title: Stress variables add differential diagnostic information between ischemic and nonischemic cardiomyopathy over myocardial perfusion SPECT imaging.
abstract: OBJECTIVE
  Noninvasive differentiation between ischemic cardiomyopathy (ICM) and nonischemic (NICM) cardiomyopathy is frequently difficult. The aim of this study was to analyze the value of stress test and stress-rest gated single-photon emission computed tomography (SPECT) criteria to differentiate between ICM and NICM.
  
  
  METHODS
  Data pertaining to 145 consecutive patients (mean age: 63±11 years, 24 women) assessed by means of stress-rest gated SPECT with Tc-tetrofosmin, with left ventricular ejection fraction less than or equal to 40% (107 patients with ICM and 38 with NICM according to coronary angiography) and known coronary anatomy, were analyzed.
  
  
  RESULTS
  Multivariate analyses of gated SPECT variables identified a summed stress score greater than 21 [odds ratio (OR) 7.67, 95% confidence interval (CI): 2.85-20.58)] and divergent pattern (OR 6.84, 95% CI: 1.83-25.5) as predictors of ICM, and analysis of exercise test variables disclosed metabolic equivalents less than or equal to 7.3 (OR 10.75, 95% CI: 3.64-31.81) and ST depression of at least 1 mm (OR 6.97, 95% CI: 1.42-34.3) as independent predictors of ICM. The exercise test variables had a significant additional predictive value of ICM over gated SPECT variables (P<0.001).
  
  
  CONCLUSIONS
  Estimated functional capacity and ST depression improve the diagnostic value of stress-rest SPECT to differentiate between ICM and NICM.
authors.affiliation: Department of Cardiology, Àrea del Cor, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autónoma de Barcelona, Barcelona, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Romero-Farina
authors.forename: Santiago
authors.initials: S
authors.lastname: Aguadé-Bruix
authors.forename: Jaume
authors.initials: J
authors.lastname: Candell-Riera
authors.forename: Joan
authors.initials: J
authors.lastname: Castell-Conesa
authors.forename: Raquel
authors.initials: R
authors.lastname: Fernández-Sálguero
authors.forename: David
authors.initials: D
authors.lastname: García-Dorado
mesh_terms: D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000150:complications; D003937:Diagnosis, Differential; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055414:Myocardial Perfusion Imaging; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging