Korean Circ J.  2006 Apr;36(4):308-317. 10.4070/kcj.2006.36.4.308.

Influences of Perfusion Defect on the Measurement of Left Ventricular Ejection Fraction and Volumes in Gated Myocardial Perfusion SPECT

• Lee JH
• Chae SC
• Ryu HM
• Bae MW
• Lee SH
• Yang DH
• Ahn BC
• Park HS
• Cho YK
• Lee J
• Jun JE
• Park WH

• KMID: 1859059
• DOI: http://doi.org/10.4070/kcj.2006.36.4.308

Abstract

BACKGROUND AND OBJECTIVES: The left ventricular ejection fraction (LVEF) and volume (LVV) are important variables in patients with coronary artery disease. Quantitative gated myocardial SPECT (QGS) permits the simultaneous assessment of perfusion, LVEF and LVV. However, the presence of a perfusion defect may influence the LVEF and LVV measured by QGS.
SUBJECTS AND METHODS
67 subjects (M/F=47/20; mean age: 60.2+/-12.4 years) underwent both QGS with Tc-99m MIBI and 2-D echocardiography (Echo) at less than 7 days apart. The LVEF and LVV were measured by Echo, using the modified Simpson's method, and by QGS, using the automatic software, AutoQUANT(TM). The QGS rest images were used to compare with the Echo.
RESULTS
The correlations between the QGS and Echo for LVEF, LVEDV and LVESV were good in all 67 subjects (r=0.781, 0.754 and 0.906, respectively, p<0.0001). In patients with no perfusion defect (n=34), the correlations between the QGS and Echo for LVEF, LVEDV and LVESV were good (r=0.689, 0.593 and 0.586, p<0.0001). In patients with a perfusion defect (n=33), the LVEF between the QGS and Echo was well correlated (r=0.777, p<0.0001), but the LVEF was higher by 7.1+/-8.7% from the Echo results. The LVEDV and LVESV by both QGS and Echo were also well correlated (r=0.804 and 0.929, respectively, p<0.0001), but the LVEDV and LVESV were higher from QGS by 17.9+/-34 and 16.9+/-25 mL, respectively. A Bland-Altman analysis showed the agreement between the QGS and Echo in patients without perfusion defect was better than for those with a perfusion defect.
CONCLUSION
The perfusion defect from QGS might affect the measurements of the LVEF and LVV; therefore, the QGS and Echo values are not interchangeable.

Keyword

Echocardiography; Tomography; emission-computed; single-photon; Left ventricular function

MeSH Terms

Coronary Artery Disease
Echocardiography
Humans
Perfusion*
Stroke Volume*
Tomography, Emission-Computed, Single-Photon*
Ventricular Function, Left