Myocardial perfusion imaging with real-time respiratory triggering: Impact of inspiration breath-hold on left ventricular functional parameters

Abstract

The latest gamma-camera generation with cadmium-zinc-telluride (CZT) detectors allows myocardial perfusion imaging (MPI) with respiratory triggering at breath-hold. We assessed its impact on functional left ventricular (LV) parameters. Twenty-eight consecutive patients underwent a one-day (99m)Tc-tetrofosmin pharmacologic stress/rest imaging protocol on a novel CZT camera. Electrocardiogram-gated high-dose (rest) MPI was performed without and with real-time respiratory triggering by intermittent scanning confined to breath-hold at deep inspiration. We studied the effect of respiratory triggering at deep inspiration levels on LV wall motion, wall thickening, LV volumes and ejection fraction (LVEF) compared to regular MPI without respiratory triggering. Compared to regular MPI without respiratory triggering, systolic and diastolic LV volumes and stroke volumes decreased significantly (P<0.05) when respiratory triggering was applied. By contrast, there was no significant change in LVEF, with a high correlation (r=.939, P<0.001) between the two measurements. Furthermore, respiratory triggering introduced a significant change (P<0.05) in regional LV wall motion. Respiratory-triggered MPI with breath-hold at deep inspiration levels introduces significant changes to the measured LV volumes, stroke volumes and regional wall motion but does not significantly affect global LVEF when compared to regular MPI with normal breathing.