Increasing frequency of dyspnea among patients referred for cardiac stress testing

To assess the frequency, change in prevalence, and prognostic significance of dyspnea among contemporary patients referred for cardiac stress testing. We evaluated the prevalence of dyspnea and its relationship to all-cause mortality among 33,564 patients undergoing stress/rest SPECT-MPI between Jan...

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Bibliographic Details
Published in:Journal of nuclear cardiology 2023-12, Vol.30 (6), p.2303-2313
Main Authors: Rozanski, Alan, Gransar, Heidi, Sakul, Sakul, Miller, Robert J.H., Han, Donghee, Hayes, Sean W., Friedman, John D., Thomson, Louise E.J., Berman, Daniel S.
Format: Article
Language:English
Subjects:
cardiac stress testing
Cardiology
Chest Pain - diagnosis
Coronary Artery Disease - complications
Dyspnea
Dyspnea - diagnosis
Dyspnea - etiology
Exercise Test - adverse effects
Humans
Imaging
Medicine
Medicine & Public Health
myocardial perfusion imaging
Myocardial Perfusion Imaging - adverse effects
Nuclear Medicine
Original Article
Prognosis
Radiology
Tomography, Emission-Computed, Single-Photon - adverse effects
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Summary:To assess the frequency, change in prevalence, and prognostic significance of dyspnea among contemporary patients referred for cardiac stress testing. We evaluated the prevalence of dyspnea and its relationship to all-cause mortality among 33,564 patients undergoing stress/rest SPECT-MPI between January 1, 2002 and December 31, 2017. Dyspnea was assessed as a single-item question. Patients were divided into three temporal groups. The overall prevalence of dyspnea in our cohort was 30.2%. However, there was a stepwise increase in the temporal prevalence of dyspnea, which was present in 25.6% of patients studied between 2002 and 2006, 30.5% of patients studied between 2007 and 2011, and 38.7% of patients studied between 2012 and 2017. There was a temporal increase in the prevalence of dyspnea in each age, symptom, and risk factor subgroup. The adjusted hazard ratio for mortality was higher among patients with dyspnea vs those without dyspnea both among all patients, and within each chest pain subgroup. Dyspnea has become increasingly prevalent among patients referred for cardiac stress testing and is now present among nearly two-fifths of contemporary cohorts referred for stress-rest SPECT-MPI. Prospective study is needed to standardize the assessment of dyspnea and evaluate the reasons for its increasing prevalence.
ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-023-03375-4