RT Journal Article
SR Electronic
T1 Transient Ischemic Dilation of the Left Ventricle on SPECT: Correlation with Findings at Coronary CT Angiography
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 917
OP 922
DO 10.2967/jnumed.113.125880
VO 55
IS 6
A1 William T. Halligan
A1 Pamela B. Morris
A1 U. Joseph Schoepf
A1 Blaine T. Mischen
A1 James V. Spearman
A1 J. Reid Spears
A1 Philipp Blanke
A1 Young Jun Cho
A1 Justin R. Silverman
A1 Salvatore A. Chiaramida
A1 Ullrich Ebersberger
YR 2014
UL http://jnm.snmjournals.org/content/55/6/917.abstract
AB Transient ischemic dilation (TID) in the setting of abnormal stress–rest cardiac SPECT myocardial perfusion imaging (MPI) has been linked with increased cardiovascular risk. However, the significance of TID in the setting of an otherwise normal SPECT MPI study has not been clearly established. In this study, cardiac CT was used to evaluate the prevalence of atherosclerotic lesions and the severity of coronary artery stenosis in patients with TID of the left ventricle with or without associated myocardial perfusion defects on SPECT MPI. Methods: The study population consisted of 1,553 consecutive patients who had undergone both cardiac CT and SPECT MPI within 1 mo between January 1, 2006, and September 1, 2011. Patients included in the study group had a pathologic TID value defined as ≥1.18 for men and ≥1.22 for women. Coronary CT angiography was used to evaluate each coronary segment for the presence and composition of atherosclerotic plaque and the degree of coronary stenosis. TID-positive patients were compared with a 2:1 risk-factor-matched-pair control cohort without TID. Results: TID was identified in 30 patients who were compared with TID-negative risk-factor-matched controls (n = 60). When compared with the TID-negative control cohort, TID-positive patients had no significant differences in the presence and extent of atherosclerosis, the degree of coronary artery stenosis, or the calcium score at cardiac CT. Similarly, there were no significant differences in these CT measures in TID-positive patients with a normal perfusion study (n = 20) when compared with TID-negative patients with a normal perfusion study (n = 48). In addition, there was no significant difference in the incidence of major adverse cardiac events when comparing both the TID-positive patients and the TID-negative control cohort and when comparing patients who were TID-positive with normal perfusion with patients who were TID-negative with normal perfusion. Conclusion: The presence of TID with an otherwise normal SPECT MPI study does not translate into a greater extent of coronary artery disease as assessed by cardiac CT or increased risk for future major adverse cardiac events.