Myocardial perfusion SPECT findings in postCOVID period

Eur J Nucl Med Mol Imaging. 2022 Feb;49(3):889-894. doi: 10.1007/s00259-021-05552-4. Epub 2021 Sep 7.

Abstract

Purpose: To investigate if (i) the risk of ischemia on myocardial perfusion scan (MPS), (ii) number of coronary angiographies (CAG) performed, and (iii) necessity for invasive (stent implantation or coronary artery bypass grafting (CABG)) or medical treatment increased in patients infected with COVID-19.

Methods: Patients who were referred to MPS between August 2020 and April 2021 with a history of active symptomatic COVID-19 infection (confirmed by PCR positivity) in the last 6 months were involved in the study group. Age-and gender-matched control group was composed of randomly chosen patients who attended for MPS between January 2019 and September 2019, before pandemic. Frequency of ischemia, CAG, and invasive or medical treatments were compared between groups.

Results: Ischemia was reported more frequently in the study group (p < 0.001). In clinical evaluation, regardless of the MPS results, the necessity for invasive evaluation with CAG and treatment (either medical therapy or invasive interventions) was higher in the study group (p = 0.006 and p = 0.015). It was also true for patients with abnormal MPS results (p = 0.008 and p = 0.024) but not for the patients with ischemia (p = 0.29 and p = 0.06).

Conclusion: There exists a significant increase in the frequency of ischemia on MPS, undergoing CAG, stent implantation or CABG, and initiation of medical therapy in patients with a history of COVID-19 infection in the last 6 months. MPS is a reliable method in patients who present with cardiovascular symptoms in the late COVID period.

Keywords: COVID-19; Ischemia; Perfusion; Radionuclide imaging.

MeSH terms

  • COVID-19*
  • Humans
  • Myocardial Ischemia*
  • Myocardial Perfusion Imaging*
  • Perfusion
  • SARS-CoV-2
  • Tomography, Emission-Computed, Single-Photon
  • Tomography, X-Ray Computed