Abstract 18968: Correlation Between Myocardial Perfusion and Contractility by SPECT and MRI, and Electromechanical Mapping Parameters in Patients with Advanced Coronary Artery Disease. A PRECISE Substudy

Abstract

Introduction: electromechanical mapping (EMM) of the left ventricle (LV) is a new technique that provides us with voltage (unipolar and bipolar voltage) and contractility (lineal local shortening) information of the LV. The objective of this study was to assess the correlation between EMM parameters and myocardial perfusion and contractility by SPECT/MRI, in patients with advanced chronic coronary artery disease (CAD).

Methods: the PRECISE clinical trial of freshly isolated adipose-derived stem cells for angiogenesis included pts with chronic stable CAD, reversible perfusion defects detectable by SPECT and not amenable for revascularization. Wall motion score index was assessed with MRI imaging in all patients (normal=1; hypokinetic=2; akinetic=3). Perfusion was studied with SPECT Tc-99m sestamibi (normal=grade 0; most impaired=grade 4) and EMM was performed with the NOGA XP system, all using the same 17-segment polar map of the LV. All studies were performed and analyzed by independent observers blinded to the results of the other techniques.

Results: 27 consecutive pts were included (62±8 years and 77% male). A total of 865 SPECT and MRI segments were correlated with the corresponding EMM data. Segments with better perfusion at rest and stress (fig.1), and segments with better WMSI by MRI (fig.2) had better voltage and local shortening parameters.

Conclusions: EMM is a useful technique for assessing myocardial health status in terms of perfusion and contractility in chronic CAD pts, and can be used for a precise delivery of stem cell therapy.