Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Imaging
Prediction of Left Main or 3-Vessel Disease Using Myocardial Perfusion Reserve on Dynamic Thallium-201 Single-Photon Emission Computed Tomography With a Semiconductor Gamma Camera
Shinya ShiraishiFumi SakamotoNoriko TsudaMorikatsu YoshidaSeiji TomiguchiDaisuke UtsunomiyaHisao OgawaYasuyuki Yamashita
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2015 Volume 79 Issue 3 Pages 623-631

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Abstract

Background:Myocardial perfusion imaging (MPI) may fail to detect balanced ischemia. We evaluated myocardial perfusion reserve (MPR) using Tl dynamic single-photon emission computed tomography (SPECT) and a novel cadmium zinc telluride (CZT) camera for predicting 3-vessel or left main coronary artery disease (CAD).Methods and Results:A total of 55 consecutive patients with suspected CAD underwent SPECT-MPI and coronary angiography. The MPR index was calculated using the standard 2-compartment kinetic model. We analyzed the utility of MPR index, other SPECT findings, and various clinical variables. On multivariate analysis, MPR index and history of previous myocardial infarction (MI) predicted left main and 3-vessel disease. The area under the receiver operating characteristic curve was 0.81 for MPR index, 0.699 for history of previous MI, and 0.86 for MPR index plus history of previous MI. MPR index ≤1.5 yielded the highest diagnostic accuracy. Sensitivity, specificity, and accuracy were 86%, 78%, and 80%, respectively, for MPR index, 64%, 76%, 73% for previous MI, and 57%, 93%, and 84% for MPR index plus history of previous MI.Conclusions:Quantification of MPR using dynamic SPECT and a novel CZT camera may identify balanced ischemia in patients with left main or 3-vessel disease. (Circ J 2015; 79: 623–631)

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© 2015 THE JAPANESE CIRCULATION SOCIETY
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