Effects of left ventricular size on the accuracy of diastolic parameters derived from myocardial perfusion SPECT: compar
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ORIGINAL ARTICLE
Effects of left ventricular size on the accuracy of diastolic parameters derived from myocardial perfusion SPECT: comparison with tissue Doppler echocardiography Satoshi Kurisu1 • Yoji Sumimoto1 • Hiroki Ikenaga1 • Noriaki Watanabe1 • Ken Ishibashi1 • Yoshihiro Dohi1 • Takayuki Hidaka1 • Yukihiro Fukuda1 • Yasuki Kihara1
Received: 6 May 2016 / Accepted: 27 July 2016 Ó The Japanese Society of Nuclear Medicine 2016
Abstract Background Impaired left ventricular (LV) diastolic function is a sensitive and early sign of myocardial ischemia. We evaluated the effects of LV size on the accuracy of diastolic parameters derived from SPECT. Methods The study population consisted of 151 patients with known or suspected coronary artery disease who underwent both SPECT and transthoracic echocardiography. Peak filling rate (PFR), one-third mean filling rate (1/3 MFR) and the ratio of time to PFR to the RR interval (TPFR/RR) were calculated by quantitative gated SPECT. Peak early mitral annular velocity (e0 ) was used as the reference standard of LV diastolic function. Results There were 43 patients with end-systolic volume (ESV) of B10 ml, 43 patients with ESV of 11–20 ml and 65 patients with ESV of [20 ml. There were significant differences in PFR (p \ 0.001), 1/3 MFR (p \ 0.001) or TPFR/RR (p = 0.01) among the 3 groups. These diastolic parameters were increased with decreased LV size. In overall patients, PFR (r = 0.24, p = 0.003) and 1/3 MFR (r = 0.31, p \ 0.001) were positively, and TPFR/RR (r = -0.23, p = 0.004) was inversely correlated with e0 . Multivariate linear regression analyses showed that male gender (b = -0.14, p = 0.07; b = -0.16, p = 0.04), ESV (b = -0.63, p \ 0.001; b = -0.45, p \ 0.001) and
& Satoshi Kurisu [email protected] 1
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi-cho, Minami-ku, Hiroshima 734-8551, Japan
e0 (b = 0.36, p \ 0.001; b = 0.40, p \ 0.001) were significant factors associated with PFR or 1/3 MFR. Multivariate linear regression analysis also showed that ESV (b = -0.17, p = 0.03) and e0 (b = -0.21, p = 0.01) were significant factors associated with TPFR/RR. Conclusions Our data suggest that PFR, 1/3 MFR and TPFR/RR derived from SPECT are correlated with e0 as the reference standard of LV diastolic function, but are overestimated in small-sized heart. LV size should be taken into consideration when interpreting these diastolic parameters. Keywords Left ventricle Diastolic function Diastolic parameter Small heart SPECT
Introduction Gated myocardial perfusion single photon emission computed tomography (SPECT) has been widely used for the assessment of left ventricular (LV) systolic function using some commercially available software programs [1–3]. Because impaired LV diastolic function is a sensitive and early sign of myocardial ischemia [4, 5], LV diastolic function has also become to be assessed on SPECT simultaneously [6–8]. However, few reports have assessed the accuracy of diastolic pa
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