Key result
Combining post-stress increases in phase SD, bandwidth, and SSS improves multivessel CAD sensitivity to 77%.
Why the study?
Limited research is available to assess whether examining exercise-induced LV mechanical dyssynchrony via phase analysis improves multivessel CAD diagnosis compared to conventional perfusion analysis.
Does phase analysis of gated SPECT improve the diagnosis of multivessel CAD compared to conventional perfusion analysis in patients with suspected or confirmed CAD?
Cross-Sectional (n=100)
No
Does phase analysis of gated SPECT improve the diagnosis of multivessel CAD compared to conventional perfusion analysis in patients with suspected or confirmed CAD?
Adding phase analysis of exercise-induced LV mechanical dyssynchrony to conventional SPECT perfusion imaging significantly improves the diagnostic accuracy for detecting multivessel coronary artery disease.
May aid gated SPECT diagnosis of multivessel CAD; leaves open prospective validation before practice change.
Background Limited research is available to assess if examining LV mechanical dyssynchrony brought on by exercise through phase analysis improves multivessel CAD diagnosis compared to conventional perfusion analysis. Methods and results One hundred CAD suspect or CAD-confirmed patients underwent both coronary angiography and Tc 99m sestaMIBI-gated SPECT. The SyncTool was utilized to assess LV mechanical dyssynchrony by calculating the SD and histogram bandwidth. Sensitivities were 74% and 67% with an SD increase of ≥ 4.4° and a bandwidth of ≥ 14° after the workout. Eighty-four percent sensitivity and 53% specificity were demonstrated by a summed stress score (SSS) of ≥ 9 among the 100 patients with multivessel CAD. Compared to SSS alone (sensitivity 70%, specificity 76%, χ 2 = 68.9), the combination of post-stress increases in phase SD, histogram bandwidth, and SSS yielded the best accurate diagnosis of multivessel CAD (sensitivity 77%, specificity 88%, χ 2 = 181.8). Conclusions The diagnosis of multivessel CAD can be effectively enhanced through phase analysis that evaluates exercise-induced LV mechanical dyssynchrony in conjunction with traditional perfusion studies.
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Sabri et al. (2024) conducted a cross-sectional in Multivessel coronary artery disease (n=100). Phase analysis of gated SPECT combined with Summed Stress Score (SSS) vs. Summed Stress Score (SSS) alone was evaluated on Accurate diagnosis of multivessel CAD (Sensitivity). The combination of post-stress increases in phase SD, histogram bandwidth, and SSS improved the diagnosis of multivessel CAD, achieving 77% sensitivity and 88% specificity compared to 70% sensitivity and 76% specificity with SSS alone.
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