BACKGROUND: A relationship between left ventricular (LV) contractile impairment and myocardial perfusion abnormalities has been suggested. METHODS AND RESULTS: Three-hundred and thirty-seven patients underwent myocardial perfusion imaging at CZT and coronary angiography. On scintigraphic images, the summed difference score (SDS) and LV-ejection fraction (EF) were computed. Patients were categorized as follows: Group-1 (LV-EF < 40%; 71 patients), Group-2 (LV-EF ≥ 40% and < 55%; 77 patients), and Group-3 (LV-EF ≥ 55%; 189 patients). Significant coronary artery disease (CAD; ≥50% stenosis) was recognized in 159/337 (47%) patients. Interestingly, while in Group-3 subjects an inverse relationship between SDS values and post-stress LV-EF was evident (P < .001), Group-1 patients presented a significant association between an increased SDS and more elevated post-stress LV-EF values (P = .009). Similarly, despite in the overall population an increasing severity of CAD was associated with higher SDS values (P < .001), this relationship disappeared in Group-1 patients (P = .298). At multiple regression analysis, after correction for CAD, LV dysfunction was negatively associated with an elevated SDS (P = .018). Conversely in patients with normal LV function and no history of myocardial infarction, CAD extent, and functional measures of stress-induced myocardial ischemia were strictly correlated. CONCLUSIONS: Independently from CAD, a significantly impaired LV function associates with a lower prevalence of reversible ischemia.
BACKGROUND: A relationship between left ventricular (LV) contractile impairment and myocardial perfusion abnormalities has been suggested. METHODS AND RESULTS: Three-hundred and thirty-seven patients underwent myocardial perfusion imaging at CZT and coronary angiography. On scintigraphic images, the summed difference score (SDS) and LV-ejection fraction (EF) were computed. Patients were categorized as follows: Group-1 (LV-EF < 40%; 71 patients), Group-2 (LV-EF ≥ 40% and < 55%; 77 patients), and Group-3 (LV-EF ≥ 55%; 189 patients). Significant coronary artery disease (CAD; ≥50% stenosis) was recognized in 159/337 (47%) patients. Interestingly, while in Group-3 subjects an inverse relationship between SDS values and post-stress LV-EF was evident (P < .001), Group-1 patients presented a significant association between an increased SDS and more elevated post-stress LV-EF values (P = .009). Similarly, despite in the overall population an increasing severity of CAD was associated with higher SDS values (P < .001), this relationship disappeared in Group-1 patients (P = .298). At multiple regression analysis, after correction for CAD, LV dysfunction was negatively associated with an elevated SDS (P = .018). Conversely in patients with normal LV function and no history of myocardial infarction, CAD extent, and functional measures of stress-induced myocardial ischemia were strictly correlated. CONCLUSIONS: Independently from CAD, a significantly impaired LV function associates with a lower prevalence of reversible ischemia.
Authors: Rory Hachamovitch; Alan Rozanski; Leslee J Shaw; Gregg W Stone; Louise E J Thomson; John D Friedman; Sean W Hayes; Ishac Cohen; Guido Germano; Daniel S Berman Journal: Eur Heart J Date: 2011-01-21 Impact factor: 29.983
Authors: Lee Fong Ling; Thomas H Marwick; Demetrio Roland Flores; Wael A Jaber; Richard C Brunken; Manuel D Cerqueira; Rory Hachamovitch Journal: Circ Cardiovasc Imaging Date: 2013-04-17 Impact factor: 7.792
Authors: Jeptha P Curtis; Seth I Sokol; Yongfei Wang; Saif S Rathore; Dennis T Ko; Farid Jadbabaie; Edward L Portnay; Stephen J Marshalko; Martha J Radford; Harlan M Krumholz Journal: J Am Coll Cardiol Date: 2003-08-20 Impact factor: 24.094
Authors: Julio A Panza; Thomas A Holly; Federico M Asch; Lilin She; Patricia A Pellikka; Eric J Velazquez; Kerry L Lee; Salvador Borges-Neto; Pedro S Farsky; Robert H Jones; Daniel S Berman; Robert O Bonow Journal: J Am Coll Cardiol Date: 2013-03-07 Impact factor: 24.094