Relationships between myocardial perfusion abnormalities and poststress left ventricular functional impairment on cadmium-zinc-telluride imaging

Alessia Gimelli, Riccardo Liga, Assuero Giorgetti, Annette Kusch, Emilio Maria Pasanisi, Paolo Marzullo

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: To evaluate the interplay between myocardial ischaemic burden and poststress left ventricular (LV) systolic and diastolic abnormalities in patients with suspected or known coronary artery disease (CAD). Methods: A total of 471 patients underwent myocardial perfusion imaging by cadmium-zinc-telluride scintigraphy and coronary angiography. A fast imaging protocol was used with stress imaging performed 10 – 15 min after tracer injection. The summed difference score (SDS) and the percent stress-to-rest ratios for LV ejection fraction and peak filling rate (PFR), measures of stress-induced systolic and diastolic impairment, were computed from scintigraphic images. A SDS of >3 was considered abnormal and >7 a marker of moderate-to-severe ischaemia. Results: Of the 471 patients, 321 (68 %) showed significant CAD in one (27 %), two (23 %) or three (18 %) vessels. The extent of CAD associated with gradual alterations in SDS (P <0.001). Interestingly, while impairment in the percent stress-to-rest PFR ratio paralleled the increase in the extent of CAD (P <0.001 for trend), the occurrence of significant stress-induced systolic dysfunction was limited to patients with multivessel disease (P <0.001 vs. patients without CAD, and P = 0.002 vs. patients with single-vessel disease). Similarly, while a strict correlation between percent stress-to-rest PFR ratio and myocardial ischaemic burden was evident (P <0.001), significant stress-induced LV systolic impairment was limited to patients with moderate-to-severe ischaemia (P <0.001 vs. patients with no or mild ischaemia). Conclusion: Stress-induced LV diastolic impairment is associated with a less extensive ischaemic burden and CAD extent than poststress systolic dysfunction, which is limited to patients with multivessel CAD.

Original languageEnglish
Pages (from-to)994-1003
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume42
Issue number7
DOIs
Publication statusPublished - Jun 1 2015

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Perfusion
Coronary Artery Disease
Ischemia
CdZnTe
Myocardial Perfusion Imaging
Coronary Angiography
Radionuclide Imaging
Stroke Volume
Injections

Keywords

  • Cadmium-zinc-telluride
  • Diastolic dysfunction
  • Ischaemic cascade
  • Myocardial perfusion imaging
  • Systolic dysfunction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Relationships between myocardial perfusion abnormalities and poststress left ventricular functional impairment on cadmium-zinc-telluride imaging. / Gimelli, Alessia; Liga, Riccardo; Giorgetti, Assuero; Kusch, Annette; Pasanisi, Emilio Maria; Marzullo, Paolo.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 42, No. 7, 01.06.2015, p. 994-1003.

Research output: Contribution to journalArticle

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abstract = "Purpose: To evaluate the interplay between myocardial ischaemic burden and poststress left ventricular (LV) systolic and diastolic abnormalities in patients with suspected or known coronary artery disease (CAD). Methods: A total of 471 patients underwent myocardial perfusion imaging by cadmium-zinc-telluride scintigraphy and coronary angiography. A fast imaging protocol was used with stress imaging performed 10 – 15 min after tracer injection. The summed difference score (SDS) and the percent stress-to-rest ratios for LV ejection fraction and peak filling rate (PFR), measures of stress-induced systolic and diastolic impairment, were computed from scintigraphic images. A SDS of >3 was considered abnormal and >7 a marker of moderate-to-severe ischaemia. Results: Of the 471 patients, 321 (68 {\%}) showed significant CAD in one (27 {\%}), two (23 {\%}) or three (18 {\%}) vessels. The extent of CAD associated with gradual alterations in SDS (P <0.001). Interestingly, while impairment in the percent stress-to-rest PFR ratio paralleled the increase in the extent of CAD (P <0.001 for trend), the occurrence of significant stress-induced systolic dysfunction was limited to patients with multivessel disease (P <0.001 vs. patients without CAD, and P = 0.002 vs. patients with single-vessel disease). Similarly, while a strict correlation between percent stress-to-rest PFR ratio and myocardial ischaemic burden was evident (P <0.001), significant stress-induced LV systolic impairment was limited to patients with moderate-to-severe ischaemia (P <0.001 vs. patients with no or mild ischaemia). Conclusion: Stress-induced LV diastolic impairment is associated with a less extensive ischaemic burden and CAD extent than poststress systolic dysfunction, which is limited to patients with multivessel CAD.",
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AU - Liga, Riccardo

