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Updated: May 27, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Does location matter? Prognostic value of single-photon emission computed tomography myocardial perfusion imaging by
Hanna B Slim1, Sanjeev U Nair, Sabeena Arora
1Nuclear Cardiology Laboratory, Henry Low Heart Center, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA. janoslim@hotmail.com
Insights
The location of myocardial perfusion abnormalities on SPECT imaging does not impact future cardiac events. This finding suggests that defect location may not be a critical factor in clinical decision-making for patients with coronary artery disease.
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Myocardial perfusion abnormalities can influence clinical decisions, particularly when the left anterior descending artery (LAD) territory is involved.
- Assessing the impact of defect location on patient outcomes is crucial for refining diagnostic and treatment strategies.
Purpose of the Study:
- To investigate whether the location of myocardial perfusion abnormalities identified by single-photon emission computed tomography (SPECT) impacts patient outcomes.
- To determine if SPECT defect location influences cardiac event rates in patients with suspected or known coronary artery disease.
Main Methods:
- Retrospective analysis of 21,294 patients undergoing stress SPECT over 10 years.
- Utilized the ASNC 17-segment model for image interpretation, assessing defect severity, size, and reversibility.
- Correlated summed stress scores (SSS) with vascular territories (LAD, RCA, LCx) and tracked cardiac events (death, myocardial infarction) over a mean of 2.5 years.
Main Results:
- No significant difference in cardiac event-free survival was observed between LAD, RCA, and LCx defect locations in patients with single-vessel territory defects (P = .235).
- Outcomes remained similar across mild, moderate, and severe SSS categories regardless of defect location.
- Patients with two-vessel territory defects showed similar outcomes whether or not the LAD territory was involved (P = .558).
Conclusions:
- The location of myocardial perfusion defects on SPECT imaging does not appear to influence future cardiac events in patients with single- or two-vessel territory abnormalities of similar defect size and severity.
- Current findings suggest that SPECT defect location may not be a significant factor in guiding clinical decisions for managing coronary artery disease.
Background:
The location of a myocardial perfusion abnormality frequently affects clinical decision making, especially if the left anterior descending artery (LAD) territory is involved. The purpose of this study was to determine whether the location of abnormalities on single-photon emission computed tomography (SPECT) imaging affects outcomes.
Methods:
We retrospectively analyzed 21,294 consecutive patients with known or suspected coronary artery disease who underwent exercise or pharmacological stress SPECT over a 10-year period. Using the ASNC 17-segment model, 2 observers interpreted images with regards to defect severity, size, and reversibility. The summed stress score (SSS) was used in relation to vascular territories [LAD, right coronary artery (RCA), and left circumflex artery (LCx)]. All patients were followed over a mean period of 2.5 ± 2 years for cardiac events (cardiac death or non-fatal myocardial infarction).
Results:
Of the enrolled patients, 5,676 had single-vessel territory defects with a mean SSS of 4.3 ± 2.8. Cardiac event-free survival curves revealed no significant difference between the 3 locations (LAD, RCA, and LCx) (P = .235). When compared by mild (2-3), moderate (4-8), or severe (>8) SSS, outcomes between the 3 groups were again similar. There were 2,907 patients with two-vessel territory defects with a mean SSS of 10.8. Outcomes were similar between the following 2 groups: two-vessel with LAD involvement and two-vessel without LAD involvement (P = .558).
Conclusion:
In patients with single- or two-vessel territory perfusion abnormalities with similar size and severity of perfusion defects, the location of defect did not impact future cardiac events. Location of myocardial perfusion defect on SPECT imaging may not be helpful in clinical decision making.
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