Biomedical Sciences ETDs

Publication Date

7-1-2015

Abstract

OBJECTIVES: We used gated single-photon emission computed tomography Technetium (99mTc) tetrofosmin (SPECT Myoview), myocardial perfusion imaging (MPI) to (i) determine whether the location of myocardial infarction and Ischemia affect left ventricular function, and (ii) associated changes between post-stress (SEF) and rest ejection fraction (REF) with segmental perfusion abnormalities. METHODS: Five hundred ninety-eight patients underwent a rest- stress or stress—rest gated SPECT Myoview. A Quantitative Gated SPECT (QGS) software program was used to calculate the left ventricular ejection fraction at rest and stress. The left ventricle was divided into thirteen segments. The perfusion abnormalities on each segment were visually assessed. The patients scans were divided into 4 groups with ischemia, infarction, artifact and no findings on scans. Associations between the segments and SEF, REF were studied. RESULTS: Patients with artifact showed no statistically significant association with decrease in either REF or SEF at any segments. Multiple segments among the patients with infarction showed association with REF or SEF including; anterior apical segment (REF p 0.039, Coeff — 10.07) apex (REF p 0.000, Coeff — 4.83), mid septal segment (SEF p 0.011, Coeff -18.61), anterior apical segment (SEF p 0.032, Coeff -9.93), apical lateral segment (SEF p 0.035, Coeff — 11.45) and apex (SEF p0.000, Coeff -5.48). The patients with ischemia showed only association with SEF on the mid septal segment (SEF p 0.038, Coeff -10.50). CONCLUSION: The segmental perfusion abnormality showed significant association with REF and SEF mostly after myocardial infarction. In this group, 4 out of 13 segments showed significant association with decreasing LVEF. Only the anterior apical segment and apex showed an association with REF while the anterior and lateral apical segments, mid septal and apex showed significant association with decreasing SEF after infarction. No significant association between any segments involved in artifact and LVEF were identified but ischemia showed association only with SEF if mid septal segment was involved. The global LVEF is the most affected by the mid septal segment in myocardial infarction. The overall results suggested that some of the segments of the infarction are more associated with decreasing LVEF compared to the other segments of the myocardium.

Keywords

"gated SPECT Myoview, left ventricular function, myocardial infarction, perfusion abnormalities"

Document Type

Thesis

Language

English

Degree Name

Biomedical Sciences

Level of Degree

Masters

Department Name

Biomedical Sciences Graduate Program

First Advisor

Crandall, Cameron

Second Advisor

Alavi, Abass

First Committee Member (Chair)

Kesler, Denece

Second Committee Member

Davis, Herbert

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