Speaker
Dr
Philippe Tellier
(CMNA Clinique Sainte Catherine)
Description
Background. Whole body exercise thallium scintigraphy can detect silent or
symptomatic PAD. Whether exercise thallium perfusion muscular asymmetry in the legs
has prognostic value is unknown.
Methods and Results –Three hundred fifty-eight consecutive patients (mean age
58.8±10.2 year; coronary artery disease, 202/358; 56.4 %) were prospectively
followed after thallium 201 myocardial scintigraphy. Scintigraphic calf perfusion
symmetry after exercise (SCPSE) was measured at the end of a treadmill exercise
test.During the follow-up period (mean, 85.3±32.8 months, range, 6-115), 93
cardiovascular events and cardiovascular deaths (incident cases) occurred. Among
incident cases, the percentage of subjects with higher SCPSE values (third tertile)
was 45.2 % compared to 29.1 % in controls (p=0.005). In stepwise multivariate
analysis performed with the Cox proportional hazards model, previous CAD and SCPSE
were the only significant independent predictors of prognosis. The multivariate
relative risk of cardiovascular death or cardiovascular event in subjets with
higher values of SCPSE was 1.94 (95 % CI: 1.15 - 3.21; p<0.01).
Conclusions – This highly reproducible index which is easily and quickly
calculated following exercise myocardial scintigraphy could be used as a new tool
for identifying high cardiovascular risk patients.
Author
Dr
Philippe Tellier
(CMNA Clinique Sainte Catherine)
Co-authors
Dr
Mahmoud Zureik
(INSERM Pästeur Lille)
Dr
Pascal Lecouffe
(CMNA Clinique Sainte Catherine)
