Assessment of diastolic heart function--experience with 16-gated myocardial perfusion SPECT.

BACKGROUND: Ischaemic heart disease (IHD) is a major health problem today. However the focus has shifted primarily to angiographically detecting epicardial vessel stenoses, and ways and means of surgically correcting the blocks. Patients are often not fully evaluated for cardiac function, and diastolic dysfunction of heart, which is often an earlier manifestation than systolic dysfunction, goes undetected. METHODS: Recent gamma cameras have better imaging quality due to attenuation correction with SPECT-CT. 121 patients underwent gated myocardial perfusion imaging (MPI) for suspected coronary artery disease (CAD). We studied the diastolic function of these patients by 16-gated SPECT MPI. RESULTS: 60% patients showed absence of inducible ischaemia on MPI, and hence further invasive procedures like angiography were prevented, 40% showed inducible ischaemia and had to be further evaluated and required intervention. Of all 121 patients, 10% had LV systolic and diastolic dysfunction whereas 66% had isolated diastolic dysfunction. 40% patients had no ischaemia, normal systolic function and only diastolic dysfunction. 40% of these cases had symptoms of chest heaviness/angina equivalent. CONCLUSION: Myocardial perfusion imaging is a useful modality for evaluating patients of suspected CAD and in addition to perfusion data, also provides functional assessment of systolic and diastolic function, which provides comprehensive information regarding patients' symptomatology and can guide further management.