Impact of specific coronary lesions on regional ischemia at single photon emission computed tomography. Issue 7 (July 2018)

• Record Type: Journal Article
• Authors: Nudi, Francesco; Schilllaci, Orazio; Biondi-Zoccai, Giuseppe; Pinto, Annamaria; Neri, Giandomenico; Procaccini, Enrica; Versaci, Francesco; Nudi, Alessandro; Tomai, Fabrizio; Frati, Giacomo; Iskandrian, Ami E.
• Is Part Of: Journal of cardiovascular medicine. Volume 19:Issue 7(2018:Jul.)
• Publication Date: 2018-07
• Subjects: coronary artery disease -- myocardial ischemia -- myocardial perfusion imaging -- revascularization -- stress testing; Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000000675
• Languages: English
• ISSNs: 1558-2027

Abstract

Abstract : Aims: Prior studies using stress myocardial perfusion imaging (MPI), which examined the association between obstructive epicardial coronary disease and presence of myocardial ischemia did not provide a detailed assessment on a regional level. We examined this relationship in a large population of patients in whom the coronary anatomy was defined by invasive coronary angiography. Methods: We retrospectively extracted details on individuals undergoing MPI with single photon emission computed tomography (SPECT) who had coronary angiography within 12 months. A 17-segment model for native coronary anatomy and a 7-region model for myocardial perfusion were used with a dedicated matching algorithm. Results: A total of 2564 patients were included, yielding a total of 6279 stenoses matched with 17 948 myocardial regions. From such a cohort, 151 (5.9%) patients had normal perfusion, 1878 (73.2%) had myocardial ischemia (reversible defects), 260 (10.1%) had myocardial necrosis (scar or fixed defects), and 275 (10.7%) had ischemia and necrosis. At per-patient analysis, significant angiographic disease was more common in the ischemic group (prevalence between 69.6 and 80.0%) than other groups. At per-region analysis, abnormal perfusion in the coronary-specific regions varied depending on location of stenosis; it was 96% for left main disease, 81% for proximal left anterior descending disease, 85% for proximal left circumflex disease, and 82% for proximal right coronary artery disease and <60% for posterior descending artery disease. Conclusion: The correlation between significant coronary stenosis and presence of corresponding regional perfusion abnormality depends on the location of the lesion and the corresponding myocardial region. Abstract : Supplemental Digital Content is available in the text