Clinical significance of right ventricular activity on treadmill thallium-201 myocardial single-photon emission computerized tomography using cadmium-zinc-telluride cameras.
OBJECTIVE
Identification of right ventricular (RV) abnormalities is important in patients with suspected coronary artery disease (CAD). RV activity can be better visualized on myocardial single-photon emission computerized tomography (SPECT) using a higher sensitivity cadmium-zinc-telluride (CZT) detector. The aim of this study was to investigate the clinical significance of RV/left ventricular (LV) uptake ratios during exercise thallium-201 SPECT using CZT detectors.


METHODS
A total of 102 patients underwent treadmill ECG-gated SPECT, coronary angiography, and echocardiography. SPECT myocardial perfusion was interpreted using a 17-segment model and a 0-4-point scale. RV/LV uptake ratios were calculated on the basis of maximum counts per pixel within the entire RV and LV walls. The relationships between RV/LV uptake ratio and gated SPECT, presence of CAD (≥50% stenosis in the left main or ≥70% in the main branches), demographics, and echocardiographic parameters were analyzed.


RESULTS
Stress RV/LV ratios correlated positively with the presence of left main or multivessel disease, and tricuspid regurgitation maximum pressure gradient. After multivariate regression, stress/rest RV/LV ratios correlated positively with mitral flow deceleration time, age, female sex, and use of β-blockers.


CONCLUSIONS
RV/LV uptake ratios on the basis of exercise myocardial perfusion SPECT imaging using CZT cameras are useful for the detection of severe CAD and could serve as an indicator of pulmonary hypertension and LV diastolic dysfunction.
aDepartment of Nuclear MedicinebDepartment of Internal Medicine, Division of Cardiology, National Taiwan University Hospital, National Taiwan University College of MedicinecNational Yang-Ming University School of Medicine, TaipeidDepartment of Nuclear Medicine, Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City.
Kuan-Yin
KY
Ko
Yen-Wen
YW
Wu
Chia-Ju
CJ
Liu
Mei-Fang
MF
Cheng
Ruoh-Fang
RF
Yen
Kai-Yuan
KY
Tzen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019187:Cadmium Compounds / Q000528:radiation effects; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000295:instrumentation* / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005080:Exercise Test / Q000379:methods; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D008297:Male; D008875:Middle Aged; D015635:Radionuclide Ventriculography / Q000295:instrumentation* / Q000379:methods; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013691:Tellurium / Q000528:radiation effects; D013794:Thallium Radioisotopes; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology; D015032:Zinc / Q000528:radiation effects
D019187:Cadmium Compounds; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D015032:Zinc; D013691:Tellurium; C028337:cadmium telluride