Journal of Nuclear Cardiology

, Volume 25, Issue 2, pp 609–615 | Cite as

Association between non-perfusion parameters and presence of ischemia in gated-SPECT myocardial perfusion imaging studies

  • Amalia Peix
  • Lázaro O. Cabrera
  • Kenia Padrón
  • Lydia Rodríguez
  • Jesús Fernández
  • Giselle López
  • Regla Carrillo
  • Erick Mena
  • Yoel Fernández
  • Maurizio Dondi
  • Diana Páez
Original Article
  • 138 Downloads

Abstract

Background

Combined assessment of perfusion and function improves diagnostic and prognostic power of gated-SPECT in patients with coronary artery disease. The aim of this study was to investigate whether the presence of stress-induced ischemia is associated with abnormal resting left ventricular (LV) function and intraventricular dyssynchrony.

Methods and Results

Gated-SPECT myocardial perfusion imaging (MPI) at rest and 15 min post-stress was performed in 101 patients, who were divided into three groups: those with stress-induced ischemia (Group 1, n = 58), those with normal scans (Group 2, n = 28), and those with scar but no ischemia (Group 3, n = 15). More extensive perfusion defects were found in patients of Groups 1 and 3 [Summed stress score (SSS): 13 ± 8 and 21 ± 9, respectively]. In Group 2, the mean SSS was 1.5. The mean change in LV ejection fraction (LVEF at stress − LVEF at rest) was higher in Group 1 v. Group 2 patients: −5.54% ± 6.24% vs −2.46% ± 5.56%, p = 0.02. Group 3 patients also had higher values, similar to Group 1: −6.47% ± 8.82%. Patients with ischemia had almost 50% higher end-diastolic volumes than patients with normal MPI. Similarly, end-systolic volumes were almost twice as high in this group (p < 0.0001). In addition, the histogram bandwidth, a measure of intraventricular dyssynchrony, was greater in Group 1.

Conclusions

Baseline differences in left ventricular volumes and degree of dyssynchrony are associated with inducible ischemia on stress testing in a gated-SPECT MPI. Stress-induced ischemia increases the degree of intraventricular dyssynchrony.

Keywords

Myocardial perfusion imaging left ventricular ejection fraction intraventricular synchrony ischemia gated-SPECT 

Abbreviations

CAD

Coronary artery disease

EDV

End-diastolic volume

ESV

End-systolic volume

HBW

Histogram bandwidth

LVEF

Left ventricular ejection fraction

MI

Myocardial infarction

MPI

Myocardial perfusion imaging

PCI

Percutaneous coronary intervention

PSD

Phase standard deviation

SDS

Summed difference score

SSS

Summed stress score

SRS

Summed rest score

SPECT

Single photon emission computed tomography

99 mTc-MIBI

Technetium-99m methoxy isobutyl isonitrile

Notes

Acknowledgements

This study is part of and was partially funded from the International Atomic Energy Agency (IAEA) Coordinated Research Protocol E1.30.34. We are grateful to Raymond Russell, MD, PhD, for his suggestions and careful review of the manuscript, as well as to Adrienne Hunter, PhD, for her contribution in reviewing.

Disclosure

There is no conflict of interest.

Supplementary material

12350_2016_728_MOESM1_ESM.pptx (275 kb)
Supplementary material 1 (PPTX 274 kb)

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Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  • Amalia Peix
    • 1
    • 3
  • Lázaro O. Cabrera
    • 1
  • Kenia Padrón
    • 1
  • Lydia Rodríguez
    • 1
  • Jesús Fernández
    • 1
  • Giselle López
    • 1
  • Regla Carrillo
    • 1
  • Erick Mena
    • 1
  • Yoel Fernández
    • 1
  • Maurizio Dondi
    • 2
  • Diana Páez
    • 2
  1. 1.Institute of CardiologyHavanaCuba
  2. 2.Nuclear Medicine and Diagnostic Imaging Section, Division of Human HealthInternational Atomic Energy AgencyViennaAustria
  3. 3.Nuclear Medicine DepartmentInstitute of CardiologyHavanaCuba

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