"Risk stratification allows us to categorize patients according to the severity of their disease and risk of future cardiac events," said Dr. Gimelli. "As a result, we are able to allocate resources where needed and treat the sickest patients more aggressively."

Gated SPECT is a noninvasive nuclear medicine procedure involving an injection of a small amount of radioactive material that circulates in the bloodstream to show if the heart muscle is receiving adequate blood supply under stress and/or rest conditions, explained the researchers. SPECT imaging performed after stress reveals the distribution of the radiopharmaceutical and therefore the relative myocardial perfusion (blood flow in the heart) to the different regions of the heart muscle. The resulting set of SPECT images provides quantitative information regarding myocardial perfusion after stress and at rest, as well as the heart as it contracts.


Myocardial perfusion imaging stress testing is sensitive to even the most modest changes in blood flow and can determine whether the heart is receiving enough blood and oxygen. In this way, gated SPECT provides information regarding the presence of myocardial infarction (heart attack) and myocardial ischemia, explained Dr. Gimelli.

Since its introduction in the late 1980s, gated SPECT has become one of the most commonly performed cardiology procedures in nuclear medicine departments. Automation of the image processing and quantification has made this technique highly reproducible, practical and user friendly in clinical settings. It is similar to a standard SPECT study, except that many more images are acquired. Diagnosis is made by comparing stress images to an additional set of images obtained at rest.

IHD is characterized by a temporary reduction in blood supply to the heart muscle and is usually the result of coronary artery disease (atherosclerosis). According to the American Heart Association, it is the leading cause of death in the United States and the European Union.

Co-authors of "Stress/Rest Myocardial Perfusion Abnormalities by Gated SPECT: Still the Best Predictor of Cardiac Events in Stable Ischemic Heart Disease" include Alessia Gimelli, Patrizia Landi, Paolo Marzullo, Giorgio Iervasi, and Daniele Rovai, CNR Clinical Physiology Institute, G. Monasterio Foundation, Pisa, Italy; Giuseppe Rossi, Unit of Biostatistics and Epidemiology, CNR Clinical Physiology Institute, G. Monasterio Foundation, Massa, Italy; and Antonio L'Abbate, CNR Clinical Physiology Institute, G. Monasterio Foundation and Scuola Superiore Sant'Anna, Pisa, Italy.

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