title: Relationships between myocardial perfusion abnormalities and poststress left ventricular functional impairment on cadmium-zinc-telluride imaging.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
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: Annette
authors: A
authors: Kusch
authors: Emilio Maria
authors: EM
authors: Pasanisi
authors: Paolo
authors: P
authors: Marzullo
mesh_terms: D000368:Aged; D002104:Cadmium; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000295:instrumentation / Q000379:methods*; D013691:Tellurium; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D015032:Zinc
chemical_list: C474490:CdZnTe; D002104:Cadmium; D015032:Zinc; D013691:Tellurium