Key result
99mTc-sestamibi gated SPECT strongly correlates with ECHO for assessing EDV, ESV, and LVEF.
Why the study?
Agreement between gated myocardial perfusion SPECT and echocardiography in assessing left ventricular volumes and ejection fraction, and the effect of perfusion defect and small hearts on this agreement, was assessed due to echocardiography's routine use.
Does rest Tc99m-sestamibi GSPECT agree with 2-D ECHO in assessing left ventricular volumes and ejection fraction?
Cross-Sectional (n=50)
Single-blind
No
Does rest Tc99m-sestamibi GSPECT agree with 2-D ECHO in assessing left ventricular volumes and ejection fraction?
Effect estimate: r = 0.764, 0.831, and 0.813
p-value: p=<0.001
GSPECT and ECHO show good overall correlation for measuring LV volumes and EF, though significant differences exist in small hearts and patients without perfusion defects.
May support gated SPECT as alternative for LV assessment; hypothesis-generating and should not yet change practice.
BACKGROUND: Agreement between gated myocardial perfusion SPECT (GSPECT) and echocardiography (ECHO) in the calculation of left ventricular end-diastolic volume (EDV), end-systolic volume (ESV) and LVEF was assessed. Effect of perfusion defect and small hearts on this agreement was obtained. Because ECHO is a routine and widely used noninvasive modality for this purpose, we chose this technique for comparison with GSPECT. MATERIAL AND METHODS: In a prospective study, 50 consecutive patients (age = 59.7 ± 10.64 years) underwent rest Tc99m-sestamibi GSPECT and 2-D ECHO. The LVEF, EDV and ESV were calculated using QGS (Quantitative Gated SPECT) software. RESULTS: Fourteen (28%) patients had perfusion defect in rest phase tomograms, while 36 (72%) had no perfusion defect. There was a significant correlation between two modalities in calculation of EDV, ESV and LVEF (all: p < 0.001, Pearson's correlation coefficients: r = 0.764, 0.831 and 0.813, respectively). A good correlation was noticed even in small hearts or in patients with or without previous myocardial infarction. There was a significant difference between GSPECT and ECHO in patients with no perfusion defect as well as in patients with small heart (ESV < 25 ml). On the other hand, no remarkable difference was noticed between two techniques in the presence of perfusion defect or in patients with ESV ≥ 25 ml. CONCLUSION: There was a good agreement between EDV, ESV and LVEF derived from GSPECT and ECHO. There was a significant difference between two modalities in small hearts and in patients without perfusion defect, although in larger ventricles or in the presence of myocardial infarction no remarkable difference between two modalities was noticed.
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Danesh-Sani et al. (2014) conducted a cross-sectional in Known or suspected coronary artery disease (n=50). 99mTc-sestamibi gated myocardial perfusion SPECT vs. 2-D Echocardiography was evaluated on Correlation of end-diastolic volume, end-systolic volume, and left ventricular ejection fraction between GSPECT and ECHO (r = 0.764, 0.831, and 0.813, p=<0.001). 99mTc-sestamibi gated myocardial perfusion SPECT showed significant correlation with echocardiography for calculating end-diastolic volume, end-systolic volume, and ejection fraction (r = 0.764, 0.831, and 0.813, respectively; p < 0.001).
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