Prognostic Value Of Gated Myocardial Perfusion SPECT In Patients With Cardiac Artery Disease

OBJECTIVE: To study the prognostic value of gated myocardial perfusion single photon emission computed tomography (SPECT) in patients with cardiac artery disease and its assistance in determining the appropriate treatment strategy for the individual patient.METHODS: We identified 141 consecutive patients who underwent rest and exercise stress (201Tl/99mTc-MIBI/ 99mTc-tetrofosmin) gated myocardial perfusion SPECT and who were followed-up for 46.38±23.70 months. Visual scoring of perfusion images used 17 segments and a scale of 1-4. and calculated the global summed stress score (SSS), summed rest score (SRS) and the summed difference score (SDS=SSS-SRS). Poststress ejection fraction (EF) and rest EF were automatically generated.RESULTS: 14 cardiac events occurred (2.57%/year). SSS, SDS,SRS and EF were the independent predictors of cardiac events (P<0.0005). Cox regression analysis showed that SSS was the best predictor of cardiac events. Integration of the poststress EF and SDS yielded effective stratification of patients into low-, intermediate-, and high-risk subgroups.CONCLUSIONS: Gated myocardial perfusion SPECT can provide appropriate prognostic assessment for the patients with cardiac artery disease and assistant in determining the appropriate treatment strategy for the individual patient by stratification of patients into low-, intermediate-, and high-risk subgroups. SSS was the best predictors of cardiac events.