The Assessment Of Myocardial Perfusion And Cardiac Function By Gated Myocardial Perfusion Imaging In Patients With Coronary Heart Disease

ObjectiveTo explore the values of Gated Myocardial perfusion imaging （GMPI） inevaluating the cardiac function and myocardial perfusion in patients withcoronary heart disease.MethodThe Gated Myocardial perfusion imaging （GMPI） were undertook in60patients with coronary heart disease.The coronary angiography, echocardiog-raphy and other tests were performed on these patients within one week. Threeaxial surface of tomography images were obtained after using the gatedmyocardial SPECT ECTbox program for image processing. The left ventricularmyocardial perfusion were observed. Then end-diastolic volume （EDV）,end-systolic volume （ESV）, left ventricular ejection fraction（LVEF）, strokevolume （SV） were obtained by drawing region of interest（ROI）. While thecontraction and relaxation situation of each myocardial segments wereobserved, the left ventricular regional wall motion were determined to judge thediagnostic value of gated myocardial perfusion imaging （GMPI） in patients withcoronary heart disease.The relevance of function parameters and other testswere analyzed. The SRS will be obtained by semi-quantitative method, thencomparing with GS in order to judge the relaxation with cardiac function.Results1.Comparing with CAG, the sensitivity, specificity, accuracy, positivepredictive value and negative predictive value of GMPI for diagnosis of coronaryheart disease were93.33%,80.00%,90.00%,93.33%and80.00%respectively.2.There were45patients with CAG abnormalities in the60patients,12cases were single lesions,17cases were double lesions,16cases were threelesions. The positive detection rate of GMPI were75.00%（9/12）,82.35%（14/17）, 93.75%（15/16）; There were94stegnotic blood vessels, among them34caseswith mild stenosis,38cases with moderate stenosis,22cases with severestenosis,The positive rate of GMPI were76.47%（26/34）,86.84%（33/38）,95.45%（21/22）; Among94stegnostic blood vessels, there are42cases with leftanterior descending artery （LAD） lesions,25cases with left circumflex artery（LCX） lesions,27cases with lesions of the right coronary artery （RCA）, thepositive rate by GMPI were61.90%（26/42）,56.00%（14/25） and59.26%（16/27）respectively.3.There is a significant correlation between GMPI and UCG in theevaluation of left ventricular overall wall motion, The related coefficient was0.883at anterior,0.900at anteroseptal,0.893at lateral,0.852at inferior,0.880atanteroseptal,0.896at posterior septal,0.902at apex,0.850at posterior（P<0.01）.4.There is a significant correlation between GMPI and UCG in detecting ofEDV, ESV, LVEF, SV. The related coefficient was0.838,0.832,0.860and0.854in EDV, ESV, LVEF and SV respectively（P<0.01）.5.Based on the results of CAG,94abnormal coronary arteries in45patientswith coronary heart disease were divided into mild, moderate to severestenosis in three groups, by Pearson correlation analyze,different degree ofstenosis of the coronary arteries GMPI semi-quantitative score was positivelycorrelated with GS points. The correlation coefficients were0.751at mild stenosis,0.816at moderate stenosis,0.857at severe stenosis（P <0.01）.6.SRS’s score level was grouped as a categorical variable ordering byquartile values, there were significant differences in LVEF, EDV, ESV andSV（P<0.05）.By Pearson correlation analysis:There was a negative linearcorrelation with LVEF and SV,the correlation coefficients were-0.851,-0.848respectively;SRS showed a linear correlation with EDV and ESV, the correlationcoefficients were0.898,0.935, P <0.05.7.Summed resting perfusion total score （SRS） was significantly associatedwith echocardiography Semi-quantitative motion score index （WMSI）, byPearson correlation analysis: correlation coefficients were0.621at mild stenosisgroup,0.734at moderate stenosis group,0.810at severe stenosis group（P <0.01）. Conclusion1.^99mTc-MIBI gated myocardial perfusion imaging has very high sensitivityand specificity in the diagnosis of coronary heart disease.2.^99mTc-MIBI gated myocardial perfusion imaging has an improtant value inevaluating myocardial perfusion and cardiac function.3.^99mTc-MIBI gated myocardial perfusion imaging can assess regional wallmotion in patients with coronary heart disease accurately.4.^99mTc-MIBI gated myocardial perfusion imaging semi-quantitative analyzeindicators （the resting perfusion total score） is positively correlated withcoronary stenosis Gensini score. SRS isnegatively correlated with leftventricular systolic function.That is, the higher SRS, the greater the degree ofcoronary stenosis, the worse cardiac function.