Impact of cardiac size on diagnostic performance of single-photon emission computed tomography myocardial perfusion imaging: insights from the REgistry of Fast Myocardial Perfusion Imaging with NExt generation single-photon emission computed tomography
Authors' conclusion
Detection of CAD with SPECT MPI is negatively impacted by small cardiac size, most notably in elderly and male patients.
Study context
- Population
- Patients without known coronary artery disease (CAD) undergoing single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) followed by coronary angiography (REFINE SPECT registry)
- Participants
- 2,066 patients9 institutions
- Comparison
- SPECT MPI diagnostic performance by cardiac size, age and sex
- Outcome
- AUC of SPECT MPI for detecting obstructive CAD, by cardiac size
Methodological detailsmulticentre registry, nine institutions, solid-state scanners
- Multicentre registry
- Nine institutions
- Solid-state scanners
Performance
As reported in the abstract
AUC for obstructive CAD by EDV
| Test or model | AUC (population threshold) | AUC (sex-specific threshold) |
|---|---|---|
| Low end-diastolic volume (EDV) | 0.72 | 0.72 |
| Normal EDV | 0.78 | 0.79 |
AUC (population threshold)
Low end-diastolic volume (EDV)0.72
Normal EDV0.78
AUC (sex-specific threshold)
Low end-diastolic volume (EDV)0.72
Normal EDV0.79
- Low EDV vs Normal EDV: P = 0.03 — population threshold: 0.72 vs 0.78
- Low EDV vs Normal EDV: P = 0.01 — sex-specific threshold: 0.72 vs 0.79
Further findings
AUC by age (elderly ≥75 vs <75 years)
- AUC elderly vs younger patients
- 0.72 vs. 0.78, P = 0.03
AUC by sex (males vs females)
- AUC males vs females, similar
- 0.77 vs. 0.76, P = 0.67
AUC, lower vs non-low EDV in males (sex-specific threshold) (subgroup)
- Reduction in accuracy with lower volumes primarily in males
- 0.69 vs. 0.79, P = 0.01
Patients with ≥2 of low EDV, elderly age or male sex
- Significant decrease in AUC, sensitivity, specificity and NPV for quantitative and visual assessments
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Impact of cardiac size on diagnostic performance of single-photon emission computed tomography myocardial perfusion imaging: insights from the REgistry of Fast Myocardial Perfusion Imaging with NExt generation single-photon emission computed tomography. Eur Heart J Cardiovasc Imaging. Published 6 March 2024. doi:10.
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