SPECT MPI for Risk Assessment in Special Groups

Abstract

Abstract Risk assessment in patients with suspected CAD is an important step to identify those at high risk of disease who require a specified diagnostic and therapeutic approach to prevent adverse events at follow-up. At present many cardiac prediction models are available for risk assessment in order to guide lifestyle modification and treatment decisions and to estimate future population trends in cardiovascular morbidity and mortality. Yet, most CAD risk prediction tools do not account for the high event rates in some populations, such as diabetic individuals or kidney and liver transplantation candidates. Gated SPECT MPI provides important prognostic information on LV function and on the extent and severity of myocardial perfusion abnormalities, including stress-induced ischemia. MPI has an important diagnostic and prognostic rule in specific patient populations, including subjects with asymptomatic CAD, diabetes mellitus, obesity, and kidney or liver disease, which are indicated as CAD equivalent populations. This chapter focuses on the role of SPECT MPI in risk assessment of specific populations at higher risk of cardiac events.