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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

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Role of Myocardial Perfusion Study in Differentiating Ischemic versus Nonischemic Cardiomyopathy Using Quantitative

Preeti Singh1, Bhairavi Bhatt2, Shwetal U Pawar1

  • 1Department of Nuclear Medicine and PET-CT, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.

Indian Journal of Nuclear Medicine : IJNM : the Official Journal of the Society of Nuclear Medicine, India
|February 13, 2018
PubMed

Insights

Myocardial perfusion imaging (MPI) effectively differentiates ischemic (ICM) and non-ischemic (NICM) cardiomyopathy using quantitative parameters. This noninvasive tool offers precise diagnostic information for improved patient management.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Diagnostic Imaging

Background:

  • Dilated cardiomyopathy presents clinically similar for both ischemic (ICM) and non-ischemic (NICM) causes.
  • Accurate differentiation is crucial as ICM and NICM have distinct management strategies and prognoses.
  • Myocardial perfusion imaging (MPI) is explored as a tool to distinguish between these etiologies.

Purpose of the Study:

  • To evaluate the efficacy of quantitative myocardial perfusion imaging (MPI) in differentiating between ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM) in the Indian population.
  • To assess the diagnostic performance of MPI parameters against coronary angiography (CAG) as the gold standard.

Main Methods:

  • Fifty patients underwent prospective myocardial perfusion imaging (MPI) and 18F-fluorodeoxyglucose metabolism studies.
  • Quantitative parameters including left ventricular ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), summed rest score (SRS), and summed difference score (SDS) were analyzed.
  • Correlation with 6-month clinical outcomes (hospital admission, management changes, death) and comparison with coronary angiography (CAG) were performed.

Main Results:

  • MPI demonstrated moderate agreement (κ = 0.463) with CAG in differentiating ICM and NICM.
  • Sensitivity and specificity for ICM were 79.31% and 66.67%, respectively; for NICM, they were 66.67% and 79.31%.
  • Significant differences were observed in EDV (rest and stress), ESV (rest), SRS, EF (rest), and SDS between ICM and NICM groups (P < 0.05).

Conclusions:

  • Quantitative MPI parameters, including EDV, ESV, SRS, SDS, and EF, provide precise information to differentiate ICM from NICM.
  • MPI is a noninvasive, objective, and readily available diagnostic tool with favorable sensitivity, specificity, and accuracy.
  • The study supports MPI as a preferable diagnostic modality for distinguishing ICM and NICM due to its ease of use and low complication rate.
Abstract

Keywords:
Cardiac viabilityheart failureischemic cardiomyopathymyocardial perfusion imagingnonischemic cardiomyopathy

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