Seminars in Nuclear Medicine
Volume 35, Issue 1 , Pages 52-61 , January 2005

The role of myocardial perfusion imaging in special populations: Women, diabetics, and heart failure

  • Jennifer H. Mieres, MD

      Affiliations

    • Division of Cardiology, North Shore University Hospital, Manhasset, NY
    • Corresponding Author InformationAddress reprint requests to Jennifer H. Mieres, MD, FACC, Director of Nuclear Cardiology, Division of Cardiology, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030
    • Corresponding Author InformationAddress reprint requests to Jennifer H. Mieres, MD, FACC, Director of Nuclear Cardiology, Division of Cardiology, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030
    • ,
  • David R. Rosman, MD

      Affiliations

    • Division of Cardiology, North Shore University Hospital, Manhasset, NY
    • ,
  • Leslee J. Shaw, PhD

      Affiliations

    • Cedars-Sinai Medical Center, Los Angeles, CA

References 

  1. World Health Report 2002: Available at. http://www.worldheart.org/pdf/publications.heartbeat.2002.12.pdf; Internet; accessed October 4, 2004
  2. American Heart Association . Heart Disease and Stroke Statistics—2004 Update . Dallas, TX: American Heart Association; 2003;
  3. Shaw LJ , Miller DD , Romeis JC , et al.   Gender differences in the noninvasive evaluation and management of patients with suspected coronary artery disease . Ann Intern Med . 1994;120:559–566
  4. Steingart RM , Packer M , Hamm P , et al.   Sex differences in the management of coronary artery disease . N Engl J Med . 1991;325:226–230
  5. Lloyd-Jones DM , Larson MG , Beiser A , et al.   Lifetime risk of developing coronary heart disease . Lancet . 1999;35:89–92
  6. Tobin JN , Wassertheil-Smoller S , Wexler JP , et al.   Sex bias in considering coronary bypass surgery . Ann Intern Med . 1987;107:19–25
  7. Douglas PS , Ginsburg GS . The evaluation of chest pain in women . N Engl J Med . 1996;334:1211–1315
  8. Kilaru PK , Kelly RF , Calvin JE , et al.   Utilization of coronary angiography and revascularization after acute myocardial infarction in men and women risk stratified by the American College of Cardiology/American Heart Association guidelines . J Am Coll Cardiol . 2000;35:974–979
  9. Mark DB , Shaw LK , DeLong ER , et al.   Absence of sex bias in the referral of patients for cardiac catheterization . N Engl J Med . 1994;330:1101–1106
  10. Hochleitner M . Coronary heart disease: sexual bias in referral for coronary angiogram: How does it work in a state-run health system? . Journal of Womens Health & Gender-Based Medicine . 2000;9:29–34
  11. Wong CC , Froelicher ES , Bacchetti P , et al.   Influence of gender on cardiovascular mortality in acute myocardial infarction patients with high indication for coronary angiography . Circulation . 1997;96:II-51–II-57
  12. Mosca L , Grundy SM , Judelson D , et al.  American Heart Association/American College of Cardiology   AHA/ACC scientific statement: Consensus panel statement: Guide to preventive cardiology for women . J Am Coll Cardiol . 1999;33:1751–1755
  13. Heller GV , Fossati AT . Detection of coronary artery disease in women . In:  Zaret B ,  Beller G editor. Nuclear Cardiology (State of the Art and Future Directions) . (ed 2). Philadelphia: Mosby; 1999;p. 298–311
  14. Kwok Y , Kim C , Grady D , et al.   Meta-analysis of exercise testing to detect coronary artery disease in women . Am J Cardiol . 1999;83:660–666
  15. Morise AP , Dalal JN , Duval RD . Value of a simple measure of estrogen status for improving the diagnosis of coronary artery disease in women . Am J Med . 1993;94:491–496
  16. Kawano H , Motoyama T , Ohgushi M , et al.   Menstrual cyclic variation of myocardial ischemia in premenopausal women with variant angina . Ann Intern Med . 2001;35:977–981
  17. Schulman SP , Thiemann DR , Ouyang P , et al.   Effects of acute hormone therapy on recurrent ischemia in postmenopausal women with unstable angina . J Am Coll Cardiol . 2002;39:231–237
  18. Gibbons RJ , Balady GJ , Beasley JW , et al.   ACC/AHA Guidelines for Exercise Testing. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines . J Am Coll Cardiol . 1997;30:260–311
  19. Okin PM , Kligfield P . Gender-specific criteria and performance of the exercise electrocardiogram . Circulation . 1995;92:1209–1216
  20. Alexander KP , Shaw LJ , Shaw LK , et al.   Value of exercise treadmill testing in women . J Am Coll Cardiol . 1998;32:1657–1664
