Prediction of Cardiovascular Events Using Radioisotopic Methods

pp 405-409

Abstract

Background

The possibilities that perfusion techniques have in identifying ischemic myocardium, grant them a great prognostic and diagnostic value in the study of patients with coronary artery disease.Material and methodWith the object of determining the cardiovascular risk using radioisotopic techniques, we followed up191 patients: 181 men with mean age 57.56 ± 9.5 years, and 10 women with mean age 56.7 ± 9.08 years. All of the 191 patients with stable chronic angina. They all underwent a perfusion study with thallium 201 in rest and during exercise. This was called group A. Eighty nine of these patients, 84 men with mean age57.83 ± 9.2 years, and 5 women with mean age 58.6 ±10 years, underwent ventriculogram with special interest in ejection fraction. This was called group B.

Results

In group A, 141 patients (73.82%) showed one or more ischemic segments and 67 patients (35.08%) one or more necrotic segments. The dilation of the left ventricular cavity was present in 19 patients (9.95%) while pulmonary uptake-thallium was seen in 4.19% and anterior ischemia in 43 (22.5%). After follow up during 48 months, 5 patients (2.62%) suffered sudden death, 10 patients (5.24%) non fatal myocardial infarction and 23 patients (12.4%) unstable angina. In group B, 55.6% did not modify ejection fraction during exercise. The risk of combination of events was 2.30.

Conclusions

We saw during a four years follow up that left ventricular dilatation increased four times the risk of cardiovascular events; pulmonary uptake and presence of one or more necrotic or ischemic segments increased in five and a half times the risk, and ulterior ischemia almost doubles the risk. Those who did not modify or reduce the ejection fraction increased more than double the risk of a cardiovascular event.