Correspondence between left ventricular 17 myocardial segments and coronary arteries

• Published in: European heart journal 2005-12, Vol.26 (24), p.2637-2643
• Main Authors: Pereztol-Valdés, Osvaldo, Candell-Riera, Jaume, Santana-Boado, César, Angel, Juan, Aguadé-Bruix, Santiago, Castell-Conesa, Joan, Garcia, Ernest V., Soler-Soler, Jordi
• Format: Article
• Language: English
• Subjects: Angiography; Angioplasty; Angioplasty, Balloon, Coronary - methods; Biological and medical sciences; Cardiology. Vascular system; Coronary Circulation; Coronary disease; Coronary heart disease; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - pathology; Coronary Stenosis - therapy; Coronary Vessels - diagnostic imaging; Coronary Vessels - pathology; Female; Heart; Heart Ventricles - diagnostic imaging; Heart Ventricles - pathology; Humans; Male; Medical sciences; Middle Aged; Scintigraphy; Sensitivity and Specificity; Stroke Volume - physiology; Tomography, Emission-Computed, Single-Photon - methods; Tomography, Emission-Computed, Single-Photon - standards
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehi496

Aims The last guidelines recommend a standardized 17-segment model for tomographic imaging of the left ventricle. The aim of this study is to analyse the correspondence of the 17 left ventricular segments with each coronary artery by myocardial perfusion SPECT studies. Methods and results Fifty patients selected for percutaneous revascularization of one coronary artery [24 left anterior descending (LAD), 15 right coronary artery (RCA), and 11 left circumflex (LCX)] were included. The 99mTc-labelled compound was injected immediately after the inflation of the balloon during percutaneous coronary angioplasty. At least 90 s of complete occlusion time was required. Maximal contour of regions of hypoperfusion corresponding to each coronary artery occlusion were delineated over the polar map of 17 segments. Nine segments corresponded to only one coronary artery: eight to LAD (basal anterior, basal anteroseptal, mid-anterior, mid-anteroseptal, apical anterior, apical septal, apical lateral, and apex) and one to LCX (basal anterolateral). Basal inferoseptal, mid-inferoseptal, and apical inferior segments could correspond to LAD or RCA. Basal inferior, basal inferolateral, mid-inferior, and mid-inferolateral segments could correspond to RCA or LCX, whereas the mid-anterolateral segment could correspond to LAD or LCX. Conclusion The most specific segments (anterior, anteroseptal, and all apical segments except the infero-apical) correspond to LAD but no segment can be exclusively attributed to the RCA. Inferoseptal segments can be attributed to LAD or RCA, inferior and inferolateral segments to RCA or LCX, and mid-anterolateral segment to LAD or LCX.