  21. Hachamovitch R , Berman DS , Kiat H , et al.   Value of stress myocardial perfusion single photon emission computed tomography in patients with normal resting electrocardiograms (an evaluation of incremental prognostic value and cost-effectiveness) . Circulation . 2002;105:823–829
  22. Friedman TD , Greene AC , Iskandrian AS , et al.   Exercise thallium-201 myocardial scintigraphy in women (correlation with coronary arteriography) . Am J Cardiol . 1982;49:1632–1637
  23. Goodgold HM , Rehder JG , Samuels LD , et al.   Improved interpretation of exercise Tl-201 myocardial perfusion scintigraphy in women (characterization of breast attenuation artifacts) . Radiology . 1987;65:361–366
  24. Amanullah AM , Berman DS , Hachamovitch R , et al.   Identification of severe or extensive coronary artery disease in women by adenosine technetium-99m sestamibi SPECT . Am J Cardiol . 1997;80:132–137
  25. Kong BA , Shaw L , Miller DD , et al.   Comparison of accuracy for detecting coronary artery disease and side-effect profile of dipyridamole thallium-201 myocardial perfusion imaging in women versus men . Am J Cardiol . 1992;70:168–173
  26. Amanullah AM , Berman DS , Erel J , et al.   Incremental prognostic value of adenosine myocardial perfusion single-photon emission computed tomography in women with suspected coronary artery disease . Am J Cardiol . 1998;82:725–730
  27. Santana-Boado C , Candell-Riera J , Castell-Conesa J , et al.   Diagnostic accuracy of technetium-99m-MIBI myocardial SPECT in women and men . J Nucl Med . 1998;39:751–755
  28. Hansen CL , Crabbe D , Rubin S . Lower diagnostic accuracy of thallium-201 SPECT myocardial perfusion imaging in women (an effect of smaller chamber size) . J Am Coll Cardiol . 1996;28:1214–1219
  29. Iskandrian AE , Heo J , Nallamothu N . Detection of coronary artery disease in women with use of stress single-photon emission computed tomography myocardial perfusion imaging . J Nucl Cardiol . 1997;4:329–335
  30. Taillefer R , DePuey EG , Udelson JE , et al.   Comparative diagnostic accuracy of Tl-201 and Tc-99m sestamibi SPECT imaging (perfusion and ECG-gated SPECT) in detecting coronary artery disease in women . J Am Coll Cardiol . 1997;29:69–77
  31. Hung J , Chaitman BR , Lam J , et al.   Noninvasive diagnostic test choices for the evaluation of coronary artery disease in women (a multivariate comparison of cardiac fluoroscopy, exercise electrocardiography and exercise thallium myocardial perfusion scintigraphy) . J Am Coll Cardiol . 1984;4:8–16
  32. Bailey IK , Griffith LS , Rouleau J , et al.   Thallium-201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease . Circulation . 1977;55:79–87
  33. Melin JA , Wijns W , Vanbutsele RJ , et al.   Alternative diagnostic strategies for coronary artery disease in women (demonstration of the usefulness and efficiency of probability analysis) . Circulation . 1985;71:535–542
  34. Okada RD , Boucher CA , Strauss HW , et al.   Exercise radionuclide imaging approaches to coronary artery disease . Am J Cardiol . 1980;46:1188–1204
  35. Marwick TH , Shaw LJ , Lauer MS , et al.  Economics of Noninvasive Diagnosis (END) Study Group   The noninvasive prediction of cardiac mortality in men and women with known or suspected coronary artery disease . Am J Med . 1999;106:172–178
  36. Hachamovitch R , Berman D , Kiat H , et al.   Effective risk stratification using exercise myocardial perfusion single-photon emission computed tomography SPECT in women (Gender-related differences in prognostic nuclear testing) . J Am Coll Cardiol . 1996;28:34–44
  37. Travin MI , Duca MD , Kline GM , et al.   Relation of gender to physician use of test results and to the prognostic value of stress technetium 99m sestamibi myocardial single-photon emission computed tomography scintigraphy . Am Heart J . 1997;134:73–82
  38. Giri S , Shaw LJ , Murthy DR , et al.   Impact of diabetes on the risk stratification using stress single-photon emission computed tomography myocardial perfusion imaging in patients with symptoms suggestive of coronary artery disease . Circulation . 2002;105:32–40
  39. Geleijnse M , Elhendy A , Domburg R , et al.   Prognostic significance of normal dobutamine-atropine stress sestamibi scintigraphy in women with chest pain . Am J Cardiol . 1996;77:1057–1061
