Feasibility and accuracy of SPECT myocardial perfusion imaging in end-stage lung disease.


Journal

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
ISSN: 1532-6551
Titre abrégé: J Nucl Cardiol
Pays: United States
ID NLM: 9423534

Informations de publication

Date de publication:
06 2020
Historique:
received: 16 11 2018
accepted: 25 07 2019
pubmed: 21 8 2019
medline: 31 8 2021
entrez: 21 8 2019
Statut: ppublish

Résumé

Coronary artery disease (CAD) is associated with increased mortality in patients with chronic lung disease. However, non-invasive diagnostic of CAD is difficult, especially in patients with more advanced disease. Therefore, we aimed to assess the feasibility and accuracy of SPECT-myocardial perfusion imaging (MPI) stress testing with regadenoson in patients with end-stage lung disease (ELD) undergoing assessment of stable CAD. Between January 2012 and May 2018, 102 patients with ELD, who were referred to our institution for lung transplant evaluation, were assessed retrospectively. All patients underwent both stress SPECT-MPI as well as coronary angiography. The mean age in our population was 57±6 years. All patients had severe pulmonary function impairment. During stress SPECT-MPI 14 patients (14%) reported regadenoson-related symptoms, but only 2 patients (2%) required medical treatment. Coronary angiography revealed obstructive CAD in 20 patients (20%). Among those, 5 patients had abnormal SPECT-MPI and PCI was performed in 3 patients accordingly. In 14 patients with obstructive CAD, revascularization was deferred based on normal SPECT-MPI findings. SPECT-MPI using regadenoson is well tolerated in patients with ELD and can help to make decisions about coronary revascularization before lung transplant.

Sections du résumé

BACKGROUND
Coronary artery disease (CAD) is associated with increased mortality in patients with chronic lung disease. However, non-invasive diagnostic of CAD is difficult, especially in patients with more advanced disease. Therefore, we aimed to assess the feasibility and accuracy of SPECT-myocardial perfusion imaging (MPI) stress testing with regadenoson in patients with end-stage lung disease (ELD) undergoing assessment of stable CAD.
METHODS
Between January 2012 and May 2018, 102 patients with ELD, who were referred to our institution for lung transplant evaluation, were assessed retrospectively. All patients underwent both stress SPECT-MPI as well as coronary angiography.
RESULTS
The mean age in our population was 57±6 years. All patients had severe pulmonary function impairment. During stress SPECT-MPI 14 patients (14%) reported regadenoson-related symptoms, but only 2 patients (2%) required medical treatment. Coronary angiography revealed obstructive CAD in 20 patients (20%). Among those, 5 patients had abnormal SPECT-MPI and PCI was performed in 3 patients accordingly. In 14 patients with obstructive CAD, revascularization was deferred based on normal SPECT-MPI findings.
CONCLUSIONS
SPECT-MPI using regadenoson is well tolerated in patients with ELD and can help to make decisions about coronary revascularization before lung transplant.

Identifiants

pubmed: 31428982
doi: 10.1007/s12350-019-01851-4
pii: 10.1007/s12350-019-01851-4
doi:

Substances chimiques

Purines 0
Pyrazoles 0
regadenoson 2XLN4Y044H

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

903-911

Commentaires et corrections

Type : CommentIn

Auteurs

Sanziana R I Schiopu (SRI)

Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany. schiopu_s@yahoo.com.
Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany. schiopu_s@yahoo.com.

Mathias Zacherl (M)

Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Marchioninistrasse. 15, 81377, Munich, Germany.

Andrei Todica (A)

Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Marchioninistrasse. 15, 81377, Munich, Germany.

Peter Bartenstein (P)

Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Marchioninistrasse. 15, 81377, Munich, Germany.

Katrin Milger (K)

Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.

Gabriela Leuschner (G)

Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.

Dieter Munker (D)

Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.

Matthäus Bauer (M)

Medical Controlling Unit, Department for Patient Management, Munich University Hospital (TM), 81366, Munich, Germany.

Steffen Massberg (S)

Medical Department I, Campus Grosshadern and Campus Innenstadt, Ludwig-Maximilians-University, Munich, Marchioninistrasse 15, Munich, Germany.

Jürgen Behr (J)

Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Asklepios Clinic München, Gauting, Germany.

Claus Neurohr (C)

Department for Pneumology and Respiratory Medicine, Robert-Bosch-Hospital, Schillerhöhe Clinic, Solitudestr. 18, 70839, Gerlingen, Germany.

Bruno C Huber (BC)

Medical Department I, Campus Grosshadern and Campus Innenstadt, Ludwig-Maximilians-University, Munich, Marchioninistrasse 15, Munich, Germany.

Nikolaus Kneidinger (N)

Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.

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Classifications MeSH