title: Association between non-perfusion parameters and presence of ischemia in gated-SPECT myocardial perfusion imaging studies.
abstract: Combined assessment of perfusion and function improves diagnostic and prognostic power of gated-SPECT in patients with coronary artery disease. The aim of this study was to investigate whether the presence of stress-induced ischemia is associated with abnormal resting left ventricular (LV) function and intraventricular dyssynchrony.
  
  
  
  Gated-SPECT myocardial perfusion imaging (MPI) at rest and 15 min post-stress was performed in 101 patients, who were divided into three groups: those with stress-induced ischemia (Group 1, n = 58), those with normal scans (Group 2, n = 28), and those with scar but no ischemia (Group 3, n = 15). More extensive perfusion defects were found in patients of Groups 1 and 3 [Summed stress score (SSS): 13 ± 8 and 21 ± 9, respectively]. In Group 2, the mean SSS was 1.5. The mean change in LV ejection fraction (LVEF at stress - LVEF at rest) was higher in Group 1 v. Group 2 patients: -5.54% ± 6.24% vs -2.46% ± 5.56%, p = 0.02. Group 3 patients also had higher values, similar to Group 1: -6.47% ± 8.82%. Patients with ischemia had almost 50% higher end-diastolic volumes than patients with normal MPI. Similarly, end-systolic volumes were almost twice as high in this group (p < 0.0001). In addition, the histogram bandwidth, a measure of intraventricular dyssynchrony, was greater in Group 1.
  
  
  
  Baseline differences in left ventricular volumes and degree of dyssynchrony are associated with inducible ischemia on stress testing in a gated-SPECT MPI. Stress-induced ischemia increases the degree of intraventricular dyssynchrony.
authors.affiliation: Institute of Cardiology, Havana, Cuba. peix@infomed.sld.cu.|Nuclear Medicine Department, Institute of Cardiology, 17 No. 702, Vedado, CP 10 400, Havana, Cuba. peix@infomed.sld.cu.
authors.forename: Amalia
authors.initials: A
authors.lastname: Peix
authors.affiliation: Institute of Cardiology, Havana, Cuba.
authors.forename: Lázaro O
authors.initials: LO
authors.lastname: Cabrera
authors.affiliation: Institute of Cardiology, Havana, Cuba.
authors.forename: Kenia
authors.initials: K
authors.lastname: Padrón
authors.affiliation: Institute of Cardiology, Havana, Cuba.
authors.forename: Lydia
authors.initials: L
authors.lastname: Rodríguez
authors.affiliation: Institute of Cardiology, Havana, Cuba.
authors.forename: Jesús
authors.initials: J
authors.lastname: Fernández
authors.affiliation: Institute of Cardiology, Havana, Cuba.
authors.forename: Giselle
authors.initials: G
authors.lastname: López
authors.affiliation: Institute of Cardiology, Havana, Cuba.
authors.forename: Regla
authors.initials: R
authors.lastname: Carrillo
authors.affiliation: Institute of Cardiology, Havana, Cuba.
authors.forename: Erick
authors.initials: E
authors.lastname: Mena
authors.affiliation: Institute of Cardiology, Havana, Cuba.
authors.forename: Yoel
authors.initials: Y
authors.lastname: Fernández
authors.affiliation: Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Dondi
authors.affiliation: Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
authors.forename: Diana
authors.initials: D
authors.lastname: Páez
mesh_terms: D000368:Aged; D002921:Cicatrix / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging; D055414:Myocardial Perfusion Imaging; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: Myocardial perfusion imaging; gated-SPECT; intraventricular synchrony; ischemia; left ventricular ejection fraction