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A study to assess changes in myocardial perfusion after treatment with spinal cord stimulation and percutaneous myocardial laser revascularisation; data from a randomised trial.

Khan SN, McNab DC, Sharples LD, Freeman CJ, Hardy I, Stone DL, Schofield PM - Trials (2008)

Bottom Line: The mean (standard deviation) baseline summed rest score (SRS) and stress scores (SSS) were 4.6 (5.7) and 13.6 (9.0) in the PMR group and 6.1 (7.4) and 16.8 (11.6) in the SCS group.At 12 months, SRS was 5.5 (6.0) and SSS 15.3 (11.3) in the PMR group and 6.9 (8.2) and 15.1 (10.9) in the SCS group.There was no significant difference between the two treatment groups adjusted for baseline (p = 1.0 for SRS, p = 0.29 for SSS).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Papworth Hospital, Papworth Everard, Cambridge, UK. peter.schofield@papworth.nhs.uk

ABSTRACT

Background: Spinal cord stimulation (SCS) and percutaneous myocardial laser revascularisation (PMR) are treatment modalities used to treat refractory angina pectoris, with the major aim of such treatment being the relief of disabling symptoms. This study compared the change in myocardial perfusion following SCS and PMR treatment.

Methods: Subjects with Canadian Cardiovascular Society class 3/4 angina and reversible perfusion defects as assessed by single-photon emission computed tomographic myocardial perfusion scintigraphy were randomised to SCS (34) or PMR (34). Twenty-eight subjects in each group underwent repeat myocardial perfusion imaging 12 months post intervention. Visual scoring of perfusion images was performed using a 20-segment model and a scale of 0 to 4.

Results: The mean (standard deviation) baseline summed rest score (SRS) and stress scores (SSS) were 4.6 (5.7) and 13.6 (9.0) in the PMR group and 6.1 (7.4) and 16.8 (11.6) in the SCS group. At 12 months, SRS was 5.5 (6.0) and SSS 15.3 (11.3) in the PMR group and 6.9 (8.2) and 15.1 (10.9) in the SCS group. There was no significant difference between the two treatment groups adjusted for baseline (p = 1.0 for SRS, p = 0.29 for SSS).

Conclusion: There was no significant difference in myocardial perfusion one year post treatment with SCS or PMR.

No MeSH data available.


Related in: MedlinePlus

Example Scintigraphic Rest and Stress Images pre (upper panel) and 1-year post treatment (lower panel) with PMR to the anterior wall.
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Figure 1: Example Scintigraphic Rest and Stress Images pre (upper panel) and 1-year post treatment (lower panel) with PMR to the anterior wall.

Mentions: For perfusion analysis the left ventricle was divided into 20 segments, with 3 radial layers of 6 segments and two apical segments. All images were visually assessed by consensus of 2 experienced observers blinded to clinical data. Perfusion was scored semiquantitatively using a 5-point scale (0 = normal uptake; 1 = equivocal uptake; 2 = moderately reduced uptake; 3 = severely reduced uptake and 4 = no uptake) [13,14]. The summed stress score (SSS) and the summed rest score (SRS) were defined as the sum of all the scores on the stress and rest images respectively with the summed difference score (SDS) being the difference between the SSS and the SRS. These scores were calculated for each patient at baseline and at 1-year follow-up. An example from a subject treated with PMR is shown in Figure 1.


A study to assess changes in myocardial perfusion after treatment with spinal cord stimulation and percutaneous myocardial laser revascularisation; data from a randomised trial.

Khan SN, McNab DC, Sharples LD, Freeman CJ, Hardy I, Stone DL, Schofield PM - Trials (2008)

Example Scintigraphic Rest and Stress Images pre (upper panel) and 1-year post treatment (lower panel) with PMR to the anterior wall.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2266700&req=5

Figure 1: Example Scintigraphic Rest and Stress Images pre (upper panel) and 1-year post treatment (lower panel) with PMR to the anterior wall.
Mentions: For perfusion analysis the left ventricle was divided into 20 segments, with 3 radial layers of 6 segments and two apical segments. All images were visually assessed by consensus of 2 experienced observers blinded to clinical data. Perfusion was scored semiquantitatively using a 5-point scale (0 = normal uptake; 1 = equivocal uptake; 2 = moderately reduced uptake; 3 = severely reduced uptake and 4 = no uptake) [13,14]. The summed stress score (SSS) and the summed rest score (SRS) were defined as the sum of all the scores on the stress and rest images respectively with the summed difference score (SDS) being the difference between the SSS and the SRS. These scores were calculated for each patient at baseline and at 1-year follow-up. An example from a subject treated with PMR is shown in Figure 1.

Bottom Line: The mean (standard deviation) baseline summed rest score (SRS) and stress scores (SSS) were 4.6 (5.7) and 13.6 (9.0) in the PMR group and 6.1 (7.4) and 16.8 (11.6) in the SCS group.At 12 months, SRS was 5.5 (6.0) and SSS 15.3 (11.3) in the PMR group and 6.9 (8.2) and 15.1 (10.9) in the SCS group.There was no significant difference between the two treatment groups adjusted for baseline (p = 1.0 for SRS, p = 0.29 for SSS).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Papworth Hospital, Papworth Everard, Cambridge, UK. peter.schofield@papworth.nhs.uk

ABSTRACT

Background: Spinal cord stimulation (SCS) and percutaneous myocardial laser revascularisation (PMR) are treatment modalities used to treat refractory angina pectoris, with the major aim of such treatment being the relief of disabling symptoms. This study compared the change in myocardial perfusion following SCS and PMR treatment.

Methods: Subjects with Canadian Cardiovascular Society class 3/4 angina and reversible perfusion defects as assessed by single-photon emission computed tomographic myocardial perfusion scintigraphy were randomised to SCS (34) or PMR (34). Twenty-eight subjects in each group underwent repeat myocardial perfusion imaging 12 months post intervention. Visual scoring of perfusion images was performed using a 20-segment model and a scale of 0 to 4.

Results: The mean (standard deviation) baseline summed rest score (SRS) and stress scores (SSS) were 4.6 (5.7) and 13.6 (9.0) in the PMR group and 6.1 (7.4) and 16.8 (11.6) in the SCS group. At 12 months, SRS was 5.5 (6.0) and SSS 15.3 (11.3) in the PMR group and 6.9 (8.2) and 15.1 (10.9) in the SCS group. There was no significant difference between the two treatment groups adjusted for baseline (p = 1.0 for SRS, p = 0.29 for SSS).

Conclusion: There was no significant difference in myocardial perfusion one year post treatment with SCS or PMR.

No MeSH data available.


Related in: MedlinePlus