Systolic Wall Thickening: A Strong Determinant of Diastolic Parameters in Patients with Pathological Findings at Exercise Stress Gated-SPECT

Background and Aim: The aim of the present study was to assess the correlation between functional and perfusion parameters with stress and resting peak filling rate in consecutive patients who showed perfusion and/or function abnormalities at exercise stress Gated-SPECT. Patients and Methods: 127 patients (112 males, 88%; mean age: 68.1 ± 9.23 y) were enrolled. Fifty-seven patients (45%) had a history of myocardial infarction and 78 (61.4%) a history of previous cardiac revascularization. All patients underwent a 2-day protocol. The patients received a dose of 740 MBq of 99mTc-SestaMIBI after stress and at rest. Results: Twenty-two (17.3%) patients showed fixed perfusion defects, 97 (76.4%) showed partially or completely reversible defects, while 8 (6.3%) showed normal perfusion but reduced LVEF. SSS was significantly higher than SRS (9.36 ± 9.94 vs. 5.91 ± 8.74; p = 0.0001). Stress peak filling rate was not significantly higher than peak filling rate at rest (1.99 ± 0.71 EDV/s vs. 1.93 ± 0.75 EDV/s; p = 0.26). Post-stress LVEF was similar to resting LVEF (54.8% ± 10.66% vs. 54.6% ± 11.17%; NS). On multivariate regression analysis, after correction for clinical, perfusion and function parameters, stress LVEF and systolic wall thickening at rest were the only independent predictors of both stress peak filling rate and peak filling rate at rest. Conclusions. Systolic wall thickening at rest seems to be the better determinant of diastolic function compared to perfusion parameters.