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Incremental prognostic value of dobutamine–atropine stress 99mTc-tetrofosmin myocardial perfusion imaging for predicting outcome in diabetic patients with limited exercise capacity

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

This study assessed the incremental value of dobutamine stress 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) for the prediction of cardiac events in diabetic patients with limited exercise capacity.

Methods

The study population comprised 125 consecutive diabetic patients (mean age 61±9 years, 61% men) who were unable to perform an exercise test and underwent dobutamine 99mTc-tetrofosmin SPECT. Follow-up was successful in 124 (99%) patients. Three patients who underwent early revascularisation (within 60 days) were excluded. End-points during follow-up were cardiac death and non-fatal myocardial infarction.

Results

An abnormal scan (with the presence of reversible or fixed perfusion defects) was observed in 76 (63%) patients. During the follow-up (3.4±1.5 years), 36 patients died (19 cardiac deaths) and four patients had non-fatal myocardial infarction. Cardiac death occurred in one of 49 (2%) patients with a normal myocardial perfusion study and in 18 of 75 (24%) patients with an abnormal study (p<0.001). Abnormal scan was incremental to the clinical parameters in predicting cardiac death (χ2=48 vs 39, p<0.05) and hard cardiac events (χ2=50 vs 43, p<0.05).

Conclusion

Dobutamine stress 99mTc-tetrofosmin SPECT provides prognostic information additional to clinical data for the prediction of cardiac death and hard cardiac events in diabetic patients unable to perform an exercise test.

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Authors and Affiliations

  1. Department of Cardiology, Bellaria Hospital, Bologna, Italy

    Chiara Pedone

  2. Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands

    Arend F. L. Schinkel, Abdou Elhendy, Ron T. van Domburg, Elena Biagini, Maarten L. Simoons & Don Poldermans

  3. Department of Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

    Roelf Valkema

  4. Department of Cardiology, University Medical Center, Leiden, The Netherlands

    Jeroen J. Bax

  5. Thoraxcenter Room Ba 300, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands

    Don Poldermans

Authors
  1. Chiara Pedone
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  2. Arend F. L. Schinkel
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  3. Abdou Elhendy
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  4. Ron T. van Domburg
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  9. Don Poldermans
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Correspondence to Don Poldermans.

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Pedone, C., Schinkel, A.F.L., Elhendy, A. et al. Incremental prognostic value of dobutamine–atropine stress 99mTc-tetrofosmin myocardial perfusion imaging for predicting outcome in diabetic patients with limited exercise capacity. Eur J Nucl Med Mol Imaging 32, 1057–1063 (2005). https://doi.org/10.1007/s00259-005-1815-y

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  • DOI: https://doi.org/10.1007/s00259-005-1815-y

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