Computer derived transient ischemic dilation ratio for identifying extensive coronary artery disease using a CZT camera and imaging in the upright position.
Transient ischemic dilation (TID) of the left ventricle (LV) has not been validated as a marker of extensive coronary artery disease (CAD) for studies using a cadmium-zinc-telluride (CZT) camera with upright imaging.



TID ratios were obtained from upright stress and rest images on a CZT camera. Separate cut-off values were determined for exercise and for regadenoson stress. The cutoffs were then applied to 28 patients with extensive CAD and 101 patients without extensive CAD.



With treadmill exercise, an upright TID ratio ≥1.16 provided a positive predictive value of 50% and a negative predictive value of 85.4% for the identification of extensive CAD. In the regadenoson group, an upright TID ratio of 1.29 provided a positive predictive value of 20% and a negative predictive value of 75.9%. Although not an independent predictor of extensive CAD in all subjects, in subjects with a normal upright LVEF, it provided a predictive value by receiver operating characteristics comparable to the SSS.



Increased upright TID measurements on a CZT camera are associated with extensive CAD. The upright TID measurements can serve in an adjunctive role to SSS, and may be most effective in patients with a normal upright exercise LVEF.
Division of Cardiology, Department of Internal Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Zenith A
ZA
Jameria
Division of Cardiology, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267-0542, USA.
Mouhamad
M
Abdallah
Division of Biostatistics and Epidemiology, Department of Biomedical Sciences, Texas Tech University Health Science Center, El Paso, TX, USA.
Alok
A
Dwivedi
Division of Nuclear Medicine, Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Erica
E
Washburn
Division of Cardiology, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267-0542, USA.
Naseer
N
Khan
Division of Cardiology, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267-0542, USA.
Mahyar
M
Khaleghi
University of Cincinnati College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
Nischelle
N
Kalakota
Division of Cardiology, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267-0542, USA. myron.gerson@uc.edu.
Myron C
MC
Gerson
D000368:Aged; D002104:Cadmium; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003936:Diagnosis, Computer-Assisted; D004106:Dilatation; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007511:Ischemia / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D011237:Predictive Value of Tests; D011687:Purines / Q000008:administration & dosage; D011720:Pyrazoles / Q000008:administration & dosage; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013691:Tellurium; D015899:Tomography, Emission-Computed, Single-Photon; D015032:Zinc
C474490:CdZnTe; D011687:Purines; D011720:Pyrazoles; D002104:Cadmium; C430916:regadenoson; D015032:Zinc; D013691:Tellurium
Cadmium-zinc-telluride; coronary artery disease; ischemic dilation (TID); myocardial perfusion imaging: SPECT; transient