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The assessment of septal wall motion in patients undergoing CABG by myocardial perfusion-gated SPECT

Ozdemir, Semraa; Yener, Ali Ümitb; Barutcu, Ahmetc; Tan, Yusuf Z.a; Çelik, Fatmanura

Nuclear Medicine Communications: July 2015 - Volume 36 - Issue 7 - p 738–746
doi: 10.1097/MNM.0000000000000309
ORIGINAL ARTICLES
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Purpose In this study, we aimed to assess the presence and prevalence of paradoxical septal motion (PSM) by myocardial perfusion-gated single-photon emission computed tomography (SPECT) imaging in patients undergoing coronary artery bypass grafting (CABG).

Methods A total of 172 patients (145 men and 27 women, with a mean age of 64.81±8.93 years) undergoing CABG surgery were included in the study. All selected scintigraphic studies of the patients undergoing CABG were reprocessed. Semiquantitative interpretation of septal perfusion, wall motion, and wall thickening was performed with QPS and QGS programs. Phase analysis parameters were also obtained using the Emory Cardiac Toolbox. According to myocardial perfusion-gated SPECT results, the patients were trichotomized as follows: group 1 (nonischemic PSM): regular perfusion and thickening of the septal wall and abnormal motion of the septal wall; group 2 (ischemic PSM): abnormal perfusion, motion, and thickening of the septal wall; group 3 (non-PSM): normal perfusion, motion, and thickening of the septal wall. The data in each of the three groups were compared using Student’s t-test and one-way analysis of variance.

Results No PSM (normal perfusion, motion, and thickening of the septal wall) was observed in 19.2% of patients undergoing CABG, whereas nonischemic PSM (regular perfusion and thickening of the septal wall and abnormal motion of the septal wall) was observed in 60.5% of patients and ischemic PSM (abnormal perfusion, motion and thickening of the septal wall) was seen in 20.3% of patients.

Conclusion According to our study results, PSM is fairly common in patients undergoing CABG. It will be beneficial to use myocardial perfusion scintigraphy-gated SPECT, which is a noninvasive examination method, to identify the presence of PSM and investigate whether it is accompanied by ischemia or infarction.

Departments of aNuclear Medicine

bCardiovascular Surgery

cCardiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey

Correspondence to Semra Ozdemir, MD, PhD, Department of Nuclear Medicine, Faculty of Medicine, Canakkale Onsekiz Mart University, 17100 Canakkale, Turkey Tel: +90 286 2180018 x1041; fax: +90 286 2635957; e-mail: semozdemir@yahoo.com

Received January 5, 2015

Received in revised form February 7, 2015

Accepted February 10, 2015

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