  40. Hachamovitch R , Hayes SW , Friedman JD , et al.   Stress Myocardial perfusion single-photon emission computed tomography is clinically effective and cost effective in risk stratification of patients with a high likelihood of coronary artery disease (CAD) but no known CAD . J Am Coll Cardiol . 2004;43:200–208
  41. Amanullah AM , Kiat H , Hachamovitch R , et al.   Impact of myocardial perfusion single-photon emission computed tomography on referral to catheterization of the very elderly. Is there evidence of gender-related referral bias? . J Am Coll Cardiol . 1996;28:680–686
  42. Pancholy S , Fattah A , Kamal A , et al.   Independent and incremental prognostic value of exercise thallium single-photon emission tomographic imaging in women . J Nucl Cardiol . 1995;2:110–116
  43. Gibbons RJ , Hodge DO , Berman DS , et al.   Long- term outcome of patients with intermediate-risk exercise electrocardiograms who do not have myocardial perfusion defects on radionuclide imaging . Circulation . 1999;100:2140–2145
  44. Galassi AR , Azzarelli S , Tomaselli A , et al.   Incremental prognostic value of technetium-99m-tetrofosmin exercise myocardial perfusion imaging for predicting outcomes in patients with suspected of known coronary artery disease . Am J Cardiol . 2001;88:101–106
  45. Vanzetto G , Ormezzano O , Farget D , et al.   Long-term additive prognostic value of thallium-201 myocardial perfusion imaging over clinical and exercise stress test in low to intermediate risk patients (study in 1137 patients with 6 year follow-up) . Circulation . 1999;100:1521–1527
  46. Olmos LI , Dakik H , Gordon R , et al.   Long- term prognostic value of exercise echocardiography compared with exercise 201 Tl, ECG, and clinical variables in patients evaluated for coronary artery disease . Circulation . 1998;98:2679–2686
  47. Alkeylani A , Miller DD , Shaw LJ , et al.   Influence of race on the prediction of cardiac events with stress technetium-99m sestamibi tomographic imaging in patients with stable angina pectoris . Am J Cardiol . 1998;81:293–297
  48. Hendel R , Chen M , L’Italien G , et al.   Sex differences in perioperative and long-term cardiac event-free survival in vascular surgery patients . Circulation . 1995;91:1044–1051
  49. Cacciabaudo JM , Hachamovitch R . Stress myocardial perfusion SPECT in women (Is it the cornerstone of the non-invasive evaluation?) . J Nucl Med . 1998;39:758–759
  50. Gibbons RJ , Chatterjee K , Daley J , et al.   ACC/AHA/ACP-ASIM Guidelines for the Management of Patients with Chronic Stable Angina (Executive Summary and Recommendations) . J Am Coll Cardiol . 1999;33:2092–2197
  51. Ficaro EP , Fessler JA , Shreve PD , et al.   Simultaneous transmission/emission myocardial perfusion tomography. Diagnostic accuracy of attenuation-corrected 99mTc-sestamibi single-photon emission computed tomography . Circulation . 1996;93:463–473
  52. Awaad MI , Heller GV . Role of myocardial perfusion imaging in the assessment of the diabetic patient . In:  Heller GV ,  Hendel RC editor. Nuclear Cardiology (Practical Applications) . New York, NY: McGraw-Hill; 2003;p. 67–76
  53. Navare SM , Heller GV . Role of stress single photon emission computed tomography imagine in asymptomatic patients with diabetes . Am Heart J . 2004;147:753–755
  54. Nesto RW . Screening for asymptomatic coronary artery disease in diabetes . Diabetes Care . 1999;22:1393–1395
  55. Kang X , Berman DS , Lewin H , et al.   Comparative ability of myocardial perfusion single-photon emission computed tomography to detect coronary artery disease in patients with and without diabetes mellitus . Am Heart J . 1999;137:949–957
  56. Paillole C , Ruiz J , Juliard JM , et al.   Detection of coronary artery disease in diabetic patient . Diabetologia . 1995;38:726–731
  57. Boudreau RJ , Strony JT , duCret RP , et al.   Perfusion thallium imaging of type I diabetes patients with end stage renal disease (Comparison of oral and intravenous dipyridamole administration) . Radiology . 1990;175:103–105
  58. Bell DS , Yumuk VD . Low Incidence of false-positive exercise thallium-201 scintigraphy in a diabetic population . Diabetes Care . 1996;19:185–186
  59. American Diabetes Association . Consensus development conference on the diagnosis of coronary heart disease in people with diabetes . Diabetes Care . 1998;21:1551–1559
  60. American Diabetes Association (Standards of medical care for patients with diabetes mellitus) . Diabetes Care . 1998;21LS23–21LS39