AU - Giorgetti, Assuero

AU - Kusch, Annette

AU - Pasanisi, Emilio Maria

AU - Marzullo, Paolo

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N2 - Purpose: To evaluate the interplay between myocardial ischaemic burden and poststress left ventricular (LV) systolic and diastolic abnormalities in patients with suspected or known coronary artery disease (CAD). Methods: A total of 471 patients underwent myocardial perfusion imaging by cadmium-zinc-telluride scintigraphy and coronary angiography. A fast imaging protocol was used with stress imaging performed 10 – 15 min after tracer injection. The summed difference score (SDS) and the percent stress-to-rest ratios for LV ejection fraction and peak filling rate (PFR), measures of stress-induced systolic and diastolic impairment, were computed from scintigraphic images. A SDS of >3 was considered abnormal and >7 a marker of moderate-to-severe ischaemia. Results: Of the 471 patients, 321 (68 %) showed significant CAD in one (27 %), two (23 %) or three (18 %) vessels. The extent of CAD associated with gradual alterations in SDS (P <0.001). Interestingly, while impairment in the percent stress-to-rest PFR ratio paralleled the increase in the extent of CAD (P <0.001 for trend), the occurrence of significant stress-induced systolic dysfunction was limited to patients with multivessel disease (P <0.001 vs. patients without CAD, and P = 0.002 vs. patients with single-vessel disease). Similarly, while a strict correlation between percent stress-to-rest PFR ratio and myocardial ischaemic burden was evident (P <0.001), significant stress-induced LV systolic impairment was limited to patients with moderate-to-severe ischaemia (P <0.001 vs. patients with no or mild ischaemia). Conclusion: Stress-induced LV diastolic impairment is associated with a less extensive ischaemic burden and CAD extent than poststress systolic dysfunction, which is limited to patients with multivessel CAD.

AB - Purpose: To evaluate the interplay between myocardial ischaemic burden and poststress left ventricular (LV) systolic and diastolic abnormalities in patients with suspected or known coronary artery disease (CAD). Methods: A total of 471 patients underwent myocardial perfusion imaging by cadmium-zinc-telluride scintigraphy and coronary angiography. A fast imaging protocol was used with stress imaging performed 10 – 15 min after tracer injection. The summed difference score (SDS) and the percent stress-to-rest ratios for LV ejection fraction and peak filling rate (PFR), measures of stress-induced systolic and diastolic impairment, were computed from scintigraphic images. A SDS of >3 was considered abnormal and >7 a marker of moderate-to-severe ischaemia. Results: Of the 471 patients, 321 (68 %) showed significant CAD in one (27 %), two (23 %) or three (18 %) vessels. The extent of CAD associated with gradual alterations in SDS (P <0.001). Interestingly, while impairment in the percent stress-to-rest PFR ratio paralleled the increase in the extent of CAD (P <0.001 for trend), the occurrence of significant stress-induced systolic dysfunction was limited to patients with multivessel disease (P <0.001 vs. patients without CAD, and P = 0.002 vs. patients with single-vessel disease). Similarly, while a strict correlation between percent stress-to-rest PFR ratio and myocardial ischaemic burden was evident (P <0.001), significant stress-induced LV systolic impairment was limited to patients with moderate-to-severe ischaemia (P <0.001 vs. patients with no or mild ischaemia). Conclusion: Stress-induced LV diastolic impairment is associated with a less extensive ischaemic burden and CAD extent than poststress systolic dysfunction, which is limited to patients with multivessel CAD.

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