Global and regional left ventricular function: a comparison between gated SPECT, 2D echocardiography and multi-slice...

Area of Science:

• Cardiovascular Imaging
• Radiology
• Cardiac Diagnostics

Background:

• Left ventricular (LV) function is crucial for assessing cardiac status in coronary artery disease (CAD).
• Non-invasive assessment of coronary arteries using multi-slice computed tomography (MSCT) is established.
• Retrospective ECG-gating in MSCT allows for derivation of LV function data.

Purpose of the Study:

• To evaluate the capability of MSCT in assessing global and regional LV function and volumes in patients with CAD.
• To compare the accuracy of MSCT-derived LV function parameters with those obtained from gated SPECT and 2D echocardiography.

Main Methods:

• Coronary angiography with MSCT was performed in 49 patients with known or suspected CAD.
• LV end-diastolic volume, LV end-systolic volume, and LV ejection fraction were analyzed using dedicated software.
• Regional wall motion was assessed using a 17-segment model and a three-point score system, compared against gated SPECT and 2D echocardiography.

Main Results:

• MSCT demonstrated good correlations with gated SPECT for LV volumes (r=0.63-0.65) and ejection fraction (r=0.60).
• MSCT showed excellent correlations with 2D echocardiography for LV volumes (r=0.92-0.93) and ejection fraction (r=0.80).
• Agreement for regional wall motion was high between MSCT and 2D echocardiography (96%, kappa=0.73) and gated SPECT (95%, kappa=0.66).

Conclusions:

• MSCT is an adequate imaging modality for assessing global and regional LV function and volumes in CAD patients.
• The correlation between MSCT and 2D echocardiography for LV function assessment is stronger than that with gated SPECT.