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Purpose <p>The study aimed to assess the prognostic value of non-perfusion parameters for gated myocardial perfusion imaging (MPI) performed using Cadmium-Zinc-Telluride (CZT) single-photon emission computed tomography (SPECT) for individuals with normal myocardial perfusion.</p> Methods <p>We analyzed data from consecutive patients who underwent thallium-201 MPI SPECT with normal perfusion. Major adverse cardiovascular events (MACEs) were recorded during a 2-year follow-up. Non-perfusion parameters were evaluated as predictors of MACEs.</p> Results <p>Among 1570 patients with normal SPECT perfusion, 80 (5.1%) experienced MACEs over a mean follow-up of 22.5 ± 10.8&#xa0;months: 12 (0.8%) had cardiac death, and 68 (4.3%) underwent coronary revascularization due to significant coronary artery disease. Independent predictors of MACEs included worsening post-stress ejection fraction (HR: 1.971; <i>p</i> = 0.008), and increased lung-to-heart ratio (HR: 2.207; <i>p</i> = 0.001). Kaplan–Meier analysis showed the highest MACEs’ incidence in patients with two of these factors (<i>p</i> &lt; 0.001). Among patients with normal resting ejection fraction, EF worsening (OR: 2.16; <i>p</i> = 0.004) and increased lung-to-heart ratio (OR: 1.91; <i>p</i> = 0.0013) both remained strong predictors.</p> Conclusions <p>Although normal myocardial perfusion typically indicates low risk for obstructive coronary artery disease, worsening post-stress ejection fraction and increased lung-to-heart ratio are crucial prognostic indicators. Importantly, these non-perfusion parameters retain their prognostic value even in patients without clinical heart failure, highlighting their relevance in comprehensive risk stratification beyond perfusion assessment alone.</p>

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Prognostic significance of non-perfusion parameters of cadmium-zinc-telluride single-photon emission computed tomography myocardial perfusion imaging for individuals with normal myocardial perfusion: a large-scale single-center retrospective cohort study

  • 期刊论文

  • 发表日期：

    2025年6月27日

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  • Chih-Yi Lin,
  • Li-Hua Tang,
  • Yi-Hsien Chou,
  • Chi-Lun Ko,
  • Mei-Fang Cheng,
  • Chien-Jung Chen,
  • Kuan-Yin Ko,
  • Chia-Ju Liu

摘要

Purpose

The study aimed to assess the prognostic value of non-perfusion parameters for gated myocardial perfusion imaging (MPI) performed using Cadmium-Zinc-Telluride (CZT) single-photon emission computed tomography (SPECT) for individuals with normal myocardial perfusion.

Methods

We analyzed data from consecutive patients who underwent thallium-201 MPI SPECT with normal perfusion. Major adverse cardiovascular events (MACEs) were recorded during a 2-year follow-up. Non-perfusion parameters were evaluated as predictors of MACEs.

Results

Among 1570 patients with normal SPECT perfusion, 80 (5.1%) experienced MACEs over a mean follow-up of 22.5 ± 10.8 months: 12 (0.8%) had cardiac death, and 68 (4.3%) underwent coronary revascularization due to significant coronary artery disease. Independent predictors of MACEs included worsening post-stress ejection fraction (HR: 1.971; p = 0.008), and increased lung-to-heart ratio (HR: 2.207; p = 0.001). Kaplan–Meier analysis showed the highest MACEs’ incidence in patients with two of these factors (p < 0.001). Among patients with normal resting ejection fraction, EF worsening (OR: 2.16; p = 0.004) and increased lung-to-heart ratio (OR: 1.91; p = 0.0013) both remained strong predictors.

Conclusions

Although normal myocardial perfusion typically indicates low risk for obstructive coronary artery disease, worsening post-stress ejection fraction and increased lung-to-heart ratio are crucial prognostic indicators. Importantly, these non-perfusion parameters retain their prognostic value even in patients without clinical heart failure, highlighting their relevance in comprehensive risk stratification beyond perfusion assessment alone.