Causes of Transient Dilatation of the Left Ventricle During Myocardial Perfusion Imaging

Robinson, V.J.; Corley, J. H.; Marks, David; Eberhardt, L; Eubig, Casimir; Burke, George; Lm, Prisant

doi:10.2214/ajr.174.5.1741349

Cited by 29 publications

(18 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In comparison to images at rest, perfusion is improved in the subendocardium and the LV cavity appears smaller (4). This phenomenon is often referred to as balanced ischemia (5). Other studies have linked long-standing hypertension to the presence of TID (5,19).…”

Section: Discussionmentioning

confidence: 99%

“…This phenomenon is often referred to as balanced ischemia (5). Other studies have linked long-standing hypertension to the presence of TID (5,19). This condition also results in a relative reduction in subendocardial perfusion during stress, possibly because of the increased epicardial diastolic pressure required to perfuse the entire width of the myocardium.…”

Section: Discussionmentioning

confidence: 99%

“…Several mechanisms for this phenomenon have been proposed, however, there is no clear consensus as to the pathophysiology resulting in the finding of TID (1)(2)(3)(4)(5). Previous studies have suggested that TID in the context of reversible myocardial perfusion defects is associated with increased risk of severe, extensive multivessel coronary artery disease (CAD) (1,6,7).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Transient Ischemic Dilation of the Left Ventricle on SPECT: Correlation with Findings at Coronary CT Angiography

et al. 2014

View full text Add to dashboard Cite

Transient ischemic dilation (TID) in the setting of abnormal stress-rest cardiac SPECT myocardial perfusion imaging (MPI) has been linked with increased cardiovascular risk. However, the significance of TID in the setting of an otherwise normal SPECT MPI study has not been clearly established. In this study, cardiac CT was used to evaluate the prevalence of atherosclerotic lesions and the severity of coronary artery stenosis in patients with TID of the left ventricle with or without associated myocardial perfusion defects on SPECT MPI. Methods:The study population consisted of 1,553 consecutive patients who had undergone both cardiac CT and SPECT MPI within 1 mo between January 1, 2006, and September 1, 2011. Patients included in the study group had a pathologic TID value defined as ≥1.18 for men and ≥1.22 for women. Coronary CT angiography was used to evaluate each coronary segment for the presence and composition of atherosclerotic plaque and the degree of coronary stenosis. TID-positive patients were compared with a 2:1 risk-factor-matched-pair control cohort without TID. Results: TID was identified in 30 patients who were compared with TID-negative risk-factor-matched controls (n 5 60). When compared with the TID-negative control cohort, TID-positive patients had no significant differences in the presence and extent of atherosclerosis, the degree of coronary artery stenosis, or the calcium score at cardiac CT. Similarly, there were no significant differences in these CT measures in TID-positive patients with a normal perfusion study (n 5 20) when compared with TID-negative patients with a normal perfusion study (n 5 48). In addition, there was no significant difference in the incidence of major adverse cardiac events when comparing both the TID-positive patients and the TIDnegative control cohort and when comparing patients who were TID-positive with normal perfusion with patients who were TID-negative with normal perfusion. Conclusion: The presence of TID with an otherwise normal SPECT MPI study does not translate into a greater extent of coronary artery disease as assessed by cardiac CT or increased risk for future major adverse cardiac events. Tr ansient ischemic dilation (TID) on stress SPECT myocardial perfusion imaging (MPI) is defined as the apparent presence of left ventricular (LV) dilation on poststress relative to rest images. Several mechanisms for this phenomenon have been proposed, however, there is no clear consensus as to the pathophysiology resulting in the finding of TID (1-5). Previous studies have suggested that TID in the context of reversible myocardial perfusion defects is associated with increased risk of severe, extensive multivessel coronary artery disease (CAD) (1,6,7). TID in the setting of an abnormal SPECT MPI study has also been linked with increased cardiovascular risk and poor cardiovascular outcomes (8-11). However, the significance of TID in the setting of an otherwise normal SPECT MPI study has not been clearly established. It is thought that TID in the setting of an other...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Transient Ischemic Dilation of the Left Ventricle on SPECT: Correlation with Findings at Coronary CT Angiography

et al. 2014

View full text Add to dashboard Cite

show abstract

“…TID is currently a well recognized marker for severe and extensive coronary artery disease during SPECT imaging [3,5]. Subsequent pictorial reviews [6] have shown that TID may be observed in non CAD related etiology.…”

Section: Discussionmentioning

confidence: 99%

Transient ischemic dilatation of the left ventricle with severe post stress left ventricular dysfunction in the setting of severe aortic stenosis and normal coronary arteries

Kowalski

Harkness

Ananthasubramaniam

2006

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Transient ischemic dilatation (TID) of the left ventricle observed during single photon myocardial perfusion emission computed tomography (SPECT) is an important non-perfusion finding that may not only suggest underlying significant (usually multi-vessel) coronary artery disease (CAD) but also an independent prognostic factor of adverse outcomes regardless of abnormal or normal perfusion finding. We present a patient with no significant epicardial coronary disease who had significant TID and considerable decrease in the left ventricular ejection fraction with left ventricular dilatation after a rest-stress Tc-99 tetrofosmin SPECT study in the setting of severe aortic stenosis. With the advent of gated SPECT imaging the additive value of determining rest and post stress EF, as demonstrated in this case, aided in the recognition of TID and transient decrease in the left ventricular ejection fraction. These are not necessarily related to obstructive epicardial coronary disease, but are a result of severe aortic valve disease causing subendocardial ischemia in the setting of multilple other non-ischemic etiologies of TID such as left ventricular hypertrophy and diabetes mellitus.

show abstract

“…Although in cases of severe ventricular hypertrophy there can be a compensatory dilation of epicardial coronary arteries, the myocardium seems to suffer transmural ischemia unrelated to any coronary stenosis 12 …”

mentioning

confidence: 99%

Quantificação da dilatação ventricular esquerda na cintilografia miocárdica perfusional

Gonzalez¹,

Azambuja²,

Bodanese³

2011

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

show abstract

Causes of Transient Dilatation of the Left Ventricle During Myocardial Perfusion Imaging

Cited by 29 publications

References 8 publications

Transient Ischemic Dilation of the Left Ventricle on SPECT: Correlation with Findings at Coronary CT Angiography

Transient Ischemic Dilation of the Left Ventricle on SPECT: Correlation with Findings at Coronary CT Angiography

Transient ischemic dilatation of the left ventricle with severe post stress left ventricular dysfunction in the setting of severe aortic stenosis and normal coronary arteries

Quantificação da dilatação ventricular esquerda na cintilografia miocárdica perfusional

Contact Info

Product

Resources

About