Serial myocardial perfusion imaging (MPI) is valuable for assessing coronary disease
progression and treatment efficacy. Previous serial MPI studies emphasized severe
perfusion defects, with no attention given to milder perfusion defects. Thus, this
study sought to compare and identify predictors of change in severe versus mild perfusion
defect size in patients who underwent serial positron emission tomography (PET) MPI.
Serial PET MPI was performed in 551 patients with an average of 1.9 years between
scans. Severe and mild perfusion defect size at both PETs were derived from automated
software as percentage of left ventricular mass with relative tracer activity <60%
(severe) and between 61% and 80% of maximum tracer activity (mild), respectively.
Predictors of change in severe and mild perfusion defect size between PETs were determined.
Overall, severe perfusion defect sizes improved (p <0.001) and mild perfusion defect
sizes worsened (p <0.001) between PETs with individual changes being highly variable.
In individuals with negligible changes in severe defect size (±2%), changes in mild
defect size ranged from a worsening of 47% to an improvement of 48% of left ventricular
mass. The strongest predictors of change in severe defect size were indicators of
obstructive coronary disease including interval myocardial infarction, interval revascularization,
history of myocardial infarction, and history of bypass surgery. Strong predictors
of change in mild defect size were cardiac risk factors including male gender, body
mass index, diabetes, and smoking. In conclusion, changes in mild perfusion defects
may provide valuable secondary information for evaluating treatment efficacy in patients
who underwent serial MPI.
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Article info
Publication history
Published online: August 26, 2014
Accepted:
August 5,
2014
Received in revised form:
August 5,
2014
Received:
May 7,
2014
Footnotes
This work was funded by the American Heart Association, University at Buffalo, and Niagara Falls Memorial Medical Center.
See page 1517 for disclosure information.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
