RT Journal Article SR Electronic T1 Prognostic significance of post-stress reduction in left ventricular ejection fraction with adenosine stress 99mTc-sestamibi in patients without reversible perfusion defects JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 309 OP 309 VO 60 IS supplement 1 A1 Obeidat, Omar S. A1 Baniissa, Bayan A1 AlHouri, Abdullah A1 Alqaisi, Omar A1 Alrimawi, Omar A1 Akkawi, Mohammad A1 Zyad, Heba A1 Juweid, Malik YR 2019 UL http://jnm.snmjournals.org/content/60/supplement_1/309.abstract AB 309Objectives: The significance of post-stress reduction in left ventricular ejection fraction (LVEF) in patients who underwent an adenosine stress/rest study with no evidence of reversible perfusion defects remains controversial with only few studies comprising a large number of patients. The aim of this study is to determine the prognostic value of post-adenosine stress decrease in LVEF in these patients. Materials and Methods: We have identified all patients who had a two-day adenosine stress/rest 99mTc-sestamibi scan performed between 1/2015 and 10/2017 at Jordan University Hospital, no evidence of reversible perfusion defects and their rest and post-stress LVEF determined. LVEF was quantified at rest and 60 minutes post adenosine by QGS (Cedars-Sinai Medical Center, Los Angles, Calif.) Patients were then followed up for both hard (cardiac death or nonfatal myocardial infarction) and soft (coronary revascularization or congestive heart failure) cardiac events for a mean (± SD) of 24.2 ± 11.0 months. Results: Of the 636 patients who met the inclusion criteria, 562 (88.4%) had normal perfusion and 74 (11.6%) had fixed perfusion defects consistent with prior infarction. 152 of the 636 patients (23.9%) had ≥ 5% reduction in LVEF (mean ± SD =-7.6 ± 2.5%) and 484 (76.1%) had < 5% reduction in LVEF (1.4 ± 4.0%). Twelve of the 152 patients (7.9%) had cardiac events (7.9% soft, 0% hard) vs. 46 of the 484 patients (9.5%; 8.1% soft, 1.4% hard). No significant differences in the soft, hard or total cardiac event rates were found between the two groups (P=0.21-0.95). There were also no significant differences in cardiac event rates between patients with ≥ 10% vs those with < 10% reduction in LVEF (P=0.3-0.99) . Moreover, when the change in LVEF as continuous variable or as a cutoff decrease of 5% or 10% was entered into a logistic regression model including age, sex, tobacco use, diabetes mellitus, hypertension, dyslipidemia, known history of coronary artery disease (CAD), family history of CAD and myocardial perfusion pattern (normal vs. fixed defect), change in LVEF was not an independent predictor of cardiac events (P=0.34-0.50). Conclusions: Post-adenosine stress reduction in LVEF does not confer an adverse prognosis and is not an independent prognosticator in patients without reversible perfusion defects on 99mTc-sestamibi myocardial perfusion scan.