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Prognostic Value of Normal Technetium-99m-Sestamibi Cardiac Imaging

Cardiology Unit, Department of Medicine, University of Vermont College of Medicine, Burlington, Vermont

Correspondence: For correspondence or reprints contact: Kenneth A. Brown, MD, Cardiology Unit, Medical Center Hospital of Vermont, Burlington, VT 05401.

ABSTRACT

The purpose of this study was to describe the clinical outcome of patients with a normal ^99mTc-sestamibi cardiac imaging study. Methods: One-day gated rest-stress planar dipyridamole (n = 112) and symptom-limited exercise (n = 122) ^99mTc-sestamibi protocols were used. All patients (n = 234, mean age 55 ± 12 yr, 127 males and 107 females) had normal perfusion and wall motion on qualitative analysis. Patients were followed for 6–16 mo (mean 10 ± 2 mo). Cardiac events were defined as cardiac death or nonfatal myocardial infarction. Results: ST-segment depression or chest pain occurred in 8 (7%) and 29 (26%) patients in the dipyridamole group, respectively, and 20 (16%) and 28 (22%) patients in the exercise group. Cardiac events occurred in only one patient. The annualized event rate was 0.5% per year. In addition, only two patients underwent coronary revascularization during the follow-up period. Conclusions: Our data confirm the benign outcome of patients with normal ^99mTc-sestamibi cardiac imaging, at least over an intermediate follow-up period.

Key Words: thallium-201 • technetium-99m • cardiac imaging

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