Relationship Between High-Sensitivity C-Reactive Protein and Left Ventricular Perfusion and Function by ECG-Gated SPECT Myocardial Perfusion Imaging

We sought to evaluate the relationship between left ventricular (LV) perfusion and function assessed by ECG-gated single-photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) and serum high-sensitivity C-reactive protein (hs-CRP).

The images of 86 patients were reviewed for perfusion/functional defects by visual (subjective) interpretation. Quantitative (objective) LV measurements, including summed stress score (SSS), were calculated with the quantitative gated SPECT/