William T Halligan1, Pamela B Morris1, U Joseph Schoepf2, Blaine T Mischen1, James V Spearman1, J Reid Spears1, Philipp Blanke1, Young Jun Cho3, Justin R Silverman1, Salvatore A Chiaramida1, Ullrich Ebersberger4. 1. Heart and Vascular Center, Medical University of South Carolina, Charleston, South Carolina. 2. Heart and Vascular Center, Medical University of South Carolina, Charleston, South Carolina schoepf@musc.edu. 3. Heart and Vascular Center, Medical University of South Carolina, Charleston, South Carolina Department of Radiology, Konyang University College of Medicine, Daejeon, Korea; and. 4. Heart and Vascular Center, Medical University of South Carolina, Charleston, South Carolina Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany.
Abstract
UNLABELLED: 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.
UNLABELLED: 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.
Authors: Rine Nakanishi; Heidi Gransar; Piotr Slomka; Reza Arsanjani; Aryeh Shalev; Yuka Otaki; John D Friedman; Sean W Hayes; Louise E B Thomson; Mathews Fish; Guido Germano; Aiden Abidov; Leslee Shaw; Alan Rozanski; Daniel S Berman Journal: J Nucl Cardiol Date: 2015-05-14 Impact factor: 5.952
Authors: Manolo Rubio; Andre Dias; Nikoloz Koshkelashvili; Jose N Codolosa; Mauricio Jalife-Bucay; Mary Rodriguez-Ziccardi; Aman M Amanullah Journal: World J Nucl Med Date: 2017 Jul-Sep
Authors: C Fielder Camm; Alexander Emery; Elizabeth Rose-Innes; Sergei Pavlitchouk; Nikant Sabharwal; Andrew D Kelion Journal: J Nucl Cardiol Date: 2018-03-15 Impact factor: 5.952