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  • Title: 'False-positive' myocardial perfusion imaging: correlation with cardiovascular risk factors and effect on event-free survival.
    Author: Gimelli A, Marzullo P, L'Abbate A, Rovai D.
    Journal: J Cardiovasc Med (Hagerstown); 2008 Jul; 9(7):707-13. PubMed ID: 18545071.
    Abstract:
    BACKGROUND: In the absence of significant coronary stenoses, stress-induced myocardial perfusion abnormalities at gated single photon emission computed tomography (g-SPECT) are usually considered to be a 'false-positive' result. Our goal was to investigate how false-positive g-SPECT perfusion abnormalities relate to cardiovascular risk factors and whether they provide any prognostic information. METHODS: From 1999 to 2005, a group of 130 anginal patients with myocardial perfusion abnormalities at stress g-SPECT, with normal coronary angiography or less than 50% lumen reduction and with a left ventricular ejection fraction more than 0.45, was selected. The extent of myocardial perfusion abnormalities after stress was quantified using the summed difference score (SDS). RESULTS: Using a logistic regression model, it was found that cardiovascular risk factors (diabetes mellitus, arterial hypertension, smoking habit, hypercholesterolemia and obesity) were closely related (r = 0.96) to the SDS. During a 44 +/- 7-month follow-up, six patients experienced nonfatal cardiac events. An SDS more than 7 (P < 0.0001) and diabetes mellitus (P < 0.0001) were the only independent predictors of event-free survival using Cox proportional hazard regression analysis. CONCLUSION: In patients with anginal-like chest pain and without significant coronary stenoses, stress-induced myocardial perfusion abnormalities at g-SPECT correlate with cardiovascular risk factors and are independent predictors of the few, minor adverse cardiac events during the follow-up.
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