Prognostic Value of Lung Sestamibi Uptake in Myocardial Perfusion Imaging of Patients With Known or Suspected Coronary Artery Disease Original Research Article

Objectives We sought to determine whether lung uptake of technetium-99m (99mTc)-based myocardial perfusion tracers predicts cardiac events. Background Increased lung uptake of thallium-201 during myocardial perfusion scintigraphy can predict important clinical outcomes. It is unclear whether lung uptake of 99mTc-based myocardial perfusion tracers can be used in a similar way. Methods Stress lung-to-heart ratio (sLHR) was determined in 718 patients undergoing 99mTc-sestamibi single-photon emission computed tomographic stress imaging. The primary outcome was acute myocardial infarction or death. Results During a mean follow-up of 5.6 years, a primary end point occurred in 114 patients (16%). The sLHR was significantly greater in those with an adverse outcome (p < 0.00001). The likelihood of an adverse outcome increased by a factor of 1.5 (95% confidence interval 1.2 to 1.7) for each standard deviation increase in sLHR after adjustment for all other variables. The sLHR provided a small but significant improvement in risk stratification when added to clinical, stress test, perfusion, and left ventricular volume information (global chi-square 168.6 vs. 150.7, p < 0.00001). Conclusions Stress LHR is an adjunctive prognostic measure in patients with known or suspected coronary artery disease.