Day-to-day variability of global left ventricular functional and perfusional measurements by quantitative gated SPECT using Tc-99m tetrofosmin in patients with heart failure due to coronary artery disease.
BACKGROUND
Although myocardial gated single photon emission computed tomography (SPECT) is routinely used for functional measurements in patients with coronary artery disease (CAD) and heart failure, day-to-day variability of left ventricular ejection fraction (LVEF), left ventricular (LV) volumes, and global perfusion scoring has not yet been investigated.


RESULTS
In 20 consecutive patients with CAD and an LVEF lower than 40% who routinely underwent a resting tetrofosmin gated SPECT study, we performed an additional gated SPECT study at rest 1 to 5 days later under the same circumstances. LV volumes and LVEF were calculated from the gated SPECT data by commercially available software (QGS). Myocardial perfusion was scored visually by use of a 20-segment, 5-point scoring method. For global LV function and perfusion, agreement between data was investigated by use of Bland-Altman plotting. The 95% limits of agreement found by Bland-Altman analysis were -0.9% +/- 6.0% for LVEF, 3 +/- 20 mL for LV end-diastolic volume, and 4 +/- 20 mL for LV end-systolic volume.


CONCLUSIONS
In CAD patients with an LVEF lower than 40%, day-to-day variability of measurements of global myocardial function and perfusion is quite similar to interobserver and intraobserver variability. Day-to-day variability of global LV functional parameters obtained by gated cardiac SPECT is fairly small, which indicates that myocardial gated SPECT can be used in daily clinical practice to determine changes in global LV function and perfusion over time in patients with diminished LV function.
De Winter
Olivier
O
Division of Nuclear Medicine, Ghent University Hospital, Belgium. olivier.dewinter@UGent.be
De Bondt
Pieter
P
Van De Wiele
Christophe
C
De Backer
Guy
G
Dierckx
Rudi A
RA
De Sutter
Johan
J
D000368:Aged; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D015637:Gated Blood-Pool Imaging; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016277:Ventricular Function, Left / Q000502:physiology*
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin