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

24925328

DOI

10.1016/j.jcmg.2013.10.021


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