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Left ventricular eccentricity index measured with SPECT myocardial perfusion imaging: An additional parameter of adverse cardiac remodeling

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Single-photon emission computed-tomography (SPECT) allows the quantification of LV eccentricity index (EI), a measure of cardiac remodeling. We sought to evaluate the feasibility of EI measurement with SPECT myocardial perfusion imaging and its interactions with relevant LV functional and structural parameters.

Methods and results

Four-hundred and fifty-six patients underwent myocardial perfusion imaging on a Cadmium-Zinc-Telluride (CZT) camera. The summed rest, stress, and difference scores were calculated. From rest images, the LV end-diastolic (EDV) and end-systolic volumes, ejection fraction (EF), and peak filling rate (PFR) were calculated. In every patient, the EI, ranging from 0 (sphere) to 1 (line), was computed using a dedicated software (QGS/QPS; Cedars-Sinai Medical Center). Three-hundred and thirty-eight/456 (74%) patients showed a normal EF (>50%), while 26% had LV systolic dysfunction. The EI was computed from CZT images with excellent reproducibility (interclass correlation coefficient: 0.99, 95% CI 0.98-0.99). More impaired EI values correlated with the presence of a more abnormal LV perfusion (P < .001), function (EF and PFR, P < .001), and structure (EDV, P < .001). On multivariate analysis, higher EDV (P < .001) and depressed EF (P = .014) values were independent predictors of abnormal EI.

Conclusions

The evaluation of LV eccentricity is feasible on gated CZT images. Abnormal EI associates with significant cardiac structural and functional abnormalities.

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Abbreviations

CZT:

Cadmium-Zinc-Telluride

SPECT:

Single-photon emission computed-tomography

EI:

Eccentricity index

MPI:

Myocardial perfusion imaging

PFR:

Peak filling rate

EF:

Ejection fraction

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Disclosure

Drs Gimelli, Liga, Clemente, Marras, Kusch, and Marzullo, have no conflict of interest to disclose.

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Authors and Affiliations

  1. Fondazione Toscana G. Monasterio, Pisa, Italy

    Alessia Gimelli MD, Alberto Clemente MD, Gavino Marras PhD, Annette Kusch RT & Paolo Marzullo MD

  2. Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Via Paradisa 2, 56100, Pisa, Italy

    Riccardo Liga MD

  3. CNR, Institute of Clinical Physiology, Pisa, Italy

    Paolo Marzullo MD

Authors
  1. Alessia Gimelli MD
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  2. Riccardo Liga MD
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  3. Alberto Clemente MD
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  4. Gavino Marras PhD
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  5. Annette Kusch RT
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  6. Paolo Marzullo MD
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Corresponding author

Correspondence to Riccardo Liga MD.

Additional information

All editorial decisions for this article, including selection of reviewers and the final decision, were made by guest editor Nagara Tamaki, MD.

Alessia Gimelli and Riccardo Liga—Shared first co-authorship.

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Gimelli, A., Liga, R., Clemente, A. et al. Left ventricular eccentricity index measured with SPECT myocardial perfusion imaging: An additional parameter of adverse cardiac remodeling. J. Nucl. Cardiol. 27, 71–79 (2020). https://doi.org/10.1007/s12350-017-0777-3

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  • DOI: https://doi.org/10.1007/s12350-017-0777-3

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