title: Relationship between myocardial perfusion abnormalities and contractile impairment in anginal patients.
abstract: BACKGROUND
  A relationship between left ventricular (LV) contractile impairment and myocardial perfusion abnormalities has been suggested.
  
  
  RESULTS
  Three-hundred and thirty-seven patients underwent myocardial perfusion imaging at CZT and coronary angiography. On scintigraphic images, the summed difference score (SDS) and LV-ejection fraction (EF) were computed. Patients were categorized as follows: Group-1 (LV-EF < 40%; 71 patients), Group-2 (LV-EF ≥ 40% and < 55%; 77 patients), and Group-3 (LV-EF ≥ 55%; 189 patients). Significant coronary artery disease (CAD; ≥50% stenosis) was recognized in 159/337 (47%) patients. Interestingly, while in Group-3 subjects an inverse relationship between SDS values and post-stress LV-EF was evident (P < .001), Group-1 patients presented a significant association between an increased SDS and more elevated post-stress LV-EF values (P = .009). Similarly, despite in the overall population an increasing severity of CAD was associated with higher SDS values (P < .001), this relationship disappeared in Group-1 patients (P = .298). At multiple regression analysis, after correction for CAD, LV dysfunction was negatively associated with an elevated SDS (P = .018). Conversely in patients with normal LV function and no history of myocardial infarction, CAD extent, and functional measures of stress-induced myocardial ischemia were strictly correlated.
  
  
  CONCLUSIONS
  Independently from CAD, a significantly impaired LV function associates with a lower prevalence of reversible ischemia.
authors: Fondazione Toscana Gabriele Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy, gimelli@ftgm.it.
authors: Alessia
authors: A
authors: Gimelli
authors: Riccardo
authors: R
authors: Liga
authors: Assuero
authors: A
authors: Giorgetti
authors: Mirta
authors: M
authors: Casagranda
authors: Paolo
authors: P
authors: Marzullo
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000000981:diagnostic imaging*; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology