Evaluation of regurgitant fraction of the left ventricle by gated cardiac blood-pool scanning using SPECT.

Abstract

Regurgitant fraction (RF) of patients with and without mitral regurgitation (MR) and/or aortic regurgitation (AR) was evaluated by gated cardiac blood-pool scanning using single photon emission computed tomography (SPECT). Using the stroke count image of a short-axis tomogram to separate the right atrium and ventricle, the left ventricular stroke count (LVSC) and right ventricular stroke count (RVSC) were determined. The RF equaled (LVSC - RVSC)/LVSC. Calculated RF in 14 subjects without significant regurgitation by contrast angiography was 5.8 +/- 5.9% (mean +/- s.d.), RF of 17 cases with angiographic regurgitation was 42.5 +/- 16.8% (p less than 0.001). The sensitivity of the radionuclide method compared to angiography was 94% (16/17 cases), and specificity was 100% (14/14 cases). RF of mild Re (1+ or 2+) was 26.0 +/- 8.9% (n = 6) and RF of severe Re (3+ or 4+) was 51.5 +/- 12.7% (n = 11) (p less than 0.001). Correlation between the RF determined with the radionuclide method and with cardiac catheterization was good (y = 5.85 + 0.700 x, r = 0.821, n = 17). We conclude that RF of MR and/or AR can be accurately evaluated by gated cardiac blood-pool scanning using SPECT.