The prevalence and predictive accuracy of quantitatively defined transient ischemic dilation of the left ventricle on otherwise normal SPECT myocardial perfusion imaging studies

Ali, Mohamed A. Mandour; Bourque, Jamieson M.; Allam, Adel H.; Watson, Denny D.

doi:10.1007/s12350-011-9458-9

Cited by 25 publications

(8 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When incorporated into stress/rest SPECT screening protocols, TID could provide additional information for severe CAD (4, 8). Although the exact significance of quantitatively elevated TID in patients with normal or minimal perfusion abnormality remains unclear and some studies showed that TID had a low prevalence and poor predictive value in the otherwise normal MPI (11–12), the presence of TID in patients with abnormal myocardial perfusion abnormality, such as those in our study, has previously been shown to be associated with extensive and severe coronary artery disease (1, 4, 7, 13, 14), as well as a strong independent predictor of future cardiac events (15, 16). However, different scanning protocols may have different normal limits for TID ratios (8, 9), and these have not been well established.…”

Section: Introductionmentioning

confidence: 99%

Transient ischemic dilation for coronary artery disease in quantitative analysis of same-day sestamibi myocardial perfusion SPECT

Arsanjani

Clond

et al. 2012

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

Background Transient ischemic dilation (TID) of the left ventricle in Myocardial Perfusion SPECT (MPS) has been shown to be a clinically useful marker of severe coronary artery disease (CAD). However, TID has not been evaluated for 99mTc-sestamibi rest/stress protocols (Mibi-Mibi). We aimed to develop normal limits and evaluate diagnostic power of TID ratio for Mibi-Mibi scans. Methods TID ratios were automatically derived from static stress/rest MPS (TID) and gated stress/rest MPS from the end-diastolic phase (TIDed) in 547 patients who underwent Mibi-Mibi scans (215 patients with correlating coronary angiography and 332 patients with low likelihood (LLk) of CAD). Scans were classified as severe (≥70% stenosis in proximal left anterior descending artery (pLAD) or left main (LM), or ≥90% in ≥2 vessels), mild to moderate (≥90% stenosis in 1 vessel or ≥70%-90% in ≥1 vessel except pLAD or LM), and normal (<70% stenosis or LLk group). Another classification based on the angiographic Duke prognostic CAD index (DI) was also applied: DI < 30 or LLk group, 30 ≤ DI < 50 and DI ≥ 50. Results The upper normal limits were 1.19 for TID and 1.23 for TIDed as established in 259 LLk patients. Both ratios increased with disease severity (P<.0001). Incidence of abnormal TID increased from 2% in normal patients to > 36% in patients with severe CAD. Similarly, when DI was used to classify disease severity, the average ratios showed significant increasing trend with DI increase [P < 0.003]; incidence of abnormal TID also increased with increasing DI. The incidence of abnormal TID in the group with high perfusion scores significantly increased compared to the group with low perfusion scores (stress total perfusion deficit – TPD <3%) (P <.0001). The sensitivity for detecting severe CAD improved for TID when added to mild to moderate perfusion abnormality (3% ≤ TPD < 10%): 71% vs. 64%: P<0.05; and trended to improve for TIDed/ TIDes: 69% vs. 64%: P=0.08, while the accuracy remained consistent if abnormal TID was considered as a marker in addition to stress TPD. Similar results were obtained when DI was used for the definition of severe CAD (sensitivity: 76% vs. 66% [P < 0.05] when TID was combined with stress TPD. Conclusion TID ratios obtained from gated or ungated Mibi-Mibi MPS and are useful markers of severe CAD.

show abstract

Section: Introductionmentioning

confidence: 99%

Transient ischemic dilation for coronary artery disease in quantitative analysis of same-day sestamibi myocardial perfusion SPECT

Arsanjani

Clond

et al. 2012

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

show abstract

“…The findings regarding TID are supported by those of a previous study by Abidov et al 35 which reported that patients with a high TID and otherwise normal SPECT-MPI or minimal perfusion defects more commonly had severe or extensive CAD incorporating 3VD or >90% stenosis in the proximal LAD as defined by ICA. Some recent papers, however, have reported that TID is not a predictor of extent, severity or high risk of CAD among patients with normal MPI 36–38 . Regarding abnormal EF/EF response abnormalities of EF response have been shown to be related to the severity of the coronary artery stenoses as defined by ICA 39 .…”

Section: Discussionmentioning

confidence: 90%

Predictors of high-risk coronary artery disease in subjects with normal SPECT myocardial perfusion imaging

Nakanishi

Gransar

Slomka

et al. 2016

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

show abstract

“…Valdiviezo et al studied a cohort of normal perfusion imaging and found no association of TID and multi-vessel disease (15). Mandour et al, found that TID had predictability in patients with perfusion abnormalities but not in the setting of normal perfusion (16). …”

Section: Tid and Its Significance On Coronary Angiographymentioning

confidence: 99%

Prognostic impact of TID in regadenoson MPI: Some patients and certain events

Löffler

Bourque

2016

Journal of Nuclear Cardiology

Self Cite

View full text Add to dashboard Cite

The prevalence and predictive accuracy of quantitatively defined transient ischemic dilation of the left ventricle on otherwise normal SPECT myocardial perfusion imaging studies

Abstract: In the setting of otherwise normal MPI, elevated TIDr has a low prevalence and poor predictive accuracy and should not be considered summarily as a marker of high risk CAD.

Cited by 25 publications

References 20 publications

Transient ischemic dilation for coronary artery disease in quantitative analysis of same-day sestamibi myocardial perfusion SPECT

Transient ischemic dilation for coronary artery disease in quantitative analysis of same-day sestamibi myocardial perfusion SPECT

Predictors of high-risk coronary artery disease in subjects with normal SPECT myocardial perfusion imaging

Prognostic impact of TID in regadenoson MPI: Some patients and certain events

Contact Info

Product

Resources

About