Prognostic utility of single-photon emission computed tomography in adult patients with hypertrophic cardiomyopathy

Paul Sorajja, Panithaya Chareonthaitawee, Steve R. Ommen, Todd D. Miller, David O. Hodge, Raymond J Gibbons

Research output: Contribution to journalArticle

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Abstract

Background: Data derived from stress myocardial perfusion imaging (MPI) carry prognostic significance in young patients with hypertrophic cardiomyopathy (HCM), but there are limited data on the utility of stress MPI in patients with HCM who are older. This study examined the prognostic significance of stress MPI in an adult population of patients with HCM. Methods: We examined 158 patients with HCM (aged 60 ± 16 years, 61% men) who underwent exercise or pharmacologic stress MPI. Summed stress score (SSS, normal = 56) and summed reversibility scores were calculated for each patient. Follow-up was complete in 157 (99%) patients at a median duration of 5.2 years. Results: Normal single-photon emission computed tomography (SPECT) images were present in 38% of the population. Summed stress score (P = .01) and summed reversibility score (P = .03) were both significantly associated with cardiovascular death. Survival at 10 years was significantly better in those with normal versus abnormal SPECT (89% vs 67%, P = .04). Ten-year survival also was better in those without versus those with ischemia (90% vs 64%, P = .02). Five-year survival could be stratified by SSS risk categories: low risk (SSS ≥53), 97%; intermediate risk (SSS = 48-52), 94%; and high risk (SSS ≤47), 79% (P = .04). Bivariate models of SSS and other significant covariates supported an independent relation of SSS to cardiovascular death. Conclusions: In an older population of patients with HCM referred for SPECT imaging, abnormal stress MPI identifies those at increased risk of cardiovascular death.

Original languageEnglish (US)
Pages (from-to)426-435
Number of pages10
JournalAmerican Heart Journal
Volume151
Issue number2
DOIs
StatePublished - Feb 2006

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Hypertrophic Cardiomyopathy
Single-Photon Emission-Computed Tomography
Myocardial Perfusion Imaging
Survival
Population
Ischemia
Exercise

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic utility of single-photon emission computed tomography in adult patients with hypertrophic cardiomyopathy. / Sorajja, Paul; Chareonthaitawee, Panithaya; Ommen, Steve R.; Miller, Todd D.; Hodge, David O.; Gibbons, Raymond J.

In: American Heart Journal, Vol. 151, No. 2, 02.2006, p. 426-435.

Research output: Contribution to journalArticle

Sorajja, Paul ; Chareonthaitawee, Panithaya ; Ommen, Steve R. ; Miller, Todd D. ; Hodge, David O. ; Gibbons, Raymond J. / Prognostic utility of single-photon emission computed tomography in adult patients with hypertrophic cardiomyopathy. In: American Heart Journal. 2006 ; Vol. 151, No. 2. pp. 426-435.
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abstract = "Background: Data derived from stress myocardial perfusion imaging (MPI) carry prognostic significance in young patients with hypertrophic cardiomyopathy (HCM), but there are limited data on the utility of stress MPI in patients with HCM who are older. This study examined the prognostic significance of stress MPI in an adult population of patients with HCM. Methods: We examined 158 patients with HCM (aged 60 ± 16 years, 61{\%} men) who underwent exercise or pharmacologic stress MPI. Summed stress score (SSS, normal = 56) and summed reversibility scores were calculated for each patient. Follow-up was complete in 157 (99{\%}) patients at a median duration of 5.2 years. Results: Normal single-photon emission computed tomography (SPECT) images were present in 38{\%} of the population. Summed stress score (P = .01) and summed reversibility score (P = .03) were both significantly associated with cardiovascular death. Survival at 10 years was significantly better in those with normal versus abnormal SPECT (89{\%} vs 67{\%}, P = .04). Ten-year survival also was better in those without versus those with ischemia (90{\%} vs 64{\%}, P = .02). Five-year survival could be stratified by SSS risk categories: low risk (SSS ≥53), 97{\%}; intermediate risk (SSS = 48-52), 94{\%}; and high risk (SSS ≤47), 79{\%} (P = .04). Bivariate models of SSS and other significant covariates supported an independent relation of SSS to cardiovascular death. Conclusions: In an older population of patients with HCM referred for SPECT imaging, abnormal stress MPI identifies those at increased risk of cardiovascular death.",
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