Assessment of Ischemic Heart Disease in Patients with Stroke Using Myocardial Perfusion SPECT: Preliminary report

Rah, Ueon Woo; Koo, Ja Weon; Moon, Hae Won; Lee, Il Yung; Park, Chan Hee

Abstract

OBJECTIVE
The purpose of this study was to investigate cardiac events and ischemic heart disease in patients with stroke. The patients were studied by myocardial perfusion SPECT (single photon emission computed tomography) and evaluated the functional outcome after rehabilitation. METHOD: Subjects were 31 patients with stroke who had myocardial perfusion SPECT for abnormal findings on the electrocardiography. There were eighteen patients with ischemic stroke: 12 patients with hemorrhagic stroke; and one patient with both ischemic and hemorrhagic stroke. We screened the patients for the hypertension, diabetes mellitus, previous history of stroke, smoking, alcohol use, and hyperlipidemia as risk factors of ischemic stroke and ischemic heart disease. For the dichotomous classification of positive or negative myocardial perfusion SPECT, reversible and persistent defects were considered as positive. We investigated the functional outcomes on the admission and discharge using the Modified Rankin scale (MRS) and functional independence measure (FIM) scores. Cardiac events in patients with stroke were investigated.
RESULTS
The myocardial perfusion SPECT was positive in 10 of 18 patients (55.6%) with ischemic stroke. Four out of ten patients with ischemic stroke had cardiac events. Positive myocardial perfusion SPECT was significantly associated with cardiac events (p<0.05). Risk factors of ischemic stroke with positive myocardial perfusion SPECT was more numerous than those of ischemic stroke with negative myocardial perfusion SPECT (p<0.05). However there was no statistically significant difference between functional outcome and findings of myocardial perfusion SPECT (p>0.05).
CONCLUSION
The results of our study suggested that myocardial perfusion SPECT is useful in the screening of silent ischemic heart disease in patients with ischemic stroke and to assess future cardiac events of them.