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Updated: Jun 20, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Pertinence of myocardial perfusion imaging in octogenarians
Manavjot Sidhu1, Meenakshi Bhalla, Anand Chockalingam
1Harry S Truman VA Medical Center, Columbia, Missouri, USA.
Insights
Myocardial perfusion imaging (MPI) accurately diagnoses coronary artery disease (CAD) in octogenarians, matching the diagnostic performance seen in younger individuals. This non-invasive test is valuable for assessing heart health in the elderly.
Area of Science:
- Cardiology
- Nuclear Medicine
- Geriatric Medicine
Background:
- Coronary artery disease (CAD) is a major health concern in the elderly.
- Diagnosing CAD in octogenarians is challenging due to atypical symptoms and comorbidities.
- Stress myocardial perfusion imaging (MPI) is a key diagnostic tool.
Purpose of the Study:
- To evaluate the diagnostic accuracy and utility of stress MPI in octogenarian patients.
- To compare MPI findings with coronary angiogram results in this age group.
Main Methods:
- Retrospective review of medical records for patients aged 80+ who underwent MPI and coronary angiogram.
- Comparison with a control group of veterans under 60 years old.
- Analysis of MPI scan results, including defect types and distribution.
Main Results:
- 53 octogenarians (mean age 85) were evaluated; 93% had hypertension, 44% diabetes.
- All patients had abnormal MPI scans, with 91% showing reversible defects.
- MPI demonstrated 98% positive predictive value and accuracy in detecting CAD compared to coronary angiography.
Conclusions:
- Stress myocardial perfusion imaging is highly accurate for diagnosing CAD in octogenarians.
- MPI findings correlate well with coronary angiogram results in this population.
- The diagnostic performance of MPI in octogenarians is comparable to that in younger patients.
Aim:
Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the elderly population. Atypical presentation, reduced activity levels, and comorbidity often confound the diagnosis. We studied the use of stress myocardial perfusion imaging (MPI) in octogenarians.
Methods:
We retrospectively reviewed the medical records of all patients with both MPI and coronary angiogram within 6 months from 1998 to 2008. Sixty veterans under the age of 60 years who underwent both cardiac procedures served as controls.
Results:
We evaluated 53 patients, predominantly men, with mean age of 85 +/- 2.5 yrs. Chest pain (68%) was the most common reason for requesting the stress test. Risk factors included diabetes 44%, hypertension 93%, smoking 48%, hyperlipidemia 93%, and peripheral vascular disease 40%. All patients had an abnormal myocardial perfusion scan. Reversible defects were present in 91% with the following distribution: mild 26%, moderate 39%, severe 15% and multiple defects 11%. Fixed defects were present in 44% of the patients. Analysis of both studies in the 53 patients revealed complete (43), partial (7) and no correlation (3) between the MPI defects and culprit lesions identified on the coronary angiogram. Positive predictive value and accuracy of the myocardial perfusion scan in detection of the disease was 98%. Follow up ranged from 1 to 10 years during which 19 patients died, and 7 deaths were cardiac.
Conclusion:
Myocardial perfusion imaging in octogenarians is as accurate in diagnosing CAD as it is in younger people.
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