Factors influencing myocardial blood flow decline and their value study
Objective This study aimed to investigate the impact of myocardial perfusion imaging(MPI),semi-quantitative parameters obtained through traditional single-photon emission computed tomography(SPECT),coronary angiography results and clin-ical parameters on myocardial ischemia.Methods Patients with coronary artery disease who underwent simultaneous cadmium zinc telluride SPECT(CZT SPECT)and coronary angiography(CAG)examinations were enrolled.Myocardial ischemia was diagnosed based on coronary flow reserve(CFR)<2.1 in the territory of any of the three major coronary arteries.Receiver operating characteristic(ROC)curves were generated for coronary stenosis severity,summed stress score(SS),rest score(RS),and score difference(DS)to determine the optimal cutoff values and corresponding diagnostic performance for myocardial ischemia.A predictive model was es-tablished using stepwise regression,and ROC curves were plotted.Results The final cohort included 39 patients with a total of 117 ma-jor vessels,of which 36 vessels(30.77%)were determined to have myocardial ischemia.The optimal cutoff values for coronary stenosis severity,SS,RS,and DS in diagnosing myocardial ischemia were 53%,3.5,1.5,and 1.5,respectively.The accuracies were 75.2%,74.4%,70.9%,and 72.6%,respectively.The area under the curve(AUC)and 95%confidence intervals(CI)were 0.78(0.68-0.87),0.64(0.53-0.74),0.58(0.49-0.66),and 0.65(0.55-0.75),respec-tively.The AUC and 95%CI of the predictive model established using stepwise regression were 0.84(0.76-0.92).Conclusion In traditional SPECT MPI,SS>3.5,DS>1.5,RS>1.5 hold certain significance in predicting myocardial ischemia.Combining angiographic results with SS,a history of hypertension and smoking habits enhance the accuracy of predicting myocardial ischemia.
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