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Prognostic Value of Combined Assessment of Regional Left Ventricular Function and Myocardial Perfusion by Dobutamine and Rest Gated SPECT in Patients with Uncomplicated Acute Myocardial Infarction

Letizia Spinelli, MD1, Mario Petretta, MD1, Wanda Acampa, MD2,3, Wei He, MD4, Andrea Petretta1, Domenico Bonaduce, MD1 and Alberto Cuocolo, MD3,4

1 Institute of Internal Medicine, Cardiology and Heart Surgery, University Federico II, Naples, Italy
2 Institute of Biostructures and Bioimaging, National Council of Research, Naples, Italy
3 IRCCS Neuromed, Pozzilli, Italy
4 Department of Biomorphological and Functional Sciences, University Federico II, Naples, Italy



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  		FIGURE 1. Event rate in patients without ischemia (summed difference score = 0), with mild ischemia (summed difference score of 1 to 2), and with moderate-to-severe (mod-sev) ischemia (summed difference score > 2). Statistically significant increase in cardiac events occurred as function of SPECT result (P < 0.01).

 


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  		FIGURE 2. Incremental prognostic value for cardiac events (global {chi}2 values on y-axis) obtained with consideration of hierarchical order: rest perfusion status (regional 99mTc-sestamibi activity score at rest; white bar); rest perfusion status and summed difference score (black bar); and rest perfusion status, summed difference score, and combined assessment of regional perfusion and regional function (i.e., regional wall thickening score at rest) at rest in akinetic or dyskinetic segments (hatched bar). SDS = summed difference score.

 




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