AI Article Synopsis
- The study investigates how the size of the heart affects the accuracy of SPECT myocardial perfusion imaging (MPI) in identifying obstructive coronary artery disease (CAD).
- Among 2066 patients, it was found that those with a low left ventricular volume had lower diagnostic performance compared to those with larger volumes, particularly affecting older and male patients.
- The results indicate that smaller heart sizes lead to a significant decrease in the effectiveness of SPECT MPI, highlighting the need for tailored diagnostic approaches based on cardiac size, age, and sex.
Article Abstract
Aims: Variation in diagnostic performance of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has been observed, yet the impact of cardiac size has not been well characterized. We assessed whether low left ventricular volume influences SPECT MPI's ability to detect obstructive coronary artery disease (CAD) and its interaction with age and sex.
Methods And Results: A total of 2066 patients without known CAD (67% male, 64.7 ± 11.2 years) across nine institutions underwent SPECT MPI with solid-state scanners followed by coronary angiography as part of the REgistry of Fast Myocardial Perfusion Imaging with NExt Generation SPECT. Area under receiver-operating characteristic curve (AUC) analyses evaluated the performance of quantitative and visual assessments according to cardiac size [end-diastolic volume (EDV); <20th vs. ≥20th population or sex-specific percentiles], age (<75 vs. ≥75 years), and sex. Significantly decreased performance was observed in patients with low EDV compared with those without (AUC: population 0.72 vs. 0.78, P = 0.03; sex-specific 0.72 vs. 0.79, P = 0.01) and elderly patients compared with younger patients (AUC 0.72 vs. 0.78, P = 0.03), whereas males and females demonstrated similar AUC (0.77 vs. 0.76, P = 0.67). The reduction in accuracy attributed to lower volumes was primarily observed in males (sex-specific threshold: EDV 0.69 vs. 0.79, P = 0.01). Accordingly, a significant decrease in AUC, sensitivity, specificity, and negative predictive value for quantitative and visual assessments was noted in patients with at least two characteristics of low EDV, elderly age, or male sex.
Conclusion: Detection of CAD with SPECT MPI is negatively impacted by small cardiac size, most notably in elderly and male patients.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210974 | PMC |
| http://dx.doi.org/10.1093/ehjci/jeae055 | DOI Listing |
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