3A) and rest (Fig. 3B) images (?0.0007 �� 3.2 and 0.4 �� 2.1, respectively), with no correlation between the differences and mean TPD. The Wilcoxon signed rank test was insignificant for stress TPD by high-speed versus conventional SPECT (p = 0.25), but significant for rest TPD comparison (p = 0.02). Center-based analysis demonstrated linear correlation between high-speed TPD and conventional TPD in the stress and rest images in all participating centers Selleckchem INK-128
(Table 4). Analysis by coronary artery territories revealed good concordance in all 3 territories (Table 5). The magnitude of stress TPD by both high-speed and conventional SPECT images was significantly greater in patients with a high pre-test likelihood of CAD than a low or intermediate likelihood (p < 0.001) (Fig. 4A). No difference between the methods was observed within each of the likelihood categories. The average amount of ischemia (calculated as the difference between stress and rest TPD) among patients with a high likelihood was significantly higher for high-speed SPECT compared with conventional SPECT (4.6 �� 4.6 vs. 3.9 �� 4.0, respectively; p < 0.05) and similar among patients with low and intermediate likelihood (Fig. 4B). Defining the stress-rest TPD difference of ��5% as a reversible defect and rest TPD ��7% as a fixed defect demonstrated 81.5% agreement between the 2 methods among patients OSI-906 mouse
with intermediate and high CAD likelihood (Table 6). Of the 32 patients with reversible or partially reversible defects by conventional SPECT, 4 had fixed defects and 8 were normal by high-speed SPECT. Conversely, of the 41 patients with reversible or partially reversible defects by the high-speed technology, 10 had fixed defects and 11 were normal by conventional SPECT (p = 0.37). Gated data of high-speed and conventional SPECT were obtained in 220 of the 238 patients. Figure 5 demonstrates linear correlation between EDV by high-speed and conventional SPECT (r = 0.96). The average post-stress LVEF for the entire group was slightly but significantly higher for high-speed compared with conventional SPECT (63.2 �� 13.15 vs. 62.2 �� 12.6, p = 0.017). The correlation between LVEF by the 2 methods was linear over a wide range of EF values (r = 0.89) (Fig. 6A). Bland-Altman analysis demonstrated a small average of the differences ABT-737
between conventional and high-speed SPECT (?0.96 �� 5.5), with no correlation between the differences and mean EF values (Fig. 6B). Figure 7A demonstrates high-speed and conventional SPECT images of a 61-year-old man, showing a reversible defect at the anterior and apical walls, consistent with moderate ischemia in the left anterior descending coronary artery territory. Quantitative analysis yielded similar TPD values for stress and rest images of the 2 methods (Fig. 7B). Invasive coronary angiography revealed 70% stenosis at the proximal mid-left anterior descending coronary artery.