title: Left ventricular eccentricity index measured with SPECT myocardial perfusion imaging: An additional parameter of adverse cardiac remodeling.
abstract: Single-photon emission computed-tomography (SPECT) allows the quantification of LV eccentricity index (EI), a measure of cardiac remodeling. We sought to evaluate the feasibility of EI measurement with SPECT myocardial perfusion imaging and its interactions with relevant LV functional and structural parameters.
  
  
  
  Four-hundred and fifty-six patients underwent myocardial perfusion imaging on a Cadmium-Zinc-Telluride (CZT) camera. The summed rest, stress, and difference scores were calculated. From rest images, the LV end-diastolic (EDV) and end-systolic volumes, ejection fraction (EF), and peak filling rate (PFR) were calculated. In every patient, the EI, ranging from 0 (sphere) to 1 (line), was computed using a dedicated software (QGS/QPS; Cedars-Sinai Medical Center). Three-hundred and thirty-eight/456 (74%) patients showed a normal EF (>50%), while 26% had LV systolic dysfunction. The EI was computed from CZT images with excellent reproducibility (interclass correlation coefficient: 0.99, 95% CI 0.98-0.99). More impaired EI values correlated with the presence of a more abnormal LV perfusion (P < .001), function (EF and PFR, P < .001), and structure (EDV, P < .001). On multivariate analysis, higher EDV (P < .001) and depressed EF (P = .014) values were independent predictors of abnormal EI.
  
  
  
  The evaluation of LV eccentricity is feasible on gated CZT images. Abnormal EI associates with significant cardiac structural and functional abnormalities.
authors.affiliation: Fondazione Toscana G. Monasterio, Pisa, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Gimelli
authors.affiliation: Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Via Paradisa 2, 56100, Pisa, Italy. riccardo.liga@gmail.com.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Liga
authors.affiliation: Fondazione Toscana G. Monasterio, Pisa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Clemente
authors.affiliation: Fondazione Toscana G. Monasterio, Pisa, Italy.
authors.forename: Gavino
authors.initials: G
authors.lastname: Marras
authors.affiliation: Fondazione Toscana G. Monasterio, Pisa, Italy.
authors.forename: Annette
authors.initials: A
authors.lastname: Kusch
authors.affiliation: Fondazione Toscana G. Monasterio, Pisa, Italy.|CNR, Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marzullo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002104:Cadmium; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology; D013691:Tellurium; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D020257:Ventricular Remodeling / Q000502:physiology*; D015032:Zinc
chemical_list: C474490:CdZnTe; D002104:Cadmium; D015032:Zinc; D013691:Tellurium
keywords: CZT; Left ventricular remodeling; eccentricity index; ejection fraction; gated SPECT