Impact of cardiac size on diagnostic performance of single-photon emission computed tomography myocardial perfusion imaging: insights from the REgistry of Fast Myocardial Perfusion Imaging with NExt generation single-photon emission computed tomography.

Autor:	Randazzo MJ; Section of Cardiology, Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA., Elias P; Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, 622 West 168th Street, PH 10-203, New York, NY 10032, USA., Poterucha TJ; Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, 622 West 168th Street, PH 10-203, New York, NY 10032, USA., Sharir T; Department of Nuclear Cardiology, Assuta Medical Centers, Tel Aviv, Israel., Fish MB; Sacred Heart Medical Center, Oregon Heart and Vascular Institute, Springfield, OR, USA., Ruddy TD; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada., Kaufmann PA; Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland., Sinusas AJ; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA., Miller EJ; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA., Bateman T; Cardiovascular Imaging Technologies LLC, Kansas City, MO, USA., Dorbala S; Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA., Di Carli M; Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA., Castillo M; Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, 622 West 168th Street, PH 10-203, New York, NY 10032, USA., Liang JX; Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Miller RJH; Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA.; Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute, Calgary, Alberta, Canada., Dey D; Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Berman DS; Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Slomka PJ; Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Einstein AJ; Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, 622 West 168th Street, PH 10-203, New York, NY 10032, USA.; Department of Radiology, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, 622 West 168th Street, PH 10-203, New York, NY 10032, USA.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2024 Jun 28; Vol. 25 (7), pp. 996-1006.
DOI:	10.1093/ehjci/jeae055
Abstrakt:	Aims: Variation in diagnostic performance of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has been observed, yet the impact of cardiac size has not been well characterized. We assessed whether low left ventricular volume influences SPECT MPI's ability to detect obstructive coronary artery disease (CAD) and its interaction with age and sex. Methods and Results: A total of 2066 patients without known CAD (67% male, 64.7 ± 11.2 years) across nine institutions underwent SPECT MPI with solid-state scanners followed by coronary angiography as part of the REgistry of Fast Myocardial Perfusion Imaging with NExt Generation SPECT. Area under receiver-operating characteristic curve (AUC) analyses evaluated the performance of quantitative and visual assessments according to cardiac size [end-diastolic volume (EDV); <20th vs. ≥20th population or sex-specific percentiles], age (<75 vs. ≥75 years), and sex. Significantly decreased performance was observed in patients with low EDV compared with those without (AUC: population 0.72 vs. 0.78, P = 0.03; sex-specific 0.72 vs. 0.79, P = 0.01) and elderly patients compared with younger patients (AUC 0.72 vs. 0.78, P = 0.03), whereas males and females demonstrated similar AUC (0.77 vs. 0.76, P = 0.67). The reduction in accuracy attributed to lower volumes was primarily observed in males (sex-specific threshold: EDV 0.69 vs. 0.79, P = 0.01). Accordingly, a significant decrease in AUC, sensitivity, specificity, and negative predictive value for quantitative and visual assessments was noted in patients with at least two characteristics of low EDV, elderly age, or male sex. Conclusion: Detection of CAD with SPECT MPI is negatively impacted by small cardiac size, most notably in elderly and male patients. Competing Interests: Conflict of interest: D.S.B. and P.J.S. participated in software royalties for QPS software at Cedars-Sinai Medical Center. P.J.S. has received research grant support from Siemens Medical Systems. D.S.B., S.D., A.J.E., and E.J.M. are consultants for GE Healthcare. S.D. is a consultant for Bracco Diagnostics and has received a grant through her institution from Astellas. M.D.C. has received research grant support from Spectrum Dynamics; and he is a consultant for Sanof and GE Healthcare. D.S.B.’s institution has received grant support from HeartFlow. E.J.M. has served as a consultant for Bracco Inc, and he and his institution have received grant support from Bracco Inc. T.D.R. has received research grant support from GE Healthcare and Advanced Accelerator Applications. A.J.E. reports receiving a speaker's fee from Ionetix, consulting fees from W. L. Gore & Associates, authorship fees from Wolters Kluwer Healthcare—UpToDate, and serving on a scientific advisory board for Canon America Medical Systems USA; his institution has grants/grants pending from Attralus, BridgeBio Pharma, Canon Medical Systems USA, GE Healthcare, Intellia Therapeutics, Ionis Pharmaceuticals, Neovasc, Pfizer, Roche Medical Systems, and W. L. Gore & Associates. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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