Impact of myocardial perfusion gated-SPECT on the decision to perform coronary angiography in patients with left ventricular dysfunction of ischemic origin

G. Romero-Farina, J. Candell-Riera, S. Aguad-Bruix, J. Castell-Conesa, D. Garca-Dorado

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2 Citations (Scopus)

Abstract

Objectives: The aim of this study was to analyze how the myocardial perfusion gated-SPECT (Single Photon Emission Computed Tomography) influences the practice of a coronary angiography in patients with ischemic cardiomyopathy (IM). Patients and methods: A total of 120 consecutive patients (mean age: 64.9 ± 11.5 years, 25 female) with IM (left ventricular ejection fraction ≤40%) and without previous coronary angiography were evaluated by myocardial perfusion gated-SPECT (96 stress-rest and 24 only at rest). The ventricular ejection fraction (EF) was obtained at rest by gated-SPECT in all patients. The ischemic origin of the systolic dysfunction was established by means of coronary angiography in 64 patients and by previous myocardial infarction in the rest. Gated-SPECT results of these 64 patients were compared with those of 56 patients in whom coronary angiography had not been indicated. Result: Scintigraphic myocardial ischemia (HR: 5.2; CI 95%: 2.68 to 10.35) in patients who were able to perform the stress-rest test) and who had severely impaired EF (<30%) (HR: 0.9; CI 95%: 0.89 to 0.99) were the best independent predictors of coronary angiography. On the contrary, scintigraphic criteria of viability were not a determinant, from the statistical point of view, of coronary angiography in this series. Conclusions: In patients with IM, demonstration of ischemia and severe reduction of the EF, but not detection of viable myocardium, prompted the performance of coronary angiography. © 2010 Elsevier Españ, S.L. and SEMNIM.
Original languageEnglish
Pages (from-to)141-146
JournalRevista Espanola de Medicina Nuclear
Volume30
Issue number3
DOIs
Publication statusPublished - 1 Jan 2011

Keywords

  • Ischemic cardiomyopathy
  • Myocardial perfusion
  • Myocardial viability

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