Journal of Nuclear Cardiology

, Volume 25, Issue 2, pp 586–592 | Cite as

The value of transient ischemic dilation for detecting restenosis after coronary artery revascularization

  • Salih Sinan Gultekin
  • Murat Sadic
  • Murat Bilgin
  • Gökhan Koca
  • Sadik Acikel
  • Ekrem Yeter
  • Meliha Korkmaz
Original Article

Abstract

Aim

Transient ischemic dilation (TID) is a marker of severe coronary artery disease (CAD). We aimed to assess the incremental value of TID in a cohort of patients with known significant CAD who had recurrence of symptoms after revascularization.

Methods

We identified in our databases 104 patients who had recent coronary revascularization and recurrence of symptoms. 62 patients had PCI (75 arteries) and 42 patients had CABG (104 arteries). All had follow-up stress SPECT MPI and repeat coronary angiography. Myocardial perfusion findings of ischemia and TID were correlated with presence of significant obstructive CAD (>70% stenosis).

Results

Follow-up stress Tc-99m Sestamibi SPECT MPI revealed inducible ischemia in 38 patients (36.5%) and TID > 1.20 in 49 patients (47%). Subsequent coronary angiography showed significant obstructive CAD in 44 patients (42%). The sensitivity for detecting obstructive CAD was 61% for SPECT MPI alone, but increased significantly to 93% by the addition of TID as a diagnostic criterion (P < 0.0001).

Conclusions

In this selected patient cohort with prior coronary revascularization, TID is an important marker of obstructive CAD and has incremental value over SPECT MPI alone.

Keywords

Coronary artery disease coronary revascularization myocardial perfusion imaging: SPECT transient ischemic dilation 

Abbreviations

CAD

Coronary artery disease

CABG

Coronary artery bypass grafting

EF

Ejection fraction

EDV

End-diastolic volume

ESV

End-systolic volume

MPI

Myocardial perfusion imaging

PCI

Percutaneous coronary intervention

SPECT

Single-photon emission computed tomography

TID

Transient ischemic dilation

Tc-99m Sestamibi

Technetium-99m-methoxyisobutylisonitrile

Notes

Acknowledgments

This article was finalized under the auspices of the “Mentorship at Distance” committee of the Journal of Nuclear Cardiology. We gratefully acknowledge the editorial suggestions by Frans J. Th. Wackers, MD, PhD.

Disclosure

The authors declared no potential conflicts of interests with respect to the authorship and/or publication of this article. The authors received no financial support for the research and/or authorship of this article.

Proprietary Interest

The authors state that they have no proprietary interest in the products named in this article.

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Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  • Salih Sinan Gultekin
    • 1
  • Murat Sadic
    • 2
  • Murat Bilgin
    • 3
  • Gökhan Koca
    • 2
  • Sadik Acikel
    • 3
  • Ekrem Yeter
    • 3
  • Meliha Korkmaz
    • 2
  1. 1.Department of Nuclear MedicineMinistry of Health, Diskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey
  2. 2.Department of Nuclear MedicineMinistry of Health, Ankara Training and Research HospitalAnkaraTurkey
  3. 3.Department of CardiologyMinistry of Health, Diskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey

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