Prognostic value of myocardial perfusion gated SPECT in patients with symptomatic intracranial large-artery atherosclerosis

Cerebrovasc Dis. 2007;24(2-3):247-54. doi: 10.1159/000104486. Epub 2007 Jun 28.

Abstract

Background: We aimed to evaluate the prognostic value of myocardial perfusion gated SPECT in patients with symptomatic intracranial large-artery atherosclerosis (ILA).

Methods: Seventy-two consecutive first-ever symptomatic ILA patients without known heart disease underwent a stress myocardial perfusion gated SPECT, and long-term follow-up was conducted thereafter.

Results: During an average follow-up of 15.2 +/- 9 months, 9 patients (13.8%) presented major coronary events (CEs). Survival analyses (Kaplan-Meier and Cox regression) identified presence of moderate-to-severe myocardial perfusion defects (log rank p = 0.004) and ejection fraction <50% (p = 0.014) as predictors of future CEs. Neurovascular ischemic events were not predicted by SPECT variables.

Conclusion: Myocardial perfusion scintigraphy predicts future CEs in patients with symptomatic ILA and may be helpful to guide therapeutic strategies in this subgroup of stroke patients.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Constriction, Pathologic
  • Coronary Circulation*
  • Exercise Test*
  • Female
  • Follow-Up Studies
  • Heart Diseases / diagnostic imaging*
  • Heart Diseases / etiology
  • Heart Diseases / mortality
  • Heart Diseases / physiopathology
  • Humans
  • Intracranial Arteriosclerosis / complications*
  • Intracranial Arteriosclerosis / diagnostic imaging
  • Intracranial Arteriosclerosis / mortality
  • Intracranial Arteriosclerosis / physiopathology
  • Ischemic Attack, Transient / complications*
  • Ischemic Attack, Transient / diagnostic imaging
  • Ischemic Attack, Transient / etiology
  • Ischemic Attack, Transient / mortality
  • Ischemic Attack, Transient / physiopathology
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Stroke / complications*
  • Stroke / diagnostic imaging
  • Stroke / etiology
  • Stroke / mortality
  • Stroke / physiopathology
  • Stroke Volume
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon / methods*