Left Ventricular Remodeling After Myocardial Infarction: A Perspective from gated-SPECT Myocardial Perfusion Imaging

pp. 15-20

Abstract

Introduction: Gated SPECT is an appropriate method for quantifying the extent of necrotic scar and identifying its culprit vessel. Analyzing patients with small to medium-sized infarctions who progress with a decrease in LVEF (Left Ventricular Ejection Fraction) could enhance our understanding of the factors influencing the presence of adverse remodeling and the subsequent evolution to ventricular dysfunction.

Materials and Methods: We conducted a retrospective analysis of consecutive patients who underwent Gated-SPECT myocardial perfusion imaging during the year 2017. Patients with significant valvular disease or arrhythmias that affected gating were excluded. Adverse remodeling was defined as the combination of reduced LVEF (LVEF less than 50%) and myocardial necrosis of less than 20%

Results: A total of 1902 patients were included. The prevalence of reduced LVEF was 8% (n=148). In multivariate analysis, independent variables associated with ventricular dysfunction were male gender (OR 2.50, 95% CI 1.30-4.9, p=0.005), diabetes (OR 1.83, 95% CI 1.12-3.00, p=0.01), and necrosis greater than 6.6% (OR 39.00 95% CI 25.00-61.28, p=0.00001). In the subgroup of patients with necrotic burden less than 20% (n=197), the prevalence of adverse remodeling was 25% (n=50). Multivariate analysis revealed that diabetes (OR 2.83, 95% CI 1.31-6.10, p=0.007) and male gender (OR 5.00 95% CI 1.1-22.9, p=0.007) were independently associated with adverse remodeling.

Conclusions: Gated SPECT can be used for assessing adverse remodeling and its associated factors. This assessment is based on the combination of variables that do not require additional software and are used in daily practice.

Cómo citar este artículo:

San Miguel L, Brodsky L, Masoli OH. Remodelado del ventrículo izquierdo postinfarto: una mirada desde la perfusión miocárdica Gated-SPECT. Rev Argent Cardiol 2024;92:15-20. http://dx.doi.org/10.7775/rac.v92.i1.20724