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Computer derived transient ischemic dilation ratio for identifying extensive coronary artery disease using a CZT camera and imaging in the upright position

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Transient ischemic dilation (TID) of the left ventricle (LV) has not been validated as a marker of extensive coronary artery disease (CAD) for studies using a cadmium-zinc-telluride (CZT) camera with upright imaging.

Methods

TID ratios were obtained from upright stress and rest images on a CZT camera. Separate cut-off values were determined for exercise and for regadenoson stress. The cutoffs were then applied to 28 patients with extensive CAD and 101 patients without extensive CAD.

Results

With treadmill exercise, an upright TID ratio ≥1.16 provided a positive predictive value of 50% and a negative predictive value of 85.4% for the identification of extensive CAD. In the regadenoson group, an upright TID ratio of 1.29 provided a positive predictive value of 20% and a negative predictive value of 75.9%. Although not an independent predictor of extensive CAD in all subjects, in subjects with a normal upright LVEF, it provided a predictive value by receiver operating characteristics comparable to the SSS.

Conclusions

Increased upright TID measurements on a CZT camera are associated with extensive CAD. The upright TID measurements can serve in an adjunctive role to SSS, and may be most effective in patients with a normal upright exercise LVEF.

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Abbreviations

AUC:

Area under the curve

CABG:

Coronary artery bypass surgery

CAD:

Coronary artery disease

CZT:

Cadmium-zinc-telluride

LV:

Left ventricle

LVEF:

Left ventricular ejection fraction

MPI:

Myocardial perfusion imaging

PCI:

Percutaneous coronary intervention

SPECT:

Single-photon emission computerized tomography

SSS:

Summed stress score

TID:

Transient ischemic dilation

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Disclosure

This work was funded by the John R. Strauss Fund for Research and Education in Cardiac Imaging, Cincinnati, Ohio.

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267-0542, USA

    Mouhamad Abdallah MD, Naseer Khan MD, Mahyar Khaleghi MD & Myron C. Gerson MD

  2. Division of Nuclear Medicine, Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA

    Erica Washburn CNMT

  3. University of Cincinnati College of Medicine, University of Cincinnati, Cincinnati, OH, USA

    Nischelle Kalakota BS

  4. Division of Cardiology, Department of Internal Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Zenith A. Jameria MD

  5. Division of Biostatistics and Epidemiology, Department of Biomedical Sciences, Texas Tech University Health Science Center, El Paso, TX, USA

    Alok Dwivedi PhD

Authors
  1. Zenith A. Jameria MD
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  2. Mouhamad Abdallah MD
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Correspondence to Myron C. Gerson MD.

Additional information

See related editorial, doi:10.1007/s12350-016-0582-4.

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Jameria, Z.A., Abdallah, M., Dwivedi, A. et al. Computer derived transient ischemic dilation ratio for identifying extensive coronary artery disease using a CZT camera and imaging in the upright position. J. Nucl. Cardiol. 24, 1702–1708 (2017). https://doi.org/10.1007/s12350-016-0515-2

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  • DOI: https://doi.org/10.1007/s12350-016-0515-2

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