The value of transient ischemic dilation for detecting restenosis after coronary artery revascularization

• Published in: Journal of nuclear cardiology Vol. 25; no. 2; pp. 586 - 592
• Main Authors: Gultekin, Salih Sinan, Sadic, Murat, Bilgin, Murat, Koca, Gökhan, Acikel, Sadik, Yeter, Ekrem, Korkmaz, Meliha
• Format: Journal Article
• Language: English
• Published: New York Elsevier Inc 01-04-2018; Springer US; Springer Nature B.V
• Subjects: Aged; Cardiology; Cardiovascular disease; Constriction, Pathologic; Coronary Angiography; Coronary Artery Bypass; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Restenosis - diagnostic imaging; coronary revascularization; Coronary vessels; Coronary Vessels - diagnostic imaging; Dilatation; Female; Follow-Up Studies; Humans; Imaging; Ischemia; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Myocardial Ischemia; Myocardial Perfusion Imaging; myocardial perfusion imaging: SPECT; Myocardial Revascularization; Nuclear Medicine; Original Article; Percutaneous Coronary Intervention; Radiology; Recurrence; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon; transient ischemic dilation; EF; CAD; MPI; ESV; Tc-99m Sestamibi; coronary revascularization; Coronary artery disease; transient ischemic dilation; SPECT; TID; EDV; PCI; myocardial perfusion imaging: SPECT; CABG
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1007/s12350-016-0607-z

Transient ischemic dilation (TID) is a marker of severe coronary artery disease (CAD). We aimed to assess the incremental value of TID in a cohort of patients with known significant CAD who had recurrence of symptoms after revascularization.
We identified in our databases 104 patients who had recent coronary revascularization and recurrence of symptoms. 62 patients had PCI (75 arteries) and 42 patients had CABG (104 arteries). All had follow-up stress SPECT MPI and repeat coronary angiography. Myocardial perfusion findings of ischemia and TID were correlated with presence of significant obstructive CAD (≥70% stenosis).
Follow-up stress Tc-99m Sestamibi SPECT MPI revealed inducible ischemia in 38 patients (36.5%) and TID ≥ 1.20 in 49 patients (47%). Subsequent coronary angiography showed significant obstructive CAD in 44 patients (42%). The sensitivity for detecting obstructive CAD was 61% for SPECT MPI alone, but increased significantly to 93% by the addition of TID as a diagnostic criterion (P < 0.0001).
In this selected patient cohort with prior coronary revascularization, TID is an important marker of obstructive CAD and has incremental value over SPECT MPI alone.