Quantification of Contraction Synchronicity and Contraction Work in Coronary Artery Disease / 대한핵의학회잡지

ABSTRACT

PURPOSE: This study quantified the contraction synchronicity (CS; with 100% representing full synchrony and −100% dyssynchrony) and contraction work (CW, millijoules per centimeter squared; representingmyocardial area) in patients with reduced left ventricular ejection fraction (LVEF) associated with coronary artery disease (CAD).METHODS: CS, CW and LVEF in 104 subjects (54 CAD patients and 50 control subjects without CAD) were measured using rest electrocardiography-gated single-photon emission computed tomography (ECG SPECT). Contraction amplitude (CA), synchronous contraction index (SCI), and CW were evaluated using the program Quantification of Segmental Function by Solving the Poisson Equation (QSFP) developed in-house.RESULTS: The mean CA, SCI and CW of 17 segments in the control subjects were 33.8 ± 4.1% (±SD), 96.6 ± 1.4%, and 6.9 ± 1.0 mJ/cm², respectively. In the patients with CAD, the respective values were 26.1 ± 7.3%, 82.1 ± 16.8%, and 5.4 ± 1.6 mJ/cm². In the CAD patients with LVEF <40% (n = 14), the mean CA, SCI,and CW were 17.9 ± 4.0%, 63.0 ± 18.4%, and 3.5 ± 1.1 mJ/cm², respectively. These values were significantly lower than in the control subjects (p < 0.005). Using receiver operating characteristic analysis, values for the area under the curve showing the performance of CA, CS,CWand LVEF in the diagnosis of CAD were 0.81, 0.86, 0.78, and 0.84, respectively.CONCLUSION: Asynchrony shown using the QSFP is useful for CAD detection.