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Updated: Mar 11, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Association between non-perfusion parameters and presence of ischemia in gated-SPECT myocardial perfusion imaging
Amalia Peix1,2, Lázaro O Cabrera3, Kenia Padrón3
1Institute of Cardiology, Havana, Cuba. peix@infomed.sld.cu.
Insights
Stress-induced ischemia in coronary artery disease is linked to abnormal resting left ventricular function and dyssynchrony. Gated-SPECT myocardial perfusion imaging reveals these associations, improving diagnostic insights.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Combined assessment of myocardial perfusion and function enhances gated-SPECT's diagnostic and prognostic power in coronary artery disease.
- Investigating the relationship between stress-induced ischemia and abnormal resting left ventricular (LV) function and intraventricular dyssynchrony is crucial.
Purpose of the Study:
- To determine if stress-induced ischemia correlates with impaired resting LV function.
- To assess the association between stress-induced ischemia and intraventricular dyssynchrony.
- To evaluate the utility of gated-SPECT myocardial perfusion imaging (MPI) in identifying these associations.
Main Methods:
- 101 patients underwent gated-SPECT MPI at rest and post-stress.
- Patients were categorized into three groups: stress-induced ischemia, normal scans, and scar without ischemia.
- Analysis included Summed Stress Score (SSS), LV ejection fraction (LVEF) changes, LV volumes, and histogram bandwidth for dyssynchrony.
Main Results:
- Patients with ischemia (Group 1) and scar (Group 3) exhibited more extensive perfusion defects (higher SSS) compared to normal scans (Group 2).
- A significant decrease in LVEF from rest to stress was observed in patients with ischemia (-5.54% ± 6.24%) versus normal scans (-2.46% ± 5.56%).
- Patients with ischemia showed significantly larger end-diastolic and end-systolic volumes and increased histogram bandwidth, indicating greater intraventricular dyssynchrony.
Conclusions:
- Abnormal resting left ventricular volumes and dyssynchrony are associated with inducible ischemia detected by gated-SPECT MPI.
- Stress-induced ischemia exacerbates intraventricular dyssynchrony, highlighting the importance of assessing both perfusion and function.
Background:
Combined assessment of perfusion and function improves diagnostic and prognostic power of gated-SPECT in patients with coronary artery disease. The aim of this study was to investigate whether the presence of stress-induced ischemia is associated with abnormal resting left ventricular (LV) function and intraventricular dyssynchrony.
Methods And Results:
Gated-SPECT myocardial perfusion imaging (MPI) at rest and 15 min post-stress was performed in 101 patients, who were divided into three groups: those with stress-induced ischemia (Group 1, n = 58), those with normal scans (Group 2, n = 28), and those with scar but no ischemia (Group 3, n = 15). More extensive perfusion defects were found in patients of Groups 1 and 3 [Summed stress score (SSS): 13 ± 8 and 21 ± 9, respectively]. In Group 2, the mean SSS was 1.5. The mean change in LV ejection fraction (LVEF at stress - LVEF at rest) was higher in Group 1 v. Group 2 patients: -5.54% ± 6.24% vs -2.46% ± 5.56%, p = 0.02. Group 3 patients also had higher values, similar to Group 1: -6.47% ± 8.82%. Patients with ischemia had almost 50% higher end-diastolic volumes than patients with normal MPI. Similarly, end-systolic volumes were almost twice as high in this group (p < 0.0001). In addition, the histogram bandwidth, a measure of intraventricular dyssynchrony, was greater in Group 1.
Conclusions:
Baseline differences in left ventricular volumes and degree of dyssynchrony are associated with inducible ischemia on stress testing in a gated-SPECT MPI. Stress-induced ischemia increases the degree of intraventricular dyssynchrony.
