Resting myocardial strain derived from gated SPECT and its associations with ventricular remodeling, synchrony, perfusion and function

To evaluate the association between resting myocardial strain derived from gSPECT-MPI and left ventricular (LV) remodeling, mechanical dyssynchrony, myocardial perfusion, and LV function. We retrospectively analyzed 131 consecutive patients (age 64.07 ± 11 years; 63.36% men) who underwent resting gSPECT-MPI with myocardial strain analysis using StrainTool™ (Emory Cardiac Toolbox™). Global longitudinal (GLS), circumferential (GCS), and radial strain (GRS), LV function, remodeling, mechanical synchrony, and myocardial perfusion were assessed. Pearson and Spearman correlations and univariable and multivariable linear regression analyses were performed. GLS, GCS, and GRS showed significant Pearson and Spearman correlations with parameters of LV remodeling, mechanical synchrony, myocardial perfusion, and LV function. In multivariable linear regression analysis, LV mass ( p = 0.031), LV ejection fraction (LVEF) ( p < 0.001), and the end-systolic ( p = 0.008) and end-diastolic ( p = 0.022) eccentricity indices were independently associated with GLS (R² = 0.86; p < 0.001). Similarly, LVEF ( p < 0.001) and the end-systolic and end-diastolic shape indices (both p < 0.001) were independently associated with GCS (R² = 0.84; p < 0.001). LVEF ( p < 0.001) was independently associated with GRS (R² = 0.65; p < 0.001). Myocardial strain derived from resting gSPECT-MPI was associated with multiple markers of ventricular function, remodeling, mechanical synchrony, and myocardial perfusion. The distinct patterns of association observed for GLS, GCS, and GRS provide further insight into the relationships between myocardial deformations and conventional gSPECT-MPI parameters. Complex integrated mechanisms of left ventricular function, incorporating structural parameters, myocardial strain, ventricular remodeling, mechanical synchrony, systolic blood pressure, and both diastolic and systolic function.