Myocardial Perfusion and Function: Comparative assessment by ECG, SPECT and MRI

Eva Persson

Research output: ThesisDoctoral Thesis (compilation)


Evaluation of myocardial perfusion and function is important in management of patients with suspected or known coronary artery disease. This thesis focuses on the use of common diagnostic methods, myocardial perfusion single-photon emission computed tomography (MPS) and electrocardiography (ECG), to enhance and validate the diagnostic information. Cardiac magnetic resonance imaging (MRI) was used as the gold standard in 2 of the 4 studies.

In the first 2 studies, MPS was performed during percutaneous transluminal coronary angioplasty (PTCA). The perfusion territories of each artery extended outside the typical borders (Paper I). This is important knowledge for correct interpretation of single- or multivessel disease. Summed ST-segment deviations during artery occlusion correlated with perfusion defects quantified by MPS (Paper II). The largest ST-segment deviation during occlusion of the left circumflex coronary artery was depression in lead V2. It is therefore essential to also consider ST-segment depression when diagnosing myocardial infarction.

ECG-gated SPECT measures left ventricular volumes in addition to myocardial perfusion. Study III showed good agreement between gated SPECT and MRI for ventricular volumes and ejection fractions, indicating that the method is robust enough to guide clinical management.

MPS is sometimes complicated by attenuation artifacts that mimic infarction. Its specificity was increased by performing prone imaging in addition to the traditional supine imaging (Paper IV), given that none of the patients whose defect disappeared in prone positioning had myocardial infarction by MRI.
Original languageEnglish
Awarding Institution
  • Clinical Physiology (Lund)
  • Pahlm, Olle, Supervisor
Award date2006 May 22
Print ISBNs91-85559-01-6
Publication statusPublished - 2006

Bibliographical note

Defence details

Date: 2006-05-22
Time: 09:00
Place: Föreläsningssal 3, Centralblocket, Universitetssjukhuset i Lund.

External reviewer(s)

Name: Thomas, James D.
Title: Dr
Affiliation: Cleveland


<div class="article_info">E Persson, J Palmer, J Pettersson, SG Warren, S Borges-Neto, GS Wagner and O Pahlm. <span class="article_issue_date">2002</span>. <span class="article_title">Quantification of myocardial hypoperfusion with 99mTc-sestamibi in patients undergoing prolonged coronary artery balloon occlusion.</span> <span class="journal_series_title">Nucl Med Commun</span>, <span class="journal_volume">vol 23</span> <span class="journal_pages">pp 219-228</span>.</div>
<div class="article_info">E Persson, J Pettersson, M Ringborn, L Sörnmo, SG Warren, GS Wagner, C Maynard and O Pahlm. <span class="article_issue_date">2006</span>. <span class="article_title">Comparison of ST-segment deviation to scintigraphically quantified myocardial ischemia during acute coronary occlusion induced by percutaneous transluminal coronary angioplasty.</span> <span class="journal_series_title">Am J Cardiol</span>, <span class="journal_volume">vol 97</span> <span class="journal_pages">pp 295-300</span>.</div>
<div class="article_info">E Persson, M Carlsson, J Palmer, O Pahlm and H Arheden. <span class="article_issue_date">2005</span>. <span class="article_title">Evaluation of left ventricular volumes and ejection fraction by automated gated myocardial SPECT versus cardiovascular magnetic resonance.</span> <span class="journal_series_title">Clin Physiol Funct imaging</span>, <span class="journal_volume">vol 25</span> <span class="journal_pages">pp 135-141</span>.</div>
<div class="article_info">E Persson, B Hedén, M Carlsson, O Pahlm and H Arheden. <span class="article_issue_date"></span>. <span class="article_title">Disappearance of myocardial perfusion defects on prone SPECT imaging: comparison with cardiac magnetic resonance imaging in patients without established coronary artery disease.</span> (manuscript)</div>

Subject classification (UKÄ)

  • Respiratory Medicine and Allergy
  • Cardiac and Cardiovascular Systems


  • tomografi
  • medicinsk instrumentering
  • Physiology
  • radiologi
  • radiology
  • tomography
  • medical instrumentation
  • Klinisk fysiologi
  • Clinical physics
  • 'ST-segment deviation'
  • 'myocardial ischemia'
  • 'myocardial perfusion'
  • MRI
  • CMR
  • MPS
  • ECG
  • Fysiologi
  • Cardiovascular system
  • 'myocardial function'
  • Kardiovaskulära systemet


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