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

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

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.

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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

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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.

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Authors and Affiliations

  1. Institute of Cardiology, Havana, Cuba

    Amalia Peix MD, PhD, FACC, Lázaro O. Cabrera MD, Kenia Padrón MD, Lydia Rodríguez BSc, Jesús Fernández MD, Giselle López MD, Regla Carrillo NMT, Erick Mena BSc & Yoel Fernández BSc

  2. Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria

    Maurizio Dondi MD & Diana Páez MD

  3. Nuclear Medicine Department, Institute of Cardiology, 17 No. 702, Vedado, CP 10 400, Havana, Cuba

    Amalia Peix MD, PhD, FACC

Authors
  1. Amalia Peix MD, PhD, FACC
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  2. Lázaro O. Cabrera MD
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  3. Kenia Padrón MD
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  4. Lydia Rodríguez BSc
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Corresponding author

Correspondence to Amalia Peix MD, PhD, FACC.

Additional information

Funding This study constitutes part of an IAEA multicenter study.

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Peix, A., Cabrera, L.O., Padrón, K. et al. Association between non-perfusion parameters and presence of ischemia in gated-SPECT myocardial perfusion imaging studies. J. Nucl. Cardiol. 25, 609–615 (2018). https://doi.org/10.1007/s12350-016-0728-4

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  • DOI: https://doi.org/10.1007/s12350-016-0728-4

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