Journal of Nuclear Cardiology

, Volume 26, Issue 1, pp 227–232 | Cite as

Stress-induced alteration of left ventricular eccentricity: An additional marker of multivessel CAD

  • Alessia Gimelli
  • Riccardo LigaEmail author
  • Assuero Giorgetti
  • Mirta Casagranda
  • Paolo Marzullo
Brief Report



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).


Post-stress alterations of LV EI on MPI may unmask the presence of multivessel CAD.


Left ventricular remodeling eccentricity index gated SPECT CZT ejection fraction 





Single-photon emission computed tomography


Eccentricity index


Myocardial perfusion imaging



The authors have no conflicts of interest to disclose.

Supplementary material

12350_2017_862_MOESM1_ESM.doc (44 kb)
Supplementary material 1 (DOC 44 kb)
12350_2017_862_MOESM2_ESM.doc (46 kb)
Supplementary material 2 (DOC 46 kb)
12350_2017_862_MOESM3_ESM.ppt (102 kb)
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 (206 kb)
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)
12350_2017_862_MOESM5_ESM.ppt (264 kb)
Supplementary material 5 (PPT 267 kb)


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Copyright information

© American Society of Nuclear Cardiology 2017

Authors and Affiliations

  • Alessia Gimelli
    • 1
  • Riccardo Liga
    • 2
    Email author
  • Assuero Giorgetti
    • 1
  • Mirta Casagranda
    • 1
  • Paolo Marzullo
    • 1
    • 3
  1. 1.Fondazione Toscana G. MonasterioPisaItaly
  2. 2.Cardio-Thoracic and Vascular DepartmentUniversity Hospital of PisaPisaItaly
  3. 3.CNR, Institute of Clinical PhysiologyPisaItaly

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