Phase analysis of gated SPECT and its role in assessment of LV dyssynchrony induced by stress test in patients with multivessel coronary artery disease

Abstract Background Limited research is available to assess if examining LV mechanical dyssynchrony brought on by exercise through phase analysis improves multivessel CAD diagnosis compared to conventional perfusion analysis. Methods and results One hundred CAD suspect or CAD-confirmed patients underwent both coronary angiography and Tc 99m sestaMIBI-gated SPECT. The SyncTool was utilized to assess LV mechanical dyssynchrony by calculating the SD and histogram bandwidth. Sensitivities were 74% and 67% with an SD increase of ≥ 4.4° and a bandwidth of ≥ 14° after the workout. Eighty-four percent sensitivity and 53% specificity were demonstrated by a summed stress score (SSS) of ≥ 9 among the 100 patients with multivessel CAD. Compared to SSS alone (sensitivity 70%, specificity 76%, χ 2 = 68.9), the combination of post-stress increases in phase SD, histogram bandwidth, and SSS yielded the best accurate diagnosis of multivessel CAD (sensitivity 77%, specificity 88%, χ 2 = 181.8). Conclusions The diagnosis of multivessel CAD can be effectively enhanced through phase analysis that evaluates exercise-induced LV mechanical dyssynchrony in conjunction with traditional perfusion studies.