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Updated: Apr 17, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
A multi-center assessment of the temporal trends in myocardial perfusion imaging
W Lane Duvall1, Mridula Rai, Alan W Ahlberg
1Division of Cardiology, Henry Low Heart Center, Hartford Hospital, 80 Seymour Streeet, Hartford, CT, 06102, USA, lane.duvall@hhchealth.org.
Insights
Abnormal myocardial perfusion imaging (MPI) and obstructive coronary artery disease (CAD) prevalence declined between 1996-2012, despite rising cardiac risk factors. However, significant rates persist, indicating ongoing clinical relevance.
Area of Science:
- Cardiology
- Nuclear Cardiology
- Interventional Cardiology
Background:
- Recent literature indicates a decrease in abnormal SPECT myocardial perfusion imaging (MPI) frequency over two decades.
- This trend occurred despite a rise in prevalent cardiac risk factors like hypertension, hyperlipidemia, and diabetes.
- This study investigates trends in obstructive coronary artery disease (CAD) using MPI and invasive angiography.
Purpose of the Study:
- To examine temporal trends in abnormal and ischemic MPI prevalence.
- To assess changes in obstructive coronary artery disease (CAD) prevalence via invasive angiography.
- To evaluate the relationship between cardiac risk factors and these imaging findings over time.
Main Methods:
- Analysis of patients undergoing stress MPI or invasive angiography at two academic centers (1996-2012).
- Inclusion of demographic data, cardiac risk factors, and study results.
- Statistical analysis of trends in imaging and angiography findings.
Main Results:
- A decline in abnormal MPI prevalence from 47.2% in 1996 to 33.9% in 2012 was observed.
- Ischemic MPI prevalence also decreased significantly over the study period.
- Obstructive coronary artery disease (CAD) prevalence on angiography declined, with one-vessel disease from 29.1% to 22.4% and multi-vessel disease from 53.6% to 35.9%.
Conclusions:
- A temporal decline in abnormal/ischemic MPI and obstructive CAD prevalence was confirmed.
- The observed decline was less pronounced than previously reported.
- Significant rates of abnormal MPI (34% overall, 19% in no-CAD, 65% in known-CAD) remain clinically relevant.
Background:
Recent literature suggests that the frequency of abnormal SPECT myocardial perfusion imaging (MPI) has decreased over the past two decades despite an increase in the prevalence of many cardiac risk factors. This study examined the trends in the prevalence of obstructive coronary artery disease (CAD) by abnormal and ischemic MPI and invasive angiography.
Methods:
We analyzed all patients who underwent stress MPI or invasive angiography at two academic centers between January 1996 and December 2012, for their demographic data and study results.
Results:
A total of 108,654 MPI studies were performed. Over time, the percentage of patients with hypertension, hyperlipidemia, diabetes, and a history of smoking increased. There was a decline in the prevalence of abnormal MPI studies in all patients as well as in those with and without known CAD (from 47.2%, 71.8%, and 31.4% in 1996 to 33.9%, 64.8%, and 18.8% in 2012, respectively, all P < .0001). Similarly, there was a decline in the prevalence of ischemic MPI studies in all patients as well as in those with and without known CAD. A total of 142,924 invasive angiograms were performed. There was a decline in the prevalence of one-vessel and multi-vessel coronary disease (from 29.1% and 53.6% in 1996 to 22.4% and 35.9% in 2012, respectively, all P < .0001).
Conclusions:
There has been a temporal decline in the prevalence of abnormal and ischemic MPI studies as well as the frequency and extent of obstructive CAD on angiography. However, this decline was not to the same extent as previously reported, and the overall 34% abnormal MPI rate, with 19% in patients with no known CAD and 65% in patients with known CAD, remains a clinically relevant percentage of patients tested.
