The prognostic value of non-perfusion variables obtained during vasodilator stress myocardial perfusion imaging

J Nucl Cardiol. 2016 Jun;23(3):390-413. doi: 10.1007/s12350-016-0441-3. Epub 2016 Mar 3.

Abstract

Myocardial perfusion imaging (MPI) is an established diagnostic test that provides useful prognostic data in patients with known or suspected coronary artery disease. In more than half of the patients referred for stress testing, vasodilator stress is used in lieu of exercise. Unlike exercise, vasodilator stress does not provide information on exercise and functional capacity, heart rate recovery, and chronotropy, and ECG changes are less frequent. These non-perfusion data provide important prognostic and patient management information. Further, event rates in patients undergoing vasodilator MPI are higher than in those undergoing exercise MPI and even in those with normal images probably due to higher pretest risk. However, there are a number of non-perfusion variables that are obtained during vasodilator stress testing, which have prognostic relevance but their use has not been well emphasized. The purpose of this review is to summarize the prognostic values of these non-perfusion data obtained during vasodilator MPI.

Keywords: Myocardial perfusion imaging; SPECT; heart rate response; perfusion; transient ischemic dilation; vasodilator.

Publication types

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

MeSH terms

  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnostic imaging*
  • Exercise Test / methods*
  • Female
  • Humans
  • Male
  • Myocardial Perfusion Imaging / methods*
  • Prognosis
  • Reproducibility of Results
  • Risk Assessment / methods
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Vasodilator Agents*
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / etiology

Substances

  • Vasodilator Agents