Heart failure diagnostics based on ventilation/perfusion single photon emission computed tomography pattern and...

Area of Science:

• Nuclear Medicine
• Cardiology
• Radiology

Background:

• Left heart failure (LHF) is frequently overlooked due to diagnostic limitations.
• Early diagnosis of LHF is crucial for timely treatment initiation.
• Ventilation/perfusion single photon emission computed tomography (V/P SPECT) shows potential in LHF detection.

Purpose of the Study:

• To evaluate the efficacy of V/P SPECT in diagnosing LHF.
• To develop and assess objective parameters, specifically perfusion gradients, for LHF diagnosis.
• To test the hypothesis that V/P SPECT can diagnose LHF.

Main Methods:

• Retrospective analysis of 247 patients with suspected pulmonary embolism (PE) who underwent V/P SPECT.
• Quantification of perfusion gradients in dorso-ventral and cranio-caudal directions.
• Comparison of quantitative results with visual interpretation and clinical follow-up for heart failure confirmation.

Main Results:

• LHF pattern identified in 15% of patients (36/247) via V/P SPECT.
• Heart failure diagnosis confirmed in 88% of cases with LHF pattern upon follow-up.
• Dorso-ventral perfusion gradients effectively differentiated LHF from normal patterns.

Conclusions:

• LHF is a common condition in patients with suspected PE.
• V/P SPECT pattern recognition, aided by dorso-ventral perfusion gradients, enables LHF diagnosis.
• A positive dorso-ventral perfusion gradient warrants consideration of LHF.