Establishment of the normal reference values of left ventricular function parameters evaluated by D-SPECT stress-gated myocardial perfusion imaging in Chinese with a low likelihood of coronary artery disease

Introduction: The purpose of this study is to establish the normal reference value of left ventricular (LV) function parameters by stress-gated myocardial perfusion imaging (G-MPI) in Chinese with a low likelihood of coronary artery disease (CAD) based on different genders.

Methods: Consecutive patients who underwent exercise or pharmacological stress G-MPI were retrospectively recruited between March 2022 to August 2022. Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) were acquired using QGS analysis. EDV and ESV were corrected by body surface area (BSA) to obtain the end-diastolic volume index (EDVI), and end-systolic volume index (ESVI), respectively. For data analysis, a two-sample t-test, ANOVA, and Mann-Whitney U test. The influence of gender, age, height, and weight on cardiac function parameters was analyzed by multiple regressions for linear models.

Results: The final study population consisted of 34 normal control (group 1, 18 males and 16 females, mean age 55±10 years) and 314 patients with a low likelihood of CAD (group 2, 128 males and 186 females, mean age 58±10 years). There was no significant difference in basic clinical characteristics in different gender in group 2 (P>0.05). Using the 95% confidence interval as the cut-off value for LV function parameters in patients with a low likelihood of CAD. The upper limits of EDV, ESV, EDVI, and ESVI in women and men are 84 mL vs. 111 ml, 30 mL vs. 44 mL, 47 mL/m² vs. 54 mL/m², and 17 mL/m² vs. 21 mL/m², respectively. The lower limit of LVEF in women and men is 58% vs. 55%, respectively. In group 2, there was a significant difference in G-MPI LV cardiac function parameters between women and men (P<0.05). The left ventricular volumes of women were smaller than that of men (P<0.05), while LVEF was higher (P<0.05). However, there was no significant difference in left ventricular volumes and LVEF among different age groups with the same gender (P>0.05). Based on multiple regression for linear models, the primary predictors of left ventricular volume and LVEF were gender and weight (P<0.001).

Conclusions: We established normal reference values of left ventricular volume and LVEF by D-SPECT stress G-MPI in Chinese with a low likelihood of CAD. Left ventricular volumes in women were smaller than in men while LVEF was higher. The influence of gender and weight on cardiac function parameters should be considered in clinical practice.