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

摘要

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 ? 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.