Dynamic perfusion SPECT for functional evaluation in symptomatic patients with myocardial bridging

• Published in: Journal of nuclear cardiology Vol. 30; no. 5; pp. 2058 - 2067
• Main Authors: Xu, Rende, Yang, Hao, Zhang, Jie, Chen, Shuguang, Pang, Lifang, Wu, Yizhe, Pei, Zhiqiang, Shi, Hongcheng, Li, Chenguang, Ge, Junbo
• Format: Journal Article
• Language: English
• Published: Cham Elsevier Inc 01.10.2023; Springer International Publishing; Springer Nature B.V
• Subjects: Aged; Cardiology; Coronary Artery Disease - diagnostic imaging; Coronary Circulation; Dynamic SPECT; Fractional Flow Reserve, Myocardial; functional significance; Humans; Imaging; Medicine; Medicine & Public Health; Middle Aged; Myocardial Bridging; myocardial flow reserve; Myocardial Perfusion Imaging - methods; Nuclear Medicine; Original Article; Perfusion; Radiology; Retrospective Studies; Tomography, Emission-Computed, Single-Photon - methods; ROC; ROI; myocardial bridging; LAD; QCA; Dynamic SPECT; DS; MBF; SSS; myocardial flow reserve; MB; functional significance; MFR; CZT
• ISSN: 1071-3581; 1532-6551; 1532-6551
• DOI: 10.1007/s12350-023-03241-3

The aim of this study was to investigate the feasibility and diagnostic value of myocardial flow reserve (MFR) assessed by rest/stress myocardial perfusion imaging with dynamic single-photon emission computed tomography (SPECT) in the functional evaluation of myocardial bridge (MB). From May 2017 to July 2021, patients with angiographically confirmed isolated MB on the left anterior descending artery (LAD) who underwent dynamic SPECT myocardial perfusion imaging were retrospectively included. The assessment of semiquantitative indices of myocardial perfusion (summed stress scores, SSS) and quantitative parameters (MFR) was performed. A total of 49 patients were enrolled. The mean age of the subjects was 61.0 ± 9.0 years. All of the patients were symptomatic, and 16 cases (32.7%) presented with typical angina. SPECT-derived MFR showed a borderline significantly negative correlation with SSS (r = 0.261, P = .070). There was a trend of higher prevalence of impaired myocardial perfusion defined as MFR < 2 than as SSS ≥ 4 (42.9% vs 26.5%; P = .090). Our data support that SPECT MFR may be a useful parameter for the functional assessment of MB. In patients with MB, the use of dynamic SPECT could be a potential method for hemodynamic assessment.