Gimelli Alessia, Liga Riccardo, Giorgetti Assuero, Casagranda Mirta, Marzullo Paolo
Fondazione Toscana G. Monasterio, Pisa, Italy.
Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Via Paradisa 2, 56100, Pisa, Italy.
J Nucl Cardiol. 2019 Feb;26(1):227-232. doi: 10.1007/s12350-017-0862-7. Epub 2017 Mar 28.
Abnormal left ventricular (LV) eccentricity index (EI) is a marker of adverse cardiac remodeling. However, the interaction between stress-induced alterations of EI and major cardiac parameters has not been explored. We sought to evaluate the relationship between LV EI and coronary artery disease (CAD) burden in patients submitted to myocardial perfusion imaging (MPI).
Three-hundred and forty-three patients underwent MPI and coronary angiography. LV ejection fraction (EF) and EI were computed from gated stress images as measures of stress-induced functional impairment. One-hundred and thirty-six (40%), 122 (35%), and 85 (25%) patients had normal coronary arteries, single-vessel CAD, and multivessel CAD, respectively. Post-stress EI was lower in patients with multivessel CAD than in those with normal coronary arteries and single-vessel CAD (P = 0.001). This relationship was confirmed only in patients undergoing exercise stress test, where a lower post-stress EI predicted the presence of multivessel CAD (P = 0.039).
Post-stress alterations of LV EI on MPI may unmask the presence of multivessel CAD.
左心室（LV）偏心指数（EI）异常是心脏不良重塑的一个标志物。然而，应激诱导的EI改变与主要心脏参数之间的相互作用尚未得到探讨。我们试图评估接受心肌灌注成像（MPI）的患者中LV EI与冠状动脉疾病（CAD）负担之间的关系。
343例患者接受了MPI和冠状动脉造影。从门控应激图像计算左室射血分数（EF）和EI，作为应激诱导的功能损害的指标。分别有136例（40%）、122例（35%）和85例（25%）患者冠状动脉正常、单支血管CAD和多支血管CAD。多支血管CAD患者的应激后EI低于冠状动脉正常和单支血管CAD患者（P = 0.001）。这种关系仅在接受运动应激试验的患者中得到证实，应激后EI较低预示着多支血管CAD的存在（P = 0.039）。
MPI上LV EI的应激后改变可能揭示多支血管CAD的存在。
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