Association between non-perfusion parameters and presence of ischemia in gated-SPECT myocardial perfusion imaging studies

Combined assessment of perfusion and function improves diagnostic and prognostic power of gated-spect in patients with coronary artery disease. the aim of this study was to investigate whether the presence of stress-induced ischemia is associated with abnormal resting left ventricular (lv) function and intraventricular dyssynchrony. gated-spect myocardial perfusion imaging (mpi) at rest and 15 min post-stress was performed in 101 patients, who were divided into three groups: those with stress-induced ischemia (group 1, n = 58), those with normal scans (group 2, n = 28), and those with scar but no ischemia (group 3, n = 15). more extensive perfusion defects were found in patients of groups 1 and 3 [summed stress score (sss): 13 ± 8 and 21 ± 9, respectively]. in group 2, the mean sss was 1.5. the mean change in lv ejection fraction (lvef at stress − lvef at rest) was higher in group 1 v. group 2 patients: −5.54% ± 6.24% vs −2.46% ± 5.56%, p = 0.02. group 3 patients also had higher values, similar to group 1: −6.47% ± 8.82%. patients with ischemia had almost 50% higher end-diastolic volumes than patients with normal mpi. similarly, end-systolic volumes were almost twice as high in this group (p < 0.0001). in addition, the histogram bandwidth, a measure of intraventricular dyssynchrony, was greater in group 1. baseline differences in left ventricular volumes and degree of dyssynchrony are associated with inducible ischemia on stress testing in a gated-spect mpi. stress-induced ischemia increases the degree of intraventricular dyssynchrony.