Featured Research

from universities, journals, and other organizations

Accurate Assessment Of Heart Disease Leads To Earlier, More Aggressive Therapy

Date:
April 10, 2009
Source:
Society of Nuclear Medicine
Summary:
In a study comparing the ability of various medical techniques to accurately determine the extent of heart disease and stratify patients according to disease severity, researchers found that myocardial perfusion testing with gated single photon emission computed tomography was a more accurate predictor of prognosis in chronic ischemic heart disease -- a painful condition caused by a temporary reduction of oxygen-rich blood to the heart.

In a study comparing the ability of various medical techniques to accurately determine the extent of heart disease and stratify patients according to disease severity, researchers found that myocardial perfusion testing with gated single photon emission computed tomography (gated SPECT) was a more accurate predictor of prognosis in chronic ischemic heart disease (IHD)—a painful condition caused by a temporary reduction of oxygen-rich blood to the heart.

Related Articles


For the study, published in the April issue of The Journal of Nuclear Medicine, researchers selected a group of patients with known or suspected—albeit stable—IHD. Those with previous coronary artery bypass surgery, chronic kidney failure and hyperthyroidism were excluded, leaving 492 study subjects between the ages of 55 and 75. Each of these underwent a complete diagnostic work-up that included a medical history, physical examination, blood tests, electrocardiography at rest, two-dimensional echocardiography and myocardial perfusion imaging (gated SPECT) after stress and at rest.

Patients also underwent coronary arteriography, which is currently the standard clinical procedure for diagnosing IHD, according to the American Heart Association. This invasive test is performed by inserting a catheter into the femoral artery of the leg and threading it into the aorta. A contrast dye is then injected, and X-rays record areas where narrowing or blockage in one or more coronary arteries has occurred.

During the next 37 months, patients returned for periodic examinations in an outpatient setting. Armed with the resulting data, the researchers determined that of the techniques investigated—including coronary arteriography—gated SPECT is the best predictor of future cardiac events.

"The prognostic value of stress testing with myocardial perfusion imaging has been investigated for several years," said Alessia Gimelli, MD, at the Clinical Physiology Institute CNR, G. Monasterio Foundation in Pisa, Italy. "However, substantial changes in nuclear cardiology have occurred over the past two decades that have led to improved techniques. The clinical profile of patients with IHD has also changed, with patients often being older and affected by more diseases than in the past. We were therefore surprised to see that gated SPECT remains the best predictor of future cardiac events in patients with IHD."

Furthermore, although left ventricular ejection fraction (the heart's action of pumping blood into the body) is more commonly used in clinical practice to predict patient outcome, this study revealed that the extent of damage to the heart muscle—as shown in the SPECT images—is a better prognosticator of how patients will fare. This ability to identify individuals at risk for future cardiac events, such as heart attacks, has considerable appeal because the early initiation of preventive therapies may alter the course of the disease, noted the researchers.

"Risk stratification allows us to categorize patients according to the severity of their disease and risk of future cardiac events," said Dr. Gimelli. "As a result, we are able to allocate resources where needed and treat the sickest patients more aggressively."

Gated SPECT is a noninvasive nuclear medicine procedure involving an injection of a small amount of radioactive material that circulates in the bloodstream to show if the heart muscle is receiving adequate blood supply under stress and/or rest conditions, explained the researchers. SPECT imaging performed after stress reveals the distribution of the radiopharmaceutical and therefore the relative myocardial perfusion (blood flow in the heart) to the different regions of the heart muscle. The resulting set of SPECT images provides quantitative information regarding myocardial perfusion after stress and at rest, as well as the heart as it contracts.

Myocardial perfusion imaging stress testing is sensitive to even the most modest changes in blood flow and can determine whether the heart is receiving enough blood and oxygen. In this way, gated SPECT provides information regarding the presence of myocardial infarction (heart attack) and myocardial ischemia, explained Dr. Gimelli.

Since its introduction in the late 1980s, gated SPECT has become one of the most commonly performed cardiology procedures in nuclear medicine departments. Automation of the image processing and quantification has made this technique highly reproducible, practical and user friendly in clinical settings. It is similar to a standard SPECT study, except that many more images are acquired. Diagnosis is made by comparing stress images to an additional set of images obtained at rest.

IHD is characterized by a temporary reduction in blood supply to the heart muscle and is usually the result of coronary artery disease (atherosclerosis). According to the American Heart Association, it is the leading cause of death in the United States and the European Union.


Story Source:

The above story is based on materials provided by Society of Nuclear Medicine. Note: Materials may be edited for content and length.


Journal Reference:

  1. Gimelli et al. Stress/Rest Myocardial Perfusion Abnormalities by Gated SPECT: Still the Best Predictor of Cardiac Events in Stable Ischemic Heart Disease. Journal of Nuclear Medicine, 2009; 50 (4): 546 DOI: 10.2967/jnumed.108.055954

Cite This Page:

Society of Nuclear Medicine. "Accurate Assessment Of Heart Disease Leads To Earlier, More Aggressive Therapy." ScienceDaily. ScienceDaily, 10 April 2009. <www.sciencedaily.com/releases/2009/04/090401101737.htm>.
Society of Nuclear Medicine. (2009, April 10). Accurate Assessment Of Heart Disease Leads To Earlier, More Aggressive Therapy. ScienceDaily. Retrieved December 18, 2014 from www.sciencedaily.com/releases/2009/04/090401101737.htm
Society of Nuclear Medicine. "Accurate Assessment Of Heart Disease Leads To Earlier, More Aggressive Therapy." ScienceDaily. www.sciencedaily.com/releases/2009/04/090401101737.htm (accessed December 18, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, December 18, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

UN: Up to One Million Facing Hunger in Ebola-Hit Countries

UN: Up to One Million Facing Hunger in Ebola-Hit Countries

AFP (Dec. 17, 2014) Border closures, quarantines and crop losses in West African nations battling the Ebola virus could lead to as many as one million people going hungry, UN food agencies said on Wednesday. Duration: 00:52 Video provided by AFP
Powered by NewsLook.com
When You Lose Weight, This Is Where The Fat Goes

When You Lose Weight, This Is Where The Fat Goes

Newsy (Dec. 17, 2014) Can fat disappear into thin air? New research finds that during weight loss, over 80 percent of a person's fat molecules escape through the lungs. Video provided by Newsy
Powered by NewsLook.com
Why Your Boss Should Let You Sleep In

Why Your Boss Should Let You Sleep In

Newsy (Dec. 17, 2014) According to research out of the University of Pennsylvania, waking up for work is the biggest factor that causes Americans to lose sleep. Video provided by Newsy
Powered by NewsLook.com
Flu Outbreak Closing Schools in Ohio

Flu Outbreak Closing Schools in Ohio

AP (Dec. 17, 2014) A wave of flu illnesses has forced some Ohio schools to shut down over the past week. State officials confirmed one pediatric flu-related death, a 15-year-old girl in southern Ohio. (Dec. 17) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins