Abstract
Background
Abnormal left ventricular (LV) eccentricity index (EI) is a marker of adverse cardiac remodeling. However, the interaction between stress-induced alterations of EI and major cardiac parameters has not been explored. We sought to evaluate the relationship between LV EI and coronary artery disease (CAD) burden in patients submitted to myocardial perfusion imaging (MPI).
Methods and results
Three-hundred and forty-three patients underwent MPI and coronary angiography. LV ejection fraction (EF) and EI were computed from gated stress images as measures of stress-induced functional impairment.
One-hundred and thirty-six (40%), 122 (35%), and 85 (25%) patients had normal coronary arteries, single-vessel CAD, and multivessel CAD, respectively. Post-stress EI was lower in patients with multivessel CAD than in those with normal coronary arteries and single-vessel CAD (P = 0.001). This relationship was confirmed only in patients undergoing exercise stress test, where a lower post-stress EI predicted the presence of multivessel CAD (P = 0.039).
Conclusions
Post-stress alterations of LV EI on MPI may unmask the presence of multivessel CAD.
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Abbreviations
- CZT:
-
Cadmium-zinc-telluride
- SPECT:
-
Single-photon emission computed tomography
- EI:
-
Eccentricity index
- MPI:
-
Myocardial perfusion imaging
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The authors have no conflicts of interest to disclose.
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Alessia Gimelli and Riccardo Liga shared first co-authorship.
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12350_2017_862_MOESM3_ESM.ppt
Relationships between CAD burden and ( A) functional (EF) and ( B) structural (EI) signs LV impairment at rest in patients submitted to either exercise (left) or vasodilator (right) stress-test. Supplementary material 3 (PPT 102 kb)
12350_2017_862_MOESM4_ESM.ppt
Relationships between post-stress LV EI and A measures of stress-induced LV functional and structural abnormalities, as well as B stress-induced LV stunning (stress/rest EF ratio) and cavitary dilatation. Supplementary material 4 (PPT 210 kb)
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Gimelli, A., Liga, R., Giorgetti, A. et al. Stress-induced alteration of left ventricular eccentricity: An additional marker of multivessel CAD. J. Nucl. Cardiol. 26, 227–232 (2019). https://doi.org/10.1007/s12350-017-0862-7
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DOI: https://doi.org/10.1007/s12350-017-0862-7