Detecting Myocardial Ischemia With Technetium-Tetrofosmin Myocardial Perfusion Imaging in Ischemic Stroke.

BACKGROUND

To assess the myocardial status in patients with stroke, employing myocardial perfusion imaging (MPI) with Technetium-tetrofosmin (Tc-TF)-single-photon emission computed tomography (SPECT).

METHODS

Fifty-two patients with ischemic stroke were subjected to Tc-TF-SPECT MPI within 1 month after stroke occurrence. None of the patients had any history or symptoms of coronary artery disease or other heart disease. Myocardial perfusion imaging was evaluated visually using a 17-segment polar map. Myocardial ischemia (MIS) was defined as present when the summed stress score (SSS) was >4; MIS was defined as mild when SSS was 4 to 8, and moderate/severe with SSS ≥9. Patients with SSS >4 were compared to patients with SSS <4. Parameters such as age, body mass index, waist perimeter, smoking habits, and medical history (diabetes mellitus, dyslipidemia, etc) were evaluated according to MPI results.

RESULTS

Myocardial ischemia was present in 32 (62%) of 52 patients with stroke. Among them, 20 (62%) of 32 patients had mild abnormalities and 12 (38%) of 32 had moderate/severe. The age and waist perimeter showed a tendency to relate to severe MIS when patients with SSS >9 were compared to patients with SSS <4. In MPI-positive patients, an age was to be association with SSS, with the oldest age exhibiting the highest SSS ( = .01). The association of age with SSS remained statistically significant in the multivariate analysis ( = .04).

CONCLUSION

The study suggested that more than half of patients with stroke without a history of cardiac disease have MIS. Although most of them have mild MIS, we suggest a thorough cardiological evaluation in this group of patients for future prevention of severe myocardial outcome.