Predictive value of incidental right ventricular abnormalities identified on SPECT for mortality and pulmonary hypertension

Abstract

Background. The clinical significance of incidentally found RV abnormalities on low-risk SPECT studies is not well-defined. The objective of this study was to determine the predictive value of incidental right ventricular (RV) abnormalities identified on single photon emission computed tomography (SPECT) scans for mortality and pulmonary hypertension (PH).Methods. We retrospectively analyzed all low-risk SPECT studies in patients without known coronary artery or pulmonary vascular disease, performed at our institution, from 2007-2020. Adjusted Cox proportional hazards models were used to evaluate the association between incidental RV abnormalities on low-risk SPECT studies and outcomes.Results. Of the 4761 patients included in the analysis, mortality events were present in 494, and echocardiographic PH was present in 619. Incidental RV abnormalities on low-risk SPECT studies were significantly and independently associated with all-cause mortality (HR = 1.41, CI [1.07-1.86], P 5 0.0152) and echocardiographic PH (HR = 2.06, CI [1.64-2.60], P < 0.0001).Conclusions. These data suggest incidental RV abnormalities found on low-risk SPECT imaging studies are significantly and independently associated with increased mortality and risk of developing echocardiographic PH, and could identify high-risk patients for closer monitoring and additional diagnostic testing. (J Nucl Cardiol 2021)

Spatial‐temporal V‐Net for automatic segmentation and quantification of right ventricle on gated myocardial perfusion SPECT images

“…5,12 Jose et al suggest that incidental RV abnormalities found on low-risk MPS are significantly and independently associated with increased mortality and could identify high-risk patients for closer monitoring and additional diagnostic testing. 25 Brunken further suggests that a structured nuclear cardiology report would benefit from the inclusion of information about RV volumes, RVEFs, and global and regional RV function for each SPECT perfusion study. 26 Accordingly, our proposed method has important clinical values for the research and development of RV functional assessment on MPS.…”

The abnormal right ventricle: Relevant on low risk SPECT perfusion images?

“…Accordingly, Jose and colleagues sought to examine the ramifications of an abnormal RV on low-risk SPECT perfusion studies acquired over a thirteen-year period at the University of Cincinnati. 9 STUDY DESIGN They reviewed 12,883 SPECT perfusion records and identified 4,761 exams with normal LV perfusion. None of the study patients had heart failure, PH, prior MI or valvular disease, and none demonstrated transient LV dilatation with stress.…”