Contractility evaluation by 2 dimensional echocardiography and gated SPECT myocardial perfusion scintigraphy in hypertensive patients with clinical presentation of atypical chest pain.

BACKGROUND

Hypertension (HT) is a growing health problem in the population and associated with increased cardiovascular event risk and mortality. In hypertensive patients, progressive left ventricular (LV) contractility deterioration is detectable by gated single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy9. We planned this study to explore the agreement in ejection fraction (EF) determination between 2 dimensional echocardiography and gated SPECT analysis in selected group of patients with hypertension.

METHODS

We studied 26 consecutive patients (mean age 56.5 ± 8.8 years; 6 men) with hypertension. Quantitative contractility analysis by both echocardiography and SPECT at rest was performed to investigate the agreement between two diagnostic tests.

RESULTS

EF at rest was greater than 55 % in all patients. All patients had a clinical presentation of atypical chest pain. Therefore, in addition to quantitative contractility analysis at rest by echocardiography and myocardial SPECT perfusion scintigraphy, we examined ischemia by stress induction and determined that 10 patients had ischemic finding (38.4 %). The mean value of EF calculated by echocardiography was 67.5 ± 5.7 %, while EF by gated SPECT was 72.8 ± 8.5 %. We documented an acceptable agreement in EF determination between these 2 diagnostic tests by meaningful correlation (r = 0.556, p = 0.003). There was no regional contractility deterioration despite existence of ischemia in 10 patients of the study group.

CONCLUSIONS

We observed that both echocardiography and gated SPECT can be used for quantification of EF in the hypertensive patients with an acceptable agreement.