The prognostic role of rest-redistribution 201-Thallium imaging has not been extensively investigated in patients with left ventricular ischemic dysfunction.
The aim of this study was to evaluate the ability of rest-redistribution 201-Thallium single photon emission computed tomography to predict cardiac death and occurrence of acute myocardial infarction in patients with ischemic mild-to-moderate left ventricular dysfunction.
One-hundred and twenty-six patients with chronic coronary artery disease and mean left ventricular ejection fraction 39 ± 11% were followed-up for 30 ± 17 months after a rest-redistribution 201-Thallium imaging single photon emission computed tomography. Cardiac death and acute myocardial infarction were considered as major cardiac events.
During the follow up, 11 (9%) cardiac deaths and 9 (7%) acute myocardial infarctions occurred. The only variable showing significant difference between patients with and without events was the number of severe irreversible defects (1.7 ± 1.9 versus 0.9 ± 1.2, respectively; P = 0.02). By Kaplan–Meier analysis, the presence of three or less, or more than three severe defects was selected as the best cutoff to identify patients with longer event-free survival from cardiac death or acute myocardial infarction (log rank 19.84; P < 0.0001). When only cardiac death was considered as clinical event, the presence of at least two severe defects best separated patients who died from those who survived (log rank 8.68; P = 0.0032).
Rest-redistribution 201-Thallium single photon emission computed tomography provides prognostic information in coronary patients with mild-to-moderate left ventricular dysfunction. The number of severe irreversible defects per patient is a powerful predictor of prognosis.
aDepartment of Internal Medicine, Cardiovascular & Immunological Sciences, Italy
bDepartment of Biomorphological and Functional Sciences, Federico II University, and I.B.B. CNR, Naples, Italy
Received 11 April, 2008
Revised 11 July, 2008
Accepted 19 September, 2008
Correspondence to Pasquale Perrone-Filardi, MD, PhD, Institute of Cardiology, ‘Federico II’ University of Naples, Via S. Pansini, 5, I-80131 Naples, Italy Tel: +39 081 746 2232; fax: +39 081 746 2229; e-mail: email@example.com