Utility of nuclear stress imaging for detecting coronary artery bypass graft disease

Basel Al Aloul, Mackenzi Mbai, Selcuk Adabag, Santiago Garcia, Hoang Thai, Steven Goldman, William Holman, Gulshan Sethi, Rosemary Kelly, Herbert B. Ward, Edward O. McFalls

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The value of Single Photon Emission Computed Tomography stress myocardial perfusion imaging (SPECT-MPI) for detecting graft disease after coronary artery bypass surgery (CABG) has not been studied prospectively in an unselected cohort.Methods: Radial Artery Versus Saphenous Vein Graft Study is a Veterans Affairs Cooperative Study to determine graft patency rates after CABG surgery. Seventy-nine participants agreed to SPECT-MPI within 24 hours of their coronary angiogram, one-year after CABG. The choice of the stress protocol was made at the discretion of the nuclear radiologist and was either a symptom-limited exercise test (n = 68) or an adenosine infusion (n = 11). The SPECT-MPI results were interpreted independent of the angiographic results and estimates of sensitivity, specificity and accuracy were based on the prediction of a graft stenosis of ≥70% on coronary angiogram.Results: A significant stenosis was present in 38 (48%) of 79 patients and 56 (22%) of 251 grafts. In those stress tests with an optimal exercise heart rate response (>80% maximum predicted heart rate) (n = 26) sensitivity, specificity and accuracy of SPECT-MPI for predicting the graft stenosis was 77%, 69% and 73% respectively. With adenosine (n = 11) it was 75%, 57% and 64%, respectively. Among participants with a suboptimal exercise heart rate response, the sensitivity of SPECT-MPI for predicting a graft stenosis was <50%. The accuracy of SPECT-MPI for detecting graft disease did not vary significantly with ischemic territory.Conclusions: Under optimal stress conditions, SPECT-MPI has a good sensitivity and accuracy for detecting graft disease in an unselected patient population 1 year post-CABG.

Original languageEnglish (US)
Article number62
JournalBMC Cardiovascular Disorders
Volume12
DOIs
StatePublished - Aug 3 2012
Externally publishedYes

Fingerprint

Coronary Artery Bypass
Myocardial Perfusion Imaging
Single-Photon Emission-Computed Tomography
Transplants
Pathologic Constriction
Heart Rate
Exercise Test
Adenosine
Angiography
Exercise
Sensitivity and Specificity
Radial Artery
Saphenous Vein
Veterans
Population

Keywords

  • CABG
  • Cardiac catheterization/intervention
  • Coronary artery bypass grafts
  • Coronary artery imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Utility of nuclear stress imaging for detecting coronary artery bypass graft disease. / Al Aloul, Basel; Mbai, Mackenzi; Adabag, Selcuk; Garcia, Santiago; Thai, Hoang; Goldman, Steven; Holman, William; Sethi, Gulshan; Kelly, Rosemary; Ward, Herbert B.; McFalls, Edward O.

In: BMC Cardiovascular Disorders, Vol. 12, 62, 03.08.2012.

Research output: Contribution to journalArticle

Al Aloul, B, Mbai, M, Adabag, S, Garcia, S, Thai, H, Goldman, S, Holman, W, Sethi, G, Kelly, R, Ward, HB & McFalls, EO 2012, 'Utility of nuclear stress imaging for detecting coronary artery bypass graft disease', BMC Cardiovascular Disorders, vol. 12, 62. https://doi.org/10.1186/1471-2261-12-62
Al Aloul, Basel ; Mbai, Mackenzi ; Adabag, Selcuk ; Garcia, Santiago ; Thai, Hoang ; Goldman, Steven ; Holman, William ; Sethi, Gulshan ; Kelly, Rosemary ; Ward, Herbert B. ; McFalls, Edward O. / Utility of nuclear stress imaging for detecting coronary artery bypass graft disease. In: BMC Cardiovascular Disorders. 2012 ; Vol. 12.
@article{8c3ce9dda956403b895a42e8381df34b,
title = "Utility of nuclear stress imaging for detecting coronary artery bypass graft disease",
abstract = "Background: The value of Single Photon Emission Computed Tomography stress myocardial perfusion imaging (SPECT-MPI) for detecting graft disease after coronary artery bypass surgery (CABG) has not been studied prospectively in an unselected cohort.Methods: Radial Artery Versus Saphenous Vein Graft Study is a Veterans Affairs Cooperative Study to determine graft patency rates after CABG surgery. Seventy-nine participants agreed to SPECT-MPI within 24 hours of their coronary angiogram, one-year after CABG. The choice of the stress protocol was made at the discretion of the nuclear radiologist and was either a symptom-limited exercise test (n = 68) or an adenosine infusion (n = 11). The SPECT-MPI results were interpreted independent of the angiographic results and estimates of sensitivity, specificity and accuracy were based on the prediction of a graft stenosis of ≥70{\%} on coronary angiogram.Results: A significant stenosis was present in 38 (48{\%}) of 79 patients and 56 (22{\%}) of 251 grafts. In those stress tests with an optimal exercise heart rate response (>80{\%} maximum predicted heart rate) (n = 26) sensitivity, specificity and accuracy of SPECT-MPI for predicting the graft stenosis was 77{\%}, 69{\%} and 73{\%} respectively. With adenosine (n = 11) it was 75{\%}, 57{\%} and 64{\%}, respectively. Among participants with a suboptimal exercise heart rate response, the sensitivity of SPECT-MPI for predicting a graft stenosis was <50{\%}. The accuracy of SPECT-MPI for detecting graft disease did not vary significantly with ischemic territory.Conclusions: Under optimal stress conditions, SPECT-MPI has a good sensitivity and accuracy for detecting graft disease in an unselected patient population 1 year post-CABG.",
keywords = "CABG, Cardiac catheterization/intervention, Coronary artery bypass grafts, Coronary artery imaging",
author = "{Al Aloul}, Basel and Mackenzi Mbai and Selcuk Adabag and Santiago Garcia and Hoang Thai and Steven Goldman and William Holman and Gulshan Sethi and Rosemary Kelly and Ward, {Herbert B.} and McFalls, {Edward O.}",
year = "2012",
month = "8",
day = "3",
doi = "10.1186/1471-2261-12-62",
language = "English (US)",
volume = "12",
journal = "BMC Cardiovascular Disorders",
issn = "1471-2261",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Utility of nuclear stress imaging for detecting coronary artery bypass graft disease

