Transient ischemic dilation: A powerful diagnostic and prognostic finding of stress myocardial perfusion imaging

TID is an abnormal finding in stress myocardial perfusion imaging that suggests severe and extensive CAD and signifies a worse prognosis. TID has been reported with exercise and pharmacologic stress testing, planar and SPECT imaging, and Tl-201, Tc-99m, and dual-isotope protocols. Underlying mechani...

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Bibliographic Details
Published in:Journal of Nuclear Cardiology 2002-11, Vol.9 (6), p.663-667
Main Authors: McLaughlin, Michael G., Danias, Peter G.
Format: Article
Language:English
Subjects:
Cardiology
Coronary Disease - complications
Coronary Disease - diagnostic imaging
Coronary Disease - physiopathology
Dilatation, Pathologic - complications
Dilatation, Pathologic - diagnostic imaging
Dilatation, Pathologic - physiopathology
Exercise Test - methods
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Humans
Prognosis
Radionuclide Imaging
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - etiology
Ventricular Dysfunction, Left - physiopathology
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Summary:TID is an abnormal finding in stress myocardial perfusion imaging that suggests severe and extensive CAD and signifies a worse prognosis. TID has been reported with exercise and pharmacologic stress testing, planar and SPECT imaging, and Tl-201, Tc-99m, and dual-isotope protocols. Underlying mechanisms include a combination of stress-induced subendocardial hypoperfusion, ischemic systolic dysfunction, and less likely physical LV dilation with severe ischemia. TID appears to represent a significant ischemic burden and, compared with increased pulmonary Tl-201 uptake, suggests less permanent LV dysfunction and more myocardium at risk. Stress-to-rest LV volume ratios of 1.12 (epicardial) and 1.22 (endocardial) have been consistently shown to be highly specific for severe and extensive CAD.[PUBLICATION ABSTRACT]
ISSN:1071-3581
1532-6551
DOI:10.1067/mnc.2002.124979