The Importance of SPECT/CT in Simultaneous Assessment of Calcinosis of Coronary Arteries, Perfusion and Contractile Function of the Myocardium among Men’s with Coronary Heart Disease

Abstract

Purpose: To study the frequency of calcinosis of coronary arteries and its effect on myocardial perfusion and contractile function among men’s with coronary heart disease (CHD). Material and methods: A survey was conducted among 1175 men’s aged 30 to 83 years with coronary artery disease (CHD): simultaneous assessment of coronary artery calcinosis, perfusion and contractile function with 99m Tc-MIBI using SPECT/CT with ECG-synchronization and X-ray radiation attenuation correction, as well as comparison of data with the results of electrocardiography (ECG), echocardiography (ECHO-CG), clinical and biochemical blood tests. Results: Of the 1175 men examined using SPECT/CT, coronary artery calcification was detected in 426 (35 %): in the age group over 55 years old – in 142 (12 %), in the age group 46−55 years old – in 200 (17 %), in the age group 27–45 years old – in 74 (6 %). The interval of calcium index indicators in accordance with the Agatston scale was established as follows: at the maximum degree > 400 units – in 87 males (7 % of all examined); at 101−400 units – at 121 (10 %); at 11−100 units – at 162 (14 %); at 1−10 units – in 46 (4 %); with a minimum degree − of 0 units – in 759 men (65 % of all examined). In 34 men of whom 15 had coronary calcification and 19 did not have it, perfusion index (SPB) was either normal or corresponded to the initial degree of decrease in perfusion, and contractile function was slightly impaired, the ejection fraction was not reduced. Conclusion: The use of SPECT/CT technology with ECG-synchronization and CT-attenuation correction of radiation, in 1175 men with CHD made it possible to detect coronary calcification in 35 %: at the age of 55 years in 12 %, at the age of 46–55 years in 17 %, at the age of 27–45 years – in 6 %. In men with CHD without acute coronary events, both with and without coronary calcinosis, SPB was either normal or corresponded to the initial degree of reduced perfusion, and contractile function was slightly impaired, EF was not reduced. Three years later, in men whose coronary artery calcification was moderate despite its increase to a high degree, the perfusion (SPB) and contractile function indicators did not significantly change, and such indicators did not significantly change in the absence of coronary artery calcification.