AU - Al Aloul, Basel

AU - Mbai, Mackenzi

AU - Adabag, Selcuk

AU - Garcia, Santiago

AU - Thai, Hoang

AU - Goldman, Steven

AU - Holman, William

AU - Sethi, Gulshan

AU - Kelly, Rosemary

AU - Ward, Herbert B.

AU - McFalls, Edward O.

PY - 2012/8/3

Y1 - 2012/8/3

N2 - Background: The value of Single Photon Emission Computed Tomography stress myocardial perfusion imaging (SPECT-MPI) for detecting graft disease after coronary artery bypass surgery (CABG) has not been studied prospectively in an unselected cohort.Methods: Radial Artery Versus Saphenous Vein Graft Study is a Veterans Affairs Cooperative Study to determine graft patency rates after CABG surgery. Seventy-nine participants agreed to SPECT-MPI within 24 hours of their coronary angiogram, one-year after CABG. The choice of the stress protocol was made at the discretion of the nuclear radiologist and was either a symptom-limited exercise test (n = 68) or an adenosine infusion (n = 11). The SPECT-MPI results were interpreted independent of the angiographic results and estimates of sensitivity, specificity and accuracy were based on the prediction of a graft stenosis of ≥70% on coronary angiogram.Results: A significant stenosis was present in 38 (48%) of 79 patients and 56 (22%) of 251 grafts. In those stress tests with an optimal exercise heart rate response (>80% maximum predicted heart rate) (n = 26) sensitivity, specificity and accuracy of SPECT-MPI for predicting the graft stenosis was 77%, 69% and 73% respectively. With adenosine (n = 11) it was 75%, 57% and 64%, respectively. Among participants with a suboptimal exercise heart rate response, the sensitivity of SPECT-MPI for predicting a graft stenosis was <50%. The accuracy of SPECT-MPI for detecting graft disease did not vary significantly with ischemic territory.Conclusions: Under optimal stress conditions, SPECT-MPI has a good sensitivity and accuracy for detecting graft disease in an unselected patient population 1 year post-CABG.

AB - Background: The value of Single Photon Emission Computed Tomography stress myocardial perfusion imaging (SPECT-MPI) for detecting graft disease after coronary artery bypass surgery (CABG) has not been studied prospectively in an unselected cohort.Methods: Radial Artery Versus Saphenous Vein Graft Study is a Veterans Affairs Cooperative Study to determine graft patency rates after CABG surgery. Seventy-nine participants agreed to SPECT-MPI within 24 hours of their coronary angiogram, one-year after CABG. The choice of the stress protocol was made at the discretion of the nuclear radiologist and was either a symptom-limited exercise test (n = 68) or an adenosine infusion (n = 11). The SPECT-MPI results were interpreted independent of the angiographic results and estimates of sensitivity, specificity and accuracy were based on the prediction of a graft stenosis of ≥70% on coronary angiogram.Results: A significant stenosis was present in 38 (48%) of 79 patients and 56 (22%) of 251 grafts. In those stress tests with an optimal exercise heart rate response (>80% maximum predicted heart rate) (n = 26) sensitivity, specificity and accuracy of SPECT-MPI for predicting the graft stenosis was 77%, 69% and 73% respectively. With adenosine (n = 11) it was 75%, 57% and 64%, respectively. Among participants with a suboptimal exercise heart rate response, the sensitivity of SPECT-MPI for predicting a graft stenosis was <50%. The accuracy of SPECT-MPI for detecting graft disease did not vary significantly with ischemic territory.Conclusions: Under optimal stress conditions, SPECT-MPI has a good sensitivity and accuracy for detecting graft disease in an unselected patient population 1 year post-CABG.

KW - CABG

KW - Cardiac catheterization/intervention

KW - Coronary artery bypass grafts

KW - Coronary artery imaging

UR - http://www.scopus.com/inward/record.url?scp=84864501786&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864501786&partnerID=8YFLogxK

U2 - 10.1186/1471-2261-12-62

DO - 10.1186/1471-2261-12-62

M3 - Article

C2 - 22862805

AN - SCOPUS:84864501786

VL - 12

JO - BMC Cardiovascular Disorders

JF - BMC Cardiovascular Disorders

SN - 1471-2261

M1 - 62

ER -