Publication Date
2014
Journal Title
JACC Cardiovasc Imaging
Abstract
The lack of standardized reporting of the magnitude of ischemia on noninvasive imaging contributes to variability in translating the severity of ischemia across stress imaging modalities. We identified the risk of coronary artery disease (CAD) death or myocardial infarction (MI) associated with >= 10% ischemic myocardium on stress nuclear imaging as the risk threshold for stress echocardiography and cardiac magnetic resonance. A narrative review revealed that >= 10% ischemic myocardium on stress nuclear imaging was associated with a median rate of CAD death or MI of 4.9%/year (interquartile range: 3.75% to 5.3%). For stress echocardiography, >= 3 newly dysfunctional segments portend a median rate of CAD death or MI of 4.5%/year (interquartile range: 3.8% to 5.9%). Although imprecisely delineated, moderate-severe ischemia on cardiac magnetic resonance may be indicated by >= 4 of 32 stress perfusion defects or >= 3 dobutamine-induced dysfunctional segments. Risk-based thresholds can define equivalent amounts of ischemia across the stress imaging modalities, which will help to translate a common understanding of patient risk on which to guide subsequent management decisions. (C) 2014 by the American College of Cardiology Foundation
Volume Number
7
Issue Number
6
Pages
593-604
Document Type
Article
EPub Date
2014/06/14
Status
Faculty
Facility
School of Medicine
Primary Department
Cardiology
Additional Departments
Occupational Medicine, Epidemiology and Prevention
PMID
DOI
10.1016/j.jcmg.2013.10.021
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