Impact of specific coronary lesions on regional ischemia at single photon emission computed tomography

Francesco Nudi, Orazio Schilllaci, Giuseppe Biondi-Zoccai, Annamaria Pinto, Giandomenico Neri, Enrica Procaccini, Francesco Versaci, Alessandro Nudi, Fabrizio Tomai, Giacomo Frati, Ami E. Iskandrian

Research output: Contribution to journalArticlepeer-review

Abstract

AIMS: Prior studies using stress myocardial perfusion imaging (MPI), which examined the association between obstructive epicardial coronary disease and presence of myocardial ischemia did not provide a detailed assessment on a regional level. We examined this relationship in a large population of patients in whom the coronary anatomy was defined by invasive coronary angiography. METHODS: We retrospectively extracted details on individuals undergoing MPI with single photon emission computed tomography (SPECT) who had coronary angiography within 12 months. A 17-segment model for native coronary anatomy and a 7-region model for myocardial perfusion were used with a dedicated matching algorithm. RESULTS: A total of 2564 patients were included, yielding a total of 6279 stenoses matched with 17 948 myocardial regions. From such a cohort, 151 (5.9%) patients had normal perfusion, 1878 (73.2%) had myocardial ischemia (reversible defects), 260 (10.1%) had myocardial necrosis (scar or fixed defects), and 275 (10.7%) had ischemia and necrosis. At per-patient analysis, significant angiographic disease was more common in the ischemic group (prevalence between 69.6 and 80.0%) than other groups. At per-region analysis, abnormal perfusion in the coronary-specific regions varied depending on location of stenosis; it was 96% for left main disease, 81% for proximal left anterior descending disease, 85% for proximal left circumflex disease, and 82% for proximal right coronary artery disease and <60% for posterior descending artery disease. CONCLUSION: The correlation between significant coronary stenosis and presence of corresponding regional perfusion abnormality depends on the location of the lesion and the corresponding myocardial region.

Original languageEnglish
Pages (from-to)329-336
Number of pages8
JournalJournal of cardiovascular medicine (Hagerstown, Md.)
Volume19
Issue number7
DOIs
Publication statusPublished - Jul 1 2018

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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