  61. Berman DS , Kang X , Hayes SW , et al.   Adenosine myocardial perfusion single-photon emission computed tomography in women compared with men. Impact of diabetes mellitus on incremental prognostic value and effect on patient management . J Am Coll Cardiol . 2003;41:1125–1133
  62. Uusitupa MI , Niskanen LK , Siitonen O , et al.   Ten-year cardiovascular mortality in relation to risk factors and abnormalities in lipoprotein composition in type 2 (non-insulin-dependent) diabetic and non-diabetic subjects . Diabetologia . 1993;36:1175–1184
  63. Sinderman A , Michel C , Racine N . Heart disease in patients with diabetes mellitus . J Clin Epidemiol . 1992;45:1357–1370 (review)
  64. Zuanetti G , Latini R , Maggioni AP , et al.   Influence of diabetes on mortality in acute myocardial infarction (data from the GISSI-2 study) . J Am Coll Cardiol . 1993;22:1788–1794
  65. Gavin IW , Lahiri A . Chapter 20 - Other heart diseases . In:  Iskandrian AE ,  Verani MS editor. Nuclear cardiac imaging principles and applications . (ed 3). London: Oxford University Press; 2003;p. 399–412
  66. Gonzalez JM , Castell-Conesa J , Candell-Riera J , et al.  Spanish Working Group of Nuclear Cardiology   Relevance of 99mTc-MIBI rest uptake, ejection fraction and location of contractile abnormality in predicting myocardial recovery after revascularization . Nucl Med Comm . 2001;22:795–805
  67. Maes AF , Borgers M , Flameng W , et al.   Assessment of myocardial viability in chronic coronary artery disease using technetium-99m sestamibi SPECT. Correlation with histologic and positron emission tomographic studies and functional follow-up . J Am Coll Cardiol . 1997;29:62–68
  68. Cuocolo A , Rubini G , Acampa W , et al.   Technetium 99m furifosmin regional myocardial uptake in patients with previous myocardial infarction (Relation to thallium-201 activity and left ventricular function) . J Nucl Cardiol . 2000;7:235–241
  69. Danias PG , Ahlberg AW , Clark BA , et al.   Combined assessment of myocardial perfusion and left ventricular function with exercise technetium-99m sestamibi gated single-photon emission computed tomography can differentiate between ischemic and nonischemic dilated cardiomyopathy . Am J Cardiol . 1998;2:1253–1258
  70. Klocke FJ , Baird MG , Lorell BH , et al.   ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging–executive summary (A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging)) . Circulation . 2003;108:1404–1418
  71. Tauberg SG , Orie JE , Bartlett BE , et al.   Usefulness of thallium-201 for distinction of ischemic from idiopathic dilated cardiomyopathy . Am J Cardiol . 1993;71:674–680
  72. Pasternac A , Noble J , Streulens Y , et al.   Pathophysiology of chest pain in patients with cardiomyopathies and normal coronary arteries . Circulation . 1982;65:778–789
  73. Cannon RO , Cunnion RE , Parrillo JE , et al.   Dynamic limitation of coronary vasodilator reserve in patients with dilated cardiomyopathy and chest pain . J Am Coll Cardiol . 1987;10:1190–1200
  74. Hudson RE . Pathology of cardiomyopathy . Cardiovasc Clin . 1972;4:3–59
  75. Mody FV , Brunken RC , Stevenson LW , et al.   Differentiating cardiomyopathy of coronary artery disease from nonischemic dilated cardiomyopathy utilizing positron emission tomography . J Am Coll Cardiol . 1991;17:373–383
  76. Miller WL , Hodge DO , Tointon SK , et al.   Relationship of myocardial perfusion imaging findings to outcome of patients with heart failure and suspected ischemic heart disease . Am Heart J . 2004;147:714–720
  77. Doi YL , Chikamori T , Tukata J , et al.   Prognostic value of thallium-201 perfusion defects in idiopathic dilated cardiomyopathy . Am J Cardiol . 1991;67:188–193
  78. Bax JJ , Wijns W , Cornel JH , et al.   Accuracy of currently available techniques for prediction of functional recovery after revascularization in patients with left ventricular dysfunction due to chronic coronary artery disease (comparison of pooled data) . J Am Coll Cardiol . 1997;30:1451–1460
  79. Allman KC , Shaw LJ , Hachamovitch R , et al.   Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction (A meta- analysis) . J Am Coll Cardiol . 2002;39:1151–1158

PII: S0001-2998(04)00063-7

doi: 10.1053/j.semnuclmed.2004.09.004

Seminars in Nuclear Medicine
Volume 35, Issue 1 , Pages 52-61 , January 2005

Article Tools

* Image Usage & Resolution