. Usefulness of diprydamole-thallium scanning for preoperative evaluation of cardiac risk for noninvasive surgery. Am J Cardiol 1992;69:1280-5 https://doi.org/10.1016/0002-9149(92)91221-O
  32. Harafuji K, Chikamori T, Kawaguchi S, Obitsu Y, Ito S, Igarashi Y, et al. Value of pharmacologic stress myocardial perfusion imaging for preoperative risk stratification for aortic surgery. Circ J 2005;69:558-63 https://doi.org/10.1253/circj.69.558
  33. Chen T, Kuwabara Y, Tsutsui H, Sasaki M, Nakagawa M, Koga H, et al. The usefulness of dipyridamole thallium-201 single photon emission computed tomography for predicting perioperative cardiac events in patients undergoing non-cardiac vascular surgery. Ann Nucl Med 2002;16:207-11 https://doi.org/10.1007/BF02996302
  34. Hashimoto J, Suzuki T, Nakahara T, Kosuda S, Kubo A. Preoperative risk stratification using stress myocardial perfusion scintigraphy with electrocardiographic gating. J Nucl Med 2003;44:385-90
  35. Rahmani N, Jeudy J, White CS. Triple rule-out and dedicated coronary artery CTA: comparison of coronary artery image quality. Acad Radiol 2009;3:100-3
  36. Hoffman U, Bamberg F, Chae CU, Nichols JH, Rogers IS, Seneviratne SK, et al. Coronary computed tomography angiography for early triage of patients with acute chest pain: the ROMICAT (Rule Out Myocardial Infacrtion using Computed Assisted Tomography) trial. J Am Coll Cardiol 2009;53:1642-50 https://doi.org/10.1016/j.jacc.2009.01.052
  37. Naghavi M, Falk E, Hecht HS, Shah PK. The first SHAPE (Screening for Heart Attack Prevention and Education) guideline. Crit Pathow Cardiol 2006;5:187-90 https://doi.org/10.1097/01.hpc.0000249784.29151.54
  38. Kaufmann PA. Cardiac hybrid imaging: state-of-the-art. Ann Nucl Med 2009;23:325-31 https://doi.org/10.1007/s12149-009-0245-5
  39. Rispler S, Keidar Z, Ghersin E, Roguin A, Soil A, Dragu R, et al. Integrated single-photon emission computed tomography and computed tomography coronary angiography for the assessment of hemodynamically significant coronary lesions. J Am Coll Cardiol 2007;49:1059-67 https://doi.org/10.1016/j.jacc.2006.10.069
  40. Di carli MF. Hybrid imaging: integration of nuclear imaging and cardiac CT. Cardiol Clin 2009;27:257-63 https://doi.org/10.1016/j.ccl.2008.12.001
  41. Mahmarian JJ. Hybrid SPECT-CT: integration of CT coronary artery calcium scoring and angiography with myocardial perfusion. Curr Cardiol Rep 2007;9:129-35 https://doi.org/10.1007/BF02938339