Transient dilation of the left ventricular cavity observed during myocardial perfusion imaging: What is its incremental diagnostic value

Taillefer, Raymond

doi:10.1007/s12350-016-0701-2

Cited by 3 publications

(3 citation statements)

References 24 publications

(29 reference statements)

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“…Significant left ventricular dilation after stress images compared with rest images on SPECT MPI is defined as the transient ischemic dilation of the left ventricle. 49 It could be regarded as the non-perfusion indices of severe and extensive CAD. 50 The most frequent causes of transient ischemic dilation are prolonged hypertension (probably due to myocardial hypertrophy-induced subendocardial ischemia) and extensive subendocardial or multivessel ischemia, resulting in the non-visualization of the subendocardial myocardium following stress MPI.…”

Section: Discussionmentioning

confidence: 99%

“… 50 The most frequent causes of transient ischemic dilation are prolonged hypertension (probably due to myocardial hypertrophy-induced subendocardial ischemia) and extensive subendocardial or multivessel ischemia, resulting in the non-visualization of the subendocardial myocardium following stress MPI. 51 , 52 Stress-induced immobility of the left ventricle 49 and endothelial dysfunction 53 are the other mechanisms of transient ischemic dilation. Similar to the present study, transient ischemic dilation is often observed in patients with DM or dyslipidemia.…”

Section: Discussionmentioning

confidence: 99%

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Association between Cardiovascular Risk Factors and High-risk Features in Myocardial Perfusion Imaging: A Multicenter Study

Khederlou,

Mohammadi,

Tajik

et al. 2023

JTHC

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Background: Myocardial perfusion imaging (MPI) is a noninvasive method with acceptable sensitivity and specificity in diagnosing coronary artery disease (CAD) in moderate-risk patients, including those with CAD risk factors. Methods: The present cross-sectional, prospective study was conducted on 4886 patients from April 2020 through March 2023 at Chamran and Tehran Heart Center hospitals. A questionnaire regarding anthropometric variables, demographic characteristics, CAD risk factors, and MPI findings was designed. Results: Totally, 2179 patients (44.6%) had abnormal MPI. Patients with abnormal MPI were significantly older than those with normal MPI. Older age (OR, 1.64; 95% CI, 1.2 to 1.72; P<0.001), diabetes mellitus (DM) (OR, 1.36; 95% CI, 1.1 to 1.48; P=0.012), hypertension (OR, 1.24; 95% CI, 1.04 to 1.37; P=0.032), and dyslipidemia (OR, 1.54; 95% CI, 1.25 to 1.8; P<0.001) were associated with abnormal MPI independently. Patients with more CAD risk factors were more likely to have abnormal MPI. Thus, in patients without or at most with 1 risk factor and those with 8 CAD risk factors, the likelihood of abnormal MPI was 3.7% and 76.2%, respectively. The frequency of left ventricular dilation and right ventricular prominence was significantly higher in patients with older age (P<0.001 and P=0.043, respectively), dyslipidemia (P<0.001 and P=0.007, respectively), DM (P<0.001 and P<0.001, respectively), and hypertension (P=0.048 and P=0.057, respectively). Conclusion: Individuals with CAD risk factors, especially those with older age, DM, hypertension, or dyslipidemia, require meticulous attention during CAD evaluation, particularly via MPI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association between Cardiovascular Risk Factors and High-risk Features in Myocardial Perfusion Imaging: A Multicenter Study

Khederlou,

Mohammadi,

Tajik

et al. 2023

JTHC

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“…Force is a new parameter but it has old and deep roots in experimental physiology and cardiac imaging, with a variety of different approaches, from nuclear cardiology (myocardial perfusion imaging and radionuclide ventriculography) to echocardiography itself. Force is observed from different perspectives in various subspecialties of cardiology: it is a reduction of the slope in the pressure-volume loop for the cardiac physiologist and invasive cardiologist [31]; a transient ischaemic LV dilation during stress for the cardiac imager [32]; and a drop in systolic blood pressure (SBP) for the clinical cardiologist [33]. All of the above have been independently associated with poor outcome.…”

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confidence: 99%

Left ventricular contractile reserve in stress echocardiography: the bright side of the force

Bombardini¹,

Preradović²,

Cortigiani³

et al. 2019

Kardiol Pol

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Stress echocardiography (SE) is based on the detection of regional wall motion abnormalities (RWMA) mirroring a physiologically critical epicardial artery stenosis which determines subendocardial underperfusion. Recently, the core protocol of SE has been enriched by the addition of left ventricular contractile reserve (LVCR) based on force. Changes in force can be caused by microvascular and/or epicardial coronary artery disease, but also by myocardial scar, necrosis, and/or sub-epicardial layer disease. Left ventricular contractile reserve is calculated as the stress-to-rest ratio of force (systolic arterial pressure measured by cuff sphygmomanometer to end-systolic volume determined by two-dimensional echocardiography). In contrast to the ejection fraction, force is not dependent on changes in preload and afterload. Cutoff values for a preserved LVCR are > 2.0 for dobutamine or exercise stress and > 1.1 for vasodilators, which are weaker inotropic stimuli. Patients with a "strong" heart (normal LVCR values) have a better outcome than patients with a "weak" heart (reduced LVCR values), and this is the prognostic "bright side of the force," meaning that the prognostic value of force-based contractile reserve is higher than that of ejection fraction-based contractile reserve or RWMA. The addition of force to standard SE based on RWMA detection increases the spectrum of risk stratification without any significant increase in imaging time and only a slight increase in analysis time. In both ischaemic (with RWMA) and non-ischaemic (without RWMA) hearts, the preserved force is associated with a more benign prognosis. The prospective multicentre international Stress Echo 2020 trial which started in September 2016 has already recruited > 5000 patients with dual RWMA-force imaging and will systematically test the impact of force on the prognosis within and beyond coronary artery disease, including heart failure and hypertrophic cardiomyopathy.

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Long-term prognostic implications of myocardial perfusion imaging in octogenarians: an all-comer, cohort study

Katsikis

Theodorakos

Manira

et al. 2017

Eur J Nucl Med Mol Imaging

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Transient dilation of the left ventricular cavity observed during myocardial perfusion imaging: What is its incremental diagnostic value

Cited by 3 publications

References 24 publications

Association between Cardiovascular Risk Factors and High-risk Features in Myocardial Perfusion Imaging: A Multicenter Study

Association between Cardiovascular Risk Factors and High-risk Features in Myocardial Perfusion Imaging: A Multicenter Study

Left ventricular contractile reserve in stress echocardiography: the bright side of the force

Long-term prognostic implications of myocardial perfusion imaging in octogenarians: an all-comer, cohort study

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