Non ECG gated supine to prone left ventricular volume ratio: a novel marker for myocardial ischemia

Autor: See Jin Jesse Ong, Wei Sheng Jonathan Ong, Min Sen Yew
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Supine position
Computed Tomography Angiography
CAD
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
Severity of Illness Index
Patient Positioning
Ventricular Function
Left
030218 nuclear medicine & medical imaging
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Internal medicine
Prone Position
Supine Position
Humans
Medicine
Radiology
Nuclear Medicine and imaging
Cardiac imaging
Aged
Retrospective Studies
Tomography
Emission-Computed
Single-Photon
business.industry
Coronary Stenosis
Myocardial Perfusion Imaging
Reproducibility of Results
Stroke Volume
Middle Aged
Transient Ischemic Dilation
medicine.disease
Prone position
Stenosis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Perfusion
Zdroj: The International Journal of Cardiovascular Imaging. 36:1377-1384
ISSN: 1573-0743
1569-5794
DOI: 10.1007/s10554-020-01836-2
Popis: Transient ischemic dilation (TID), a marker of severe coronary artery disease (CAD), is the post-stress to rest left ventricular (LV) volume ratio quantified using non ECG gated single photon emission computerized tomography (SPECT). Although prone positioning causes physiological reduction of LV volume in normal subjects, we hypothesize this may not occur in TID with underlying severe CAD as cardiac hemodynamics worsen when prone. We aim to evaluate the utility of the non ECG gated supine to prone LV volume ratio (SPLVr) for identifying severe CAD. Retrospective data analysis from 130 patients with TID ratio ≥ 1.21 and both post-stress supine and prone images. SPLVr had a significant negative correlation with summed stress (r = - 0.221, p = 0.011) and rest (r = - 0.292, p = 0.001) scores. Of the 129 cases with follow-up invasive or computed tomography coronary angiography, 52 (40.3%) had severe CAD (left main ≥ 50% stenosis, 3-vessel with ≥ 70% stenosis or 2-vessel with proximal left anterior descending ≥ 70% stenosis). Mean SPLVr was significantly lower in severe CAD cases (1.05 ± 0.14 vs 1.12 ± 0.17, p = 0.012). SPLVr predicted severe CAD on univariate [OR 0.12 (95% CI 0.00-0.35) p = 0.01] but not in multivariate analysis. SPLVr is a novel marker that negatively correlates with extent of perfusion abnormalities and is lower amongst TID patients with severe CAD. Larger studies are needed to assess if SPLVr can reliably identify underlying severe CAD amongst TID cases.
Databáze: OpenAIRE
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