Prediction of all-cause mortality from gated-SPECT global myocardial wall thickening: comparison with ejection fraction and global longitudinal 2D-strain

J Nucl Cardiol. 2014 Feb;21(1):86-95. doi: 10.1007/s12350-013-9813-0. Epub 2013 Oct 30.

Abstract

Background: The aim of this study was to assess the correlation between global wall thickening (GWT) obtained by gated-single photon emission computed tomography (SPECT) and echocardiographic measures [ejection fraction (EF), global longitudinal strain (GLS), and strain rate (GLSR)] and to compare their prognostic value for all-cause mortality.

Methods and results: Seventy-four patients with referral for dipyridamole myocardial perfusion SPECT were prospectively included and underwent transthoracic echocardiography to measure left ventricular EF, GLS, and GLSR. The strongest correlation with GWT was for EF (R = 0.63, P < .001), followed by GLSR (R = -0.57, P < .001) and GLS (R = -0.53, P < .001). There were ten deaths over a period of 14.6 ± 5.7 months. Using the multivariate Cox analysis, summed stress score (HR 1.108; P = .023), EF (HR 1.01, P = .031), GLS (HR 1.593, P = .001), and GWT (HR 0.898, P = .034) remained independent predictors of mortality. Mean survival rate evaluated by Kaplan-Meier analysis was longer in patients with GWT ≥ 24% (21.9 ± 0.6 months) than those with GWT < 24% (13.6 ± 2.7 months; P < .001).

Conclusions: GWT assessed is a highly sensitive tool to detect early myocardial systolic dysfunction and may bring additional prognostic information.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Area Under Curve
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / mortality
  • Dipyridamole / chemistry
  • Echocardiography / methods
  • Female
  • Follow-Up Studies
  • Heart / diagnostic imaging*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardium / pathology*
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / mortality
  • Ventricular Function, Left

Substances

  • Dipyridamole