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Updated: Jul 4, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Non-invasive detection of ischemic left ventricular dysfunction using rest gated SPECT: expectation of simultaneous
Hirofumi Maeba1, Kazuya Takehana, Seishi Nakamura
1Division of Cardiology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka, Japan. maebah@hirakata.kmu.ac.jp
Insights
Quantitative gated single-photon emission computed tomography (QGS) effectively distinguishes ischemic left ventricular (LV) dysfunction from other causes in patients with severe LV dysfunction. This non-invasive method assesses both myocardial perfusion and wall motion abnormalities.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Accurate detection of ischemic etiology is crucial for managing severe left ventricular (LV) dysfunction.
- Non-invasive strategies for determining ischemic etiology in severe LV dysfunction are challenging.
Purpose of the Study:
- To investigate the utility of quantitative gated single-photon emission computed tomography (QGS) at rest.
- To determine if perfusion and regional functional abnormalities identified by QGS can detect ischemic LV dysfunction in patients with severe LV dysfunction.
Main Methods:
- Rest QGS using (99m)Tc-tetrofosmin was performed on 54 patients with LV ejection fraction ≤40%.
- Ischemic LV dysfunction was defined using established standards.
- Regional perfusion and wall motion were assessed using a 14-segment model and compared to a normal control group.
Main Results:
- The number of hypoperfused segments was significantly higher in ischemic LV dysfunction patients (9.3 ± 3.8) compared to non-ischemic patients (2.0 ± 2.8).
- A cut-off of 4 hypoperfused segments provided 88% sensitivity and 91% specificity for differentiating ischemic from non-ischemic LV dysfunction.
- Patients with non-ischemic LV dysfunction had no severely hypoperfused segments, while ischemic patients had 4.4 ± 0.2.
Conclusions:
- Rest QGS can accurately differentiate ischemic LV dysfunction from other causes in patients with severe LV dysfunction.
- Simultaneous regional evaluation of myocardial perfusion and wall motion by QGS is effective.
Objective:
Although the accurate detection of ischemic etiology is important in the management of patients with severe left ventricular (LV) dysfunction, it is difficult to determine using a non-invasive strategy. The present study investigates whether perfusion and regional functional abnormalities identified by quantitative electrocardiographic gated single-photon emission computed tomography (QGS) at rest can detect ischemic LV dysfunction in patients with severe LV dysfunction.
Methods:
Rest QGS with (99m)Tc-tetrofosmin was performed on 54 consecutive patients with LV ejection fraction of
Results:
The numbers of reduced [mean -1 standard deviation (SD) of normal individuals] and severely reduced (mean -2 SD) wall motion segments were similar between patients with ischemic and non-ischemic LV dysfunction (13.5 +/- 1.1 vs. 13.6 +/- 0.9 and 10.6 +/- 2.0 vs. 9.9 +/- 3.0 segments, respectively). The number of hypoperfused (mean -1 SD) segments was significantly greater in patients with ischemic LV dysfunction than in those with non-ischemic LV dysfunction (9.3 +/- 3.8 vs. 2.0 +/- 2.8 segments, P < 0.0001). The analysis of the receiver operating characteristics showed that a cut-off value of 4 hypoperfused segments among 14 segments provided the best separation between ischemic and non-ischemic LV dysfunction (sensitivity = 88% and specificity = 91%). Furthermore, patients with non-ischemic LV dysfunction had no severely hypoperfused (mean -2 SD) segments in any of the segments, whereas patients with ischemic LV dysfunction had 4.4 +/- 0.2 segments.
Conclusions:
The QGS strategy at rest can accurately differentiate patients with ischemic LV dysfunction from those with severe LV dysfunction by simultaneous regional evaluation of wall motion and myocardial perfusion.
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