Transient ischemic dilation or transient RV visualization in patients with normal SPECT stress myocardial perfusion imaging: Correlation with CT coronary artery calcium scoring and coronary angiography
| Autor: | Mehdi Moradi, Behshad Naghshtabrizi, Seyed Kamaledin Hadei, Mohammad Ali Seif Rabie, Zahra Shaghaghi, Maryam Alvandi, Farnaz Fariba |
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| Rok vydání: | 2021 |
| Předmět: |
Coronary angiography
medicine.medical_specialty Myocardial Ischemia Coronary Artery Disease Coronary Angiography Correlation Myocardial perfusion imaging Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Clinical significance In patient cardiovascular diseases Tomography Emission-Computed Single-Photon medicine.diagnostic_test business.industry Myocardial Perfusion Imaging Transient Ischemic Dilation medicine.disease Dilatation Perfusion Stenosis Angiography Cardiology Calcium Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Nuclear Cardiology. 29:2149-2156 |
| ISSN: | 1532-6551 1071-3581 |
| Popis: | Ancillary findings on MPI, such as transient ischemic dilation (TID) and transient right ventricular visualization (TRV), are recognized as markers of extensive CAD and predictive of adverse outcomes. They usually occur in association with stress-induced regional MPI abnormalities. However, the clinical significance of these ancillary markers in the presence of normal stress MPI is incompletely understood.From a cohort of 564 consecutive patients referred for clinical SPECT stress MPI, 44 patients had normal stress SPECT MPI and either TID (n = 28) or TRV (n = 16). These imaging findings were correlated with CT coronary calcium (CAC), CT coronary angiography (CTA), and invasive coronary angiography (ICA) in patients with severe CAC ≥ 1000 HU. TID and TRV were quantified as stress/rest ratios. Severe CAD was defined as gt; 70% luminal stenosis on CTA or ICA.The median TID ratio was 1.23, with a range of 1.13-1.48; the median TRV ratio was 1.30, with a range of 1.20-1.48. Of 44 patients with TID or TRV, only 9 patients (20.5%) had severe obstructive gt; 70% CAD by angiography (6 of 28 patients (21.5%) with TID and 3 of 16 patients (19%) with TRV). Severe multi-vessel CAD occurred in only 2 of 44 patients (4.5%). In contrast, of 9 patients with CAC gt; 1000 HU, 6 (67%) had severe obstructive CAD.In patients with normal stress SPECT MPI and TID or TRV, the incidence of severe obstructive CAD was relatively low and predominantly single-vessel CAD. These findings do not support the concept that TID or TRV with normal stress MPI is predictive of high-risk CAD. |
| Databáze: | OpenAIRE |
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