Journal of Nuclear Cardiology

, Volume 26, Issue 1, pp 250–262 | Cite as

Adenosine stress myocardial perfusion imaging in octogenarians: Safety, tolerability, and long-term prognostic implications of hemodynamic response and SPECT-related variables

  • Athanasios KatsikisEmail author
  • Athanasios Theodorakos
  • Spyridon Papaioannou
  • Antonios Kalkinis
  • Genovefa Kolovou
  • Konstantinos Konstantinou
  • Maria Koutelou
Original Article



Evaluation of tolerability, safety, and prognostic implications of adenosine stress myocardial perfusion imaging (MPI) in octogenarians.


370 octogenarians (49% known coronary artery disease) were studied. Hemodynamic response, MPI-related data, and rest-left ventricular ejection fraction (LVEF) based on echocardiography were registered per patient, and prospective follow-up was performed to document all-cause death (ACD), cardiac death (CD), myocardial infarction (MI), and late revascularization.


No deaths or MIs were observed during adenosine infusion or the short-term post-infusion period. 86% of patients were able to tolerate a 6-minute infusion. All side effects terminated spontaneously after infusion cessation, except for one case of pulmonary oedema. After 9.3 years, there were 124 ACDs, 62 CDs, 16 MIs, and 35 revascularizations. Differences between survival curves of summed stress score (SSS)-based risk groups were significant for all end points (P < .001). SSS and LVEF were independent predictors of all end points (P ≤ .01) and lung uptake of cardiac end points. ΔHR <10 bpm (OR = 1.78, P = .004) and inability to increase HR by >10 bpm and decrease systolic blood pressure by >10 mmHg (OR = 2, P = .02) during adenosine infusion were independent predictors of ACD and CD, respectively. Hemodynamic response variables, SSS, and lung uptake provided incremental prognostic value over pre-test data for ACD and CD.


In octogenarians, adenosine stress MPI is well tolerated and provides effective long-term risk stratification.


Octogenarians adenosine myocardial perfusion imaging risk stratification safety 



Myocardial perfusion imaging


Systolic blood pressure


Heart rate


Summed stress score


Summed rest score


Summed difference score


Transient ischemic left ventricular dilation


Lung to heart ratio


All-cause death


Cardiac death



No conflicts of interest to disclose.

Supplementary material

12350_2017_893_MOESM1_ESM.pptx (2.2 mb)
Supplementary material 1 (PPTX 2266 kb)


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Copyright information

© American Society of Nuclear Cardiology 2017

Authors and Affiliations

  • Athanasios Katsikis
    • 1
    • 3
    • 5
    Email author
  • Athanasios Theodorakos
    • 1
  • Spyridon Papaioannou
    • 1
  • Antonios Kalkinis
    • 1
  • Genovefa Kolovou
    • 2
  • Konstantinos Konstantinou
    • 3
    • 4
  • Maria Koutelou
    • 1
  1. 1.Nuclear Medicine DepartmentOnassis Cardiac Surgery CenterAthensGreece
  2. 2.Cardiology DepartmentOnassis Cardiac Surgery CenterAthensGreece
  3. 3.Cardiology Department401 General Military Hospital of AthensAthensGreece
  4. 4.Cardiology DepartmentIpokration Hospital of AthensAthensGreece
  5. 5.AthensGreece

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