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Exercise myocardial perfusion imaging in elderly patients.

Richard M Steingart1, Patty Hodnett, Joseph Musso

  • 1Division of Cardiology, Winthrop-University Hospital, Mineola, NY 11501, USA. rsteinga@winthrop.org

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|December 6, 2002
PubMed
Summary

Exercise myocardial perfusion imaging (MPI) provides valuable prognostic information in elderly patients. Key predictors of adverse events include increasing age, male sex, limited exercise tolerance, and MPI-detected ischemia.

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Area of Science:

  • Cardiology
  • Nuclear Cardiology
  • Diagnostic Imaging

Background:

  • Exercise myocardial perfusion imaging (MPI) is valuable for risk stratification, primarily in middle-aged populations.
  • The prognostic utility of exercise MPI in elderly individuals with interpretable electrocardiograms (ECGs) remains less defined.

Purpose of the Study:

  • To evaluate the prognostic value of exercise MPI in elderly outpatients (≥65 years) with interpretable ECG stress tests.
  • To identify predictors of death or myocardial infarction in this specific demographic.

Main Methods:

  • Analysis of clinical, ECG stress test, MPI, and follow-up data from 626 elderly outpatients undergoing symptom-limited exercise MPI.
  • Exclusion of patients revascularized within 90 days of MPI; multivariable modeling was used for prediction.

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Main Results:

  • Univariate analysis identified age, male sex, abnormal rest ECG, lower exercise tolerance, and MPI findings as predictors.
  • Multivariable analysis confirmed increasing patient age, male sex, limited exercise tolerance, and number of ischemic segments on MPI as significant predictors of death or myocardial infarction.

Conclusions:

  • In elderly patients undergoing exercise MPI, age, sex, exercise tolerance, and the extent of ischemia detected by MPI are significant prognostic indicators.
  • These factors provide crucial information for risk stratification in older adults.