Ventricular-arterial coupling assessment using gated single-photon emission computed tomography: relationship with reserve pulse pressure and repolarization abnormalities
| Autor: | Marcela Redruello, Lucas San Miguel, Osvaldo Masoli, Carlos Collaud, Jorgelina Medus, Juan M. Blanco, Nadia Pabstleben |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Blood Pressure Coronary Artery Disease 030204 cardiovascular system & hematology Single-photon emission computed tomography 030218 nuclear medicine & medical imaging 03 medical and health sciences Myocardial perfusion imaging Electrocardiography 0302 clinical medicine Internal medicine Coronary Circulation medicine Repolarization Humans Ventricular Function Radiology Nuclear Medicine and imaging Prospective Studies Depression (differential diagnoses) Aged Retrospective Studies medicine.diagnostic_test business.industry Myocardial Perfusion Imaging Stroke Volume General Medicine Stroke volume Middle Aged Pulse pressure Cardiology Exercise Test Female Nuclear medicine business Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography Perfusion Emission computed tomography |
| Zdroj: | Nuclear medicine communications. 37(12) |
| ISSN: | 1473-5628 |
| Popis: | AIMS In patients with normal myocardial perfusion, ST-segment depression and reserve pulse pressure (rPP) can identify patients at higher risk of cardiovascular events. We aimed to explore the prevalence of impaired ventricular-arterial coupling (VAc) in patients with normal myocardial perfusion imaging and its relationship with ST-segment depression and rPP. METHODS AND RESULTS The present study included consecutive patients with normal myocardial perfusion imaging by single-photon emission computed tomography and ST-segment depression. Stroke volume, end-systolic pressure, arterial elastance (Ea), ventricular elastance (Ev), and VAc (Ea/Ev) were estimated both at rest and during stress. The difference between stress and rest (ΔVAc) was calculated. A positive ΔVAc was considered an impaired ΔVAc (iVAc). RESULTS A total of 92 patients were prospectively included. iVAc was identified in 44 (59%) patients with ST-segment depression compared with 3 (16%) patients with normal repolarization (P=0.001). A higher incidence of abnormal rPP was identified in patients with ST-segment depression compared with the control group (61 vs. 16%, P=0.0001). ST-segment depression was identified as the only independent predictor of iVAc (adjusted OR 7.5; 95% CI 1.9-30.0, P=0.004). CONCLUSION Noninvasive assessment of VAc is feasible with gated single-photon emission computed tomography and appears to be related to ST-segment depression and reserve rPP. |
| Databáze: | OpenAIRE |
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