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Ventricular function following coronary artery bypass grafting: comparison between gated SPECT and cardiac magnetic
Cláudio Tinoco Mesquita1, Maria Carolina Pinheiro Pessoa, Paulo Pontes Vasconcelos
1Serviço de Medicina Nuclear, Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brasil. claudiotinoco@globo.com
Insights
Electrocardiogram-gated SPECT reliably assesses left ventricular ejection fraction after coronary artery bypass grafting (CABG). However, gated SPECT shows inadequate correlation for ventricular volumes in these patients.
Area of Science:
- Cardiovascular Imaging
- Nuclear Cardiology
- Cardiac MRI
Background:
- Assessing left ventricular function post-coronary artery bypass grafting (CABG) is challenging due to abnormal septal motion.
- Validation studies for gated SPECT in this specific patient group are limited.
Purpose of the Study:
- To evaluate the agreement and correlation of left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) using gated SPECT versus cardiac magnetic resonance imaging (CMR).
- To assess the utility of gated SPECT for left ventricular function assessment in CABG patients.
Main Methods:
- Twenty patients undergoing CABG were included.
- Spearman's correlation coefficient (rho) was used to measure correlation.
- Bland-Altman analysis was employed to assess agreement between gated SPECT and CMR.
Main Results:
- Gated SPECT demonstrated good correlation with CMR for LVEF (rho = 0.85, p = 0.0001).
- Moderate correlation was observed for EDV (rho = 0.51, p = 0.02).
- Non-significant correlation was found for ESV (rho = 0.13, p = 0.5).
Conclusions:
- Gated SPECT provides a reliable assessment of LVEF in patients after CABG when compared to CMR.
- The correlation for ventricular volumes (EDV and ESV) between gated SPECT and CMR is not adequate for clinical use.
Background:
The assessment of left ventricular function may be impaired by the abnormal interventricular septal motion frequently found after coronary artery bypass grafting (CABG). Studies on the validation of gated SPECT as a tool for the assessment of left ventricular function in this patient group are scarce.
Objective:
We investigated the agreement and correlation between left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) as obtained using electrocardiogram-gated myocardial perfusion scintigraphy (gated SPECT) and cardiac magnetic resonance imaging in 20 patients undergoing coronary artery bypass grafting.
Methods:
Correlation was measured using Spearman's correlation coefficient (rho). Agreement was assessed using Bland-Altman analysis.
Results:
A good correlation was found between gated SPECT and cardiac magnetic resonance imaging in patients after CABG with regard to left ventricular ejection fraction (rho = 0.85; p =0.0001), moderate correlation for end-diastolic volume (rho = 0.51; p = 0.02), and non-significant correlation for end-diastolic volume (rho = 0.13; p = 0.5). Agreement ranges for LVEF, ESV and EDV were: -20% to 12%; -38 to 54 ml and; -96 to 100 ml, respectively.
Conclusion:
A reliable correlation was found for left ventricular ejection fraction as obtained by gated SPECT and magnetic resonance imaging in patients undergoing CABG. For ventricular volumes, however, the correlation is not adequate.
