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Updated: Jun 6, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
The relation between left ventricular ejection fraction and perfusion defect size by gated SPECT myocardial perfusion
W Aljaroudi1, M Mundkur, J Heo
1Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294-0006, USA. wjaroudi@hotmail.com
Insights
Left ventricular ejection fraction (EF) and perfusion defect size (PDS) show a moderate correlation in coronary artery disease (CAD) patients. This finding supports their independent prognostic value in cardiovascular disease assessment.
Area of Science:
- Cardiology
- Medical Imaging
- Prognostics
Background:
- Left ventricular ejection fraction (EF) and perfusion defect size (PDS) are key prognostic indicators in coronary artery disease (CAD).
- These metrics offer independent and complementary prognostic information for patients with CAD.
Purpose of the Study:
- To investigate the correlation between left ventricular ejection fraction (EF) and perfusion defect size (PDS) in patients with CAD.
- To understand the relationship between these cardiac function and myocardial damage indicators.
Main Methods:
- Automated programs were used to measure LVEF and PDS in 96 consecutive CAD patients with abnormal perfusion scans.
- PDS was quantified as a percentage of the left ventricular myocardium, categorized into total, fixed, or reversible defects.
Main Results:
- A moderate but statistically significant negative correlation was observed between EF and total PDS (r=-0.46) and fixed PDS (r=-0.45).
- No significant correlation was found between EF and reversible PDS.
- Stronger correlations were noted between EF and left ventricular volumes (EDV and ESV) than with PDS.
Conclusions:
- The statistically significant but moderate correlation between PDS and EF supports their independent prognostic value.
- This finding reinforces the clinical utility of both PDS and EF measurements in assessing patient outcomes.
- The study also highlights the prognostic importance of left ventricular volume measurements.
Aim:
Left ventricular (LV) ejection fraction (EF) and perfusion defect size (PDS) provide independent and incremental prognostic information in patients with coronary artery disease (CAD). The purpose of this study was to examine the correlation between EF and PDS.
Methods:
LVEF and PDS were measured in 96 consecutive patients with CAD and abnormal perfusion scan using well-validated automated programs. The PDS was expressed as % of LV myocardium as total (reversible plus fixed), fixed or reversible.
Results:
The EF was 49±15% (range 17-84), the total PDS was 29±15% (2-77) and the fixed PDS was 20±13% (2-58). The end-diastolic volume (EDV) was 131±59 mL (29-342) and end-systolic volume (ESV) was 72±51 mL (4-283). There were moderate but significant correlations between EF and total PDS (r=-0.46, P<0.0001) and fixed PDS (r=-0.45, P<0.0001) but not with reversible PDS. In the subgroup analysis, the correlations were stronger in patients with history of prior coronary artery bypass grafting than without, and higher in men than women. The highest correlations were seen between EF and EDV in both men and women (r=-0.68 and -0.74 respectively, P<0.0001 each), and between EF and ESV (r =-0.80, P<0.0001).
Conclusion:
Although there is a statistically significant correlation between PDS and EF, the correlation is not strong. This observation provides supportive evidence of why PDS and EF provide incremental prognostic information. It also supports the incremental prognostic merits of LV volume measurements.
