title: Stress-induced alteration of left ventricular eccentricity: An additional marker of multivessel CAD.
abstract: Abnormal left ventricular (LV) eccentricity index (EI) is a marker of adverse cardiac remodeling. However, the interaction between stress-induced alterations of EI and major cardiac parameters has not been explored. We sought to evaluate the relationship between LV EI and coronary artery disease (CAD) burden in patients submitted to myocardial perfusion imaging (MPI).
  
  
  
  Three-hundred and forty-three patients underwent MPI and coronary angiography. LV ejection fraction (EF) and EI were computed from gated stress images as measures of stress-induced functional impairment. One-hundred and thirty-six (40%), 122 (35%), and 85 (25%) patients had normal coronary arteries, single-vessel CAD, and multivessel CAD, respectively. Post-stress EI was lower in patients with multivessel CAD than in those with normal coronary arteries and single-vessel CAD (P = 0.001). This relationship was confirmed only in patients undergoing exercise stress test, where a lower post-stress EI predicted the presence of multivessel CAD (P = 0.039).
  
  
  
  Post-stress alterations of LV EI on MPI may unmask the presence of multivessel CAD.
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: Assuero
authors.initials: A
authors.lastname: Giorgetti
authors.affiliation: Fondazione Toscana G. Monasterio, Pisa, Italy.
authors.forename: Mirta
authors.initials: M
authors.lastname: Casagranda
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; D000465:Algorithms; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D010477:Perfusion; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left; D016277:Ventricular Function, Left
keywords: CZT; Left ventricular remodeling; eccentricity index; ejection fraction; gated SPECT