Prognostic Value of Diastolic Dysfunction Derived From D-SPECT in Coronary Artery Disease Patients With Normal Ejection Fraction

Bin Xu; Lu Liu; Fuad A Abdu; Guoqing Yin; Abdul-Quddus Mohammed; Siling Xu; Xian Lv; Rui Fan; Cailin Feng; Tingting Shi; Wen Zhang; Yawei Xu; Haidong Cai; Fei Yu; Wenliang Che

doi:10.3389/fcvm.2021.700027

Prognostic Value of Diastolic Dysfunction Derived From D-SPECT in Coronary Artery Disease Patients With Normal Ejection Fraction

Front Cardiovasc Med. 2021 Jul 15:8:700027. doi: 10.3389/fcvm.2021.700027. eCollection 2021.

Authors

Bin Xu^{1

2}, Lu Liu¹, Fuad A Abdu¹, Guoqing Yin¹, Abdul-Quddus Mohammed¹, Siling Xu¹, Xian Lv¹, Rui Fan¹, Cailin Feng¹, Tingting Shi¹, Wen Zhang¹, Yawei Xu¹, Haidong Cai³, Fei Yu³, Wenliang Che^{1

4}

Affiliations

¹ Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
² Medical College of Soochow University, Soochow University, Suzhou, China.
³ Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
⁴ Department of Cardiology, Shanghai Tenth People' s Hospital Chongming Branch, Shanghai, China.

Abstract

Diastolic dysfunction (DD) with normal systolic function has been elucidated to be associated with heart failure and worse prognosis. The recently introduced single photon emission computed tomography (SPECT) with dedicated cardiac cadmium-zinc-telluride (CZT) cameras (D-SPECT) is a novel method to quantitate left ventricular functional parameters. We aimed to evaluate the prognostic value of DD derived from D-SPECT in coronary artery disease (CAD) patients with normal ejection fraction. All CAD patients who underwent D-SPECT and invasive coronary angiography within 3 months were considered. DD was defined as peak filling rate (PFR) <2.1 end diastolic volume (EDV, ml)/s according to the D-SPECT results. Patients were divided into three groups: group 1 (n = 226)-normal PFR; group 2 (n = 67)-ischemia-related DD (abnormal stress PFR and normal rest PFR); and group 3 (n = 106)-rest DD (abnormal rest PFR). The primary clinical endpoint of the present study was a composite of heart failure events (HFE). A total of 399 consecutive CAD patients with normal systolic function undergoing stress D-SPECT were analyzed. The incidence rates of HFE among the three groups were 4.0, 7.5, and 11.3%, respectively. Cox regression analysis showed that the multivariate predictors of HFE were rest PFR, diabetes mellitus, obesity, and old age. DD derived from D-SPECT in CAD patients with normal ejection fraction is predictive of HFE.

Keywords: CAD; D-SPECT; diastolic dysfunction; peak filling rate; prognosis.