Predictors of hemodynamically significant coronary stenoses in patients with disturbed myocardial perfusion based on the results of single-photon emission computed tomography
Kuznetsov, V.A.; Iaroslavskaia, E.I.; Gorbatenko, E.A.
Klinicheskaia Meditsina 90(7): 25-30
2012
ISSN/ISBN: 0023-2149 PMID: 23019970 Document Number: 663739
Patients with positive results of single-photon emission CT (SPECT) were examined to identify parameters indicative of hemodynamically significant coronary stenosis (HSCS) prior to coronaroangiography (CAG). 47 of the 84 patients (mean age 49.1 +/- 8.7 yr, 71% men) had positive results of SPECT. Patients with HSCS more frequently experienced acute myocardial infarction (37.1% vs 6.5%. p = 0.005) and circulatory failure (II-IV functional class NYHA) (92.3% vs 51.6%, p = 0.026). Also, they had higher blood glucose levels (6.9 +/- 2.5 vs 5.3 +/- 0.8 mmol/l, p = 0.007). The echocardiographic study more frequently revealed the 50% impairment of left ventricular function in these patients (17.4 vs 7.4%, p = 0.001), reduced ejection fraction (59.6 +/- 8.9 vs 48.9 +/- 10.5%), greater LV size and asynergia (20.8 +/- 18.0 vs 2.0 +/- 5.5% and 1.4 +/- 0.3 vs 1.0 +/- 0.1%), more pronounced mitral insufficiency (81.3 +/- 59.4%, p = 0.026). Only these patients had post-infarctional changes in myocardium (31.3%. p = 0.001). Discrimination analysis revealed independent association of HSCS with LV asynergia and mitral regurgitation. These echocardiographic parameters may be regarded as predictors of HSCS in patients with suspected CHD and positive results of SPECT.