Depressed heart rate response to vasodilator stress for myocardial SPECT predicts mortality in patients after myocardial infarction.

The International Journal of Cardiovascular Imaging
Young Hwan KimByung-Tae Kim

Abstract

As heart rate (HR) response during vasodilator stress myocardial perfusion studies can be a marker of HR variability, we investigated its prognostic value in patients after myocardial infarction (MI). Subjects were 147 survivors of MI who underwent vasodilator stress thallium-201 scintigraphy. HR response was measured as peak to basal (P/B) ratios during vasodilator infusion. End points for survival analysis were all-cause deaths, non-fatal recurrent MI, and soft events. HR response was significantly depressed in the post-MI patients compared to controls (p<0.0005). HR response correlated to LVEF (r=0.37, p<0.0001) and summed stress scores (r=-0.18, p<0.05), but not with antianginal medication. During 58+/-30 mo of follow-up, there were 15 deaths, 7 recurrent MI, and 11 soft events. Low HR response, old age, low LVEF, and high difference score were significant univariate risk factors for death. Multivariate analysis identified low HR response (p=0.03), high stress score (p=0.02), and low LVEF (p=0.05) as independent predictors of mortality. The predictive value of HR response was incremental to that offered by other variables (p=0.02). HR response, readily attained during vasodilator stress myocardial perfusion studies, may pro...Continue Reading

References

Jun 1, 1992·Circulation·G C CasoloS Lazzerini
Feb 1, 1989·British Journal of Clinical Pharmacology·A H WattC G Swift
Jan 1, 1988·European Journal of Clinical Pharmacology·B ClarkeP J Barnes
Aug 11, 1983·The New England Journal of Medicine·UNKNOWN Multicenter Postinfarction Research Group
May 1, 1995·Journal of the American College of Cardiology·J J MahmarianM S Verani
May 30, 1998·The American Journal of Cardiology·E PinarM Valdés
Jun 20, 1998·Pacing and Clinical Electrophysiology : PACE·M V PitzalisP Rizzon
Feb 17, 2001·The American Journal of Cardiology·D KrollL L Johnson
Apr 11, 2001·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·K H LeeB T Kim
Apr 11, 2001·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·V ChiamvimonvatM R Freeman
Jan 17, 2002·The American Journal of Cardiology·Aseem VashistNarendra C Bhalodkar

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Citations

Jun 21, 2012·Annals of Nuclear Medicine·Gozde Daglioz GorurHakan Demir
Mar 29, 2008·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Andrea De Lorenzo, Ronaldo S L Lima
Oct 12, 2010·Annals of Nuclear Medicine·Ronaldo de Souza Leão LimaAndrea De Lorenzo
Feb 6, 2017·The International Journal of Cardiovascular Imaging·Arash GholoobiVahid Reza Dabbagh Kakhki

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