Dyssynchrony contributes to false-positive myocardial perfusion SPECT results in patients with stable angina

Eur J Echocardiogr. 2011 Jun;12(6):461-6. doi: 10.1093/ejechocard/jer048. Epub 2011 May 6.

Abstract

Aim: We designed this study to evaluate the possibility that dyssynchrony might lead to false-positive myocardial perfusion single photon emission computed tomography myocardial perfusion image (MPS) results in stable angina patients.

Methods and results: This study included 61 patients with both clinically diagnosed stable angina and quantitative MPS results who underwent coronary angiography. The patients were divided into two groups: those who had positive MPS results and normal coronary angiography (Group I, n = 28, 64.05 ± 10.14 years, 11 males and 17 females) and those who had positive MPS results and significant coronary lesions as determined by coronary angiography (Group II, n = 33, 69.2 ± 10.4 years, 14 males and 19 females). The maximal difference in time-to-peak myocardial sustained systolic velocity among all 12 left ventricular (LV) segments (maximal difference in TS) was significantly delayed in Group I as compared with Group II (125.00 ± 46.10 vs. 87.33 ± 40.53 ms, P=0.001). The standard deviation of the time-to-peak myocardial sustained systolic velocity of all 12 LV segments (TS-SD) was also significantly different in the two groups (45.12 ± 19.25 vs. 30.10 ± 15.80 , P=0.002).

Conclusion: Dyssynchrony may be a cause of false-positive quantitative MPS results, even if patients have narrow QRS complexes on ECG. Dyssynchrony index can increase the specificity of quantitative MPS in stable angina patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angina Pectoris / diagnostic imaging
  • Angina Pectoris / pathology*
  • Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / instrumentation
  • Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / methods*
  • Coronary Angiography
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / pathology
  • False Positive Reactions
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Perfusion Imaging / instrumentation
  • Myocardial Perfusion Imaging / methods*
  • Technetium Tc 99m Sestamibi*
  • Ultrasonography

Substances

  • Technetium Tc 99m Sestamibi