The International Journal of Cardiovascular Imaging

, Volume 28, Issue 6, pp 1427–1434

Head-to-head comparison of contrast-enhanced cardiovascular magnetic resonance and 201Thallium single photon emission computed tomography for prediction of reversible left ventricular dysfunction in chronic ischaemic heart disease

  • Matthias Regenfus
  • Christian Schlundt
  • Johannes von Erffa
  • Michaela Schmidt
  • Udo Reulbach
  • Torsten Kuwert
  • Werner G. Daniel
  • Michael Schmid
Original paper

DOI: 10.1007/s10554-011-9941-z

Cite this article as:
Regenfus, M., Schlundt, C., von Erffa, J. et al. Int J Cardiovasc Imaging (2012) 28: 1427. doi:10.1007/s10554-011-9941-z

Abstract

Delayed contrast-enhanced cardiovascular magnetic resonance (DE-CMR) allows assessment of reversibility of myocardial dysfunction. Comparative data to other modalities is scarce. Purpose of this study was to compare DE-CMR and 201Thallium single photon emission computed tomography (SPECT) for prediction of reversible left ventricular (LV) dysfunction in patients with chronic ischaemic heart disease. Fifty-four patients with LV dysfunction (mean ejection fraction (EF) 35 ± 8%) scheduled to undergo myocardial revascularization underwent DE-CMR and SPECT. Cine CMR was performed at baseline and at 8 months follow-up for assessment of regional and global myocardial function. Myocardial viability was determined by the segmental extent of delayed enhancement for DE-CMR, and by quantitative analysis of tracer uptake for SPECT, and was correlated to functional recovery after revascularization. After revascularization, 172 (49%) of 350 dysfunctional segments improved at follow-up cine CMR. Sensitivity and specificity for the prediction of functional recovery was 92 and 88%, respectively, for DE-CMR as compared to 86% (P = 0.4) and 56% (P = 0.001) for SPECT. Global LV function showed an increase of EF > 5% in 22 (41%) patients. The DE-CMR derived viability ratio (dysfunctional but viable myocardium) of 0.46 (sensitivity 91%, specificity 91%) was identified as predictor of increase in EF > 5% (P = 0.02), whereas the corresponding SPECT parameters were not predictive. DE-CMR compares favorably to SPECT for the prediction of regional and global improvement in LV function in the setting of chronic myocardial ischemia.

Keywords

Cardiovascular magnetic resonanceSingle photon emission computed tomographyReversible left ventricular dysfunctionMyocardial viabilityChronic ischaemic heart disease

Supplementary material

10554_2011_9941_MOESM1_ESM.avi (838 kb)
Video 1 Short axis cine CMR view of the patient from figure 1 (before coronary artery bypass grafting) showing akinesis in the inferior wall. CMR = cardiovascular magnetic resonance. Supplementary material 1 (AVI 837 kb)
10554_2011_9941_MOESM2_ESM.avi (1.3 mb)
Video 2 Short axis cine CMR view (corresponding slice position to video 1) of the patient from figure 1 (after coronary artery bypass grafting) showing improved wall thickening in the inferior and septal wall. CMR = cardiovascular magnetic resonance. Supplementary material 2 (AVI 1347 kb)
10554_2011_9941_MOESM3_ESM.avi (654 kb)
Video 3 Short axis cine CMR view of the patient from figure 2 (before coronary artery bypass grafting) showing akinesis in the inferior wall. CMR = cardiovascular magnetic resonance. Supplementary material 3 (AVI 654 kb)
10554_2011_9941_MOESM4_ESM.avi (692 kb)
Video 4 Short axis cine CMR view (corresponding slice position to video 3) of the patient from figure 2 (after coronary artery bypass grafting) showing no improvement of wall thickening in the inferior wall. CMR = cardiovascular magnetic resonance. Supplementary material 4 (AVI 692 kb)

Copyright information

© Springer Science+Business Media, B.V. 2011

Authors and Affiliations

  • Matthias Regenfus
    • 1
  • Christian Schlundt
    • 1
  • Johannes von Erffa
    • 1
  • Michaela Schmidt
    • 2
  • Udo Reulbach
    • 3
  • Torsten Kuwert
    • 4
  • Werner G. Daniel
    • 1
  • Michael Schmid
    • 1
  1. 1.Department of Internal Medicine IIFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
  2. 2.Siemens Medical SolutionsErlangenGermany
  3. 3.Department of Medical Informatics, Biometry and EpidemiologyFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
  4. 4.Department of Nuclear MedicineFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany