Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 12, Number 3, June 2021, pages 193-200

Contradictory Effect of Coronary Collateral Circulation on Regional Myocardial Perfusion That Assessed by Quantitative Myocardial Perfusion Scintigraphy

Figure 1. An example of patient. (a) Proximal right RCA with 100% total stenosis (blue arrow) and Rentrop 3 collateral flow to the RCA from LAD (red arrow). (b) Myocardial perfusion bull’s eye image of the same patient shows infarction and minimal ischemia on the inferior wall (yellow arrows). LAD: left artery descending; RCA: right coronary artery.

**Table 1.** Demographic and Clinical Parameters of Groups
Clinical characteristics	Patients cohort (n = 96)	P value
*P < 0.05. CAD: coronary artery disease.
The mean age (years)	64.05 ± 10.13	61.71 ± 11.69	0.300
Gender, n (%)
Male	41 (70.7)	28 (73.7)	0.750
Female	17 (29.3)	10 (26.3)
Body mass index (kg/m²)	28.14 ± 4.31	29.34 ± 4.76	0.211
Comorbidities
Diabetes mellitus, n (%)	29 (50.0)	11 (28.9)	0.041*
Hypertension, n (%)	23 (39.7)	15 (39.5)	0.986
Hyperlipidemia, n (%)	33 (57.9)	20 (52.6)	0.613
Smoking, n (%)	28 (48.3)	19 (50.0)	0.869
Family history of CAD, n (%)	32 (55.2)	24 (63.2)	0.438
Cardiac drugs
Antihypertensive	23 (39.7)	15 (39.5)	0.986
Beta blocker	50 (86.2)	31 (81.5)	0.516
Vasodilators	18 (31.0)	11 (28.9)	0.828
Coronary angiography
Rentrop 0 (n)	52	-
Rentrop 1 (n)	6	-
Rentrop 2 (n)	-	24
Rentrop 3 (n)	-	14

Table 1. Demographic and Clinical Parameters of Groups

Clinical characteristics

Patients cohort (n = 96)

P value

Not-well-developed collateral group (n = 58)

Well-developed collateral group (n = 38)

*P < 0.05. CAD: coronary artery disease.

The mean age (years)

64.05 ± 10.13

61.71 ± 11.69

0.300

Gender, n (%)

Male

41 (70.7)

28 (73.7)

0.750

Female

17 (29.3)

10 (26.3)

Body mass index (kg/m²)

28.14 ± 4.31

29.34 ± 4.76

0.211

Comorbidities

Diabetes mellitus, n (%)

29 (50.0)

11 (28.9)

0.041*

Hypertension, n (%)

23 (39.7)

15 (39.5)

0.986

Hyperlipidemia, n (%)

33 (57.9)

20 (52.6)

0.613

Smoking, n (%)

28 (48.3)

19 (50.0)

0.869

Family history of CAD, n (%)

32 (55.2)

24 (63.2)

0.438

Cardiac drugs

Antihypertensive

23 (39.7)

15 (39.5)

0.986

Beta blocker

50 (86.2)

31 (81.5)

0.516

Vasodilators

18 (31.0)

11 (28.9)

0.828

Coronary angiography

Rentrop 0 (n)

Rentrop 1 (n)

Rentrop 2 (n)

Rentrop 3 (n)

**Table 2.** The Statistics of Myocardial Perfusion Scintigraphy Findings in the Current Patients
Myocardial perfusion gated SPECT imaging parameters	Patients cohort (n = 96)	P value
*P < 0.05. SPECT: single-photon emission computerized tomography; QPS: Quantitative Perfusion SPECT; QGS: Quantitative Gated SPECT; SSS: summed stress score; SDS: summed difference score; SMS: summed motion score; EF: ejection fraction; TID: transient ischemic dilation; PP: peak phase; PSD: phase standard deviation; PHB: phase histogram bandwidth.
QPS and QGS
SSS = perfusion damage score	14.16 ± 6.41	15.03 ± 6.96	0.531
SDS = ischemia score	7.29 ± 3.26	7.63 ± 3.59	0.634
SMS = motion damage score	11.78 ± 6.47	11.84 ± 7.89	0.964
Stress EF (%)	53.21 ± 5.63	54.05 ± 6.31	0.495
Left ventricular mass (g)	128.32 ± 17.65	137.18 ± 14.36	0.011*
Left ventricular mass index (g/m²)	68.96 ± 10.29	73.08 ± 10.40	0.059
TID	1.11 ± 0.17	1.06 ± 0.13	0.158
Phase analysis (desynchronization scores)
PP	147.05 ± 24.19	138.55 ± 20.00	0.075
PSD	35.07 ± 16.57	28.53 ± 15.08	0.053
PHB	69.82 ± 34.22	57.56 ± 29.55	0.074

Table 2. The Statistics of Myocardial Perfusion Scintigraphy Findings in the Current Patients

Myocardial perfusion gated SPECT imaging parameters

Patients cohort (n = 96)

P value

Not-well-developed collateral group (n = 58)

Well-developed collateral group (n = 38)

*P < 0.05. SPECT: single-photon emission computerized tomography; QPS: Quantitative Perfusion SPECT; QGS: Quantitative Gated SPECT; SSS: summed stress score; SDS: summed difference score; SMS: summed motion score; EF: ejection fraction; TID: transient ischemic dilation; PP: peak phase; PSD: phase standard deviation; PHB: phase histogram bandwidth.

QPS and QGS

SSS = perfusion damage score

14.16 ± 6.41

15.03 ± 6.96

0.531

SDS = ischemia score

7.29 ± 3.26

7.63 ± 3.59

0.634

SMS = motion damage score

11.78 ± 6.47

11.84 ± 7.89

0.964

Stress EF (%)

53.21 ± 5.63

54.05 ± 6.31

0.495

Left ventricular mass (g)

128.32 ± 17.65

137.18 ± 14.36

0.011*

Left ventricular mass index (g/m²)

68.96 ± 10.29

73.08 ± 10.40

0.059

TID

1.11 ± 0.17

1.06 ± 0.13

0.158

Phase analysis (desynchronization scores)

147.05 ± 24.19

138.55 ± 20.00

0.075

PSD

35.07 ± 16.57

28.53 ± 15.08

0.053

PHB

69.82 ± 34.22

57.56 ± 29.55

0.074

Table 3. The Statistics of Myocardial Perfusion Scintigraphy Findings in the Current Patient’s Subgroups Divided by Coronary Arteries

Gated myocardial perfusion scintigraphy parameters

Coronary artery subgroups (patients n = 96, coronary artery n = 116^a)

P value

Group1 (not-well-developed collateral group)

Group 2 (well-developed collateral group)

Subgroup LAD1 (n = 30)

Subgroup CX1 (n = 20)

Subgroup RCA1 (n = 26)

Subgroup LAD2 (n = 15)

Subgroup CX1 (n = 10)

Subgroup RCA2 (n = 15)

^aSome patients had stenosis in more than one coronary artery. SSS: summed stress score; SDS: summed difference score; SMS: summed motion score; EF: ejection fraction; TID: transient ischemic dilation; PP: peak phase; PSD: phase standard deviation; PHB: phase histogram bandwidth; LAD: left artery descending; CX: circumflex artery; RCA: right coronary artery.

QPS and QGS

SSS = perfusion damage score

8.33 ± 4.70

9.43 ± 3.38

9.65 ± 3.95

8.00 ± 2.92

8.89 ± 2.57

9.13 ± 4.47

Subgroup LAD 0.809

Subgroup CX 0.553

Subgroup RCA 0.873

SDS = ischemia score

3.11 ± 1.51

3.54 ± 1.15

3.79 ± 1.35

2.98 ± 1.02

3.02 ± 1.03

3.98 ± 1.26

Subgroup LAD 0.815

Subgroup CX 0.455

Subgroup RCA 0.756

SMS = motion damage score

6.67 ± 4.10

7.95 ± 3.58

8.58 ± 2.94

5.00 ± 2.56

6.33 ± 4.09

5.93 ± 3.15

Subgroup LAD 0.083

Subgroup CX 0.097

Subgroup RCA 0.102

Stress EF (%)

52.77 ± 6.36

51.40 ± 6.28

52.38 ± 5.79

54.47 ± 5.52

54.10 ± 7.15

54.67 ± 5.80

Subgroup LAD 0.537

Subgroup CX 0.231

Subgroup RCA 0.314

Left ventricular mass (g)

133.40 ± 21.95

133.60 ± 14.68

129.11 ± 16.29

137.20 ± 11,57

136.30 ± 15.64

134.73 ± 14.87

Subgroup LAD 0.462

Subgroup CX 0.475

Subgroup RCA 0.253

Left ventricular mass index (g/m²)

70.76 ± 10.62

69.46 ± 10.41

70.08 ± 12.26

72.46 ± 11.03

73.45 ± 9.34

69.83 ± 8.45

Subgroup LAD 0.485

Subgroup CX 0.328

Subgroup RCA 0.640

TID

1.12 ± 0.15

1.11 ± 0.18

1.13 ± 0.18

1.05 ± 0.10

1.04 ± 0.09

1.05 ± 0.13

Subgroup LAD 0.126

Subgroup CX 0.230

Subgroup RCA 0.184

Phase analysis (desynchronization)

151.03 ± 28.10

144.15 ± 24.58

146.69 ± 21.37

140.60 ± 17.12

135.70 ± 24.16

137.73 ± 14.73

Subgroup LAD 0.219

Subgroup CX 0.328

Subgroup RCA 0.121

PSD

34.21 ± 18.94

36.60 ± 21.34

36.27 ± 16.46

26.80 ± 12.45

28.58 ± 15.98

30.34 ± 11.30

Subgroup LAD 0.295

Subgroup CX 0.301

Subgroup RCA 0.221

PHD

70.03 ± 35.09

84.05 ± 44.65

65.53 ± 25.08

52.33 ± 16.14

66.60 ± 43.08

55.03 ± 20.87

Subgroup LAD 0.135

Subgroup CX 0.091

Subgroup RCA 0.165