Relationships between myocardial perfusion abnormalities and poststress left ventricular functional impairment on cadmium-zinc-telluride imaging

被引:17
|
作者
Gimelli, Alessia [1 ]
Liga, Riccardo [2 ]
Giorgetti, Assuero [1 ]
Kusch, Annette [1 ]
Pasanisi, Emilio Maria [1 ]
Marzullo, Paolo [1 ,3 ]
机构
[1] Fdn Toscana Gabriele Monasterio, I-56124 Pisa, Italy
[2] Univ Hosp Pisa, Cardio Thorac & Vasc Dept, Pisa, Italy
[3] CNR, Inst Clin Physiol, I-56100 Pisa, Italy
关键词
Myocardial perfusion imaging; Systolic dysfunction; Diastolic dysfunction; Ischaemic cascade; Cadmium-zinc-telluride; CORONARY-ARTERY-DISEASE; DIASTOLIC DYSFUNCTION; CONSCIOUS DOGS; ISCHEMIA; FLOW; ECHOCARDIOGRAPHY; ANGIOPLASTY; CAMERA; SPECT;
D O I
10.1007/s00259-015-3008-7
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose To evaluate the interplay between myocardial ischaemic burden and poststress left ventricular (LV) systolic and diastolic abnormalities in patients with suspected or known coronary artery disease (CAD). Methods A total of 471 patients underwent myocardial perfusion imaging by cadmium-zinc-telluride scintigraphy and coronary angiography. A fast imaging protocol was used with stress imaging performed 10 - 15 min after tracer injection. The summed difference score (SDS) and the percent stress-to-rest ratios for LV ejection fraction and peak filling rate (PFR), measures of stress-induced systolic and diastolic impairment, were computed from scintigraphic images. A SDS of > 3 was considered abnormal and > 7 a marker of moderate-to-severe ischaemia. Results Of the 471 patients, 321 (68 %) showed significant CAD in one (27 %), two (23 %) or three (18 %) vessels. The extent of CAD associated with gradual alterations in SDS (P < 0.001). Interestingly, while impairment in the percent stress-to-rest PFR ratio paralleled the increase in the extent of CAD (P < 0.001 for trend), the occurrence of significant stress-induced systolic dysfunction was limited to patients with multivessel disease (P < 0.001 vs. patients without CAD, and P = 0.002 vs. patients with single-vessel disease). Similarly, while a strict correlation between percent stress-to-rest PFR ratio and myocardial ischaemic burden was evident (P < 0.001), significant stress-induced LV systolic impairment was limited to patients with moderate-to-severe ischaemia (P < 0.001 vs. patients with no or mild ischaemia). Conclusion Stress-induced LV diastolic impairment is associated with a less extensive ischaemic burden and CAD extent than poststress systolic dysfunction, which is limited to patients with multivessel CAD.
引用
收藏
页码:994 / 1003
页数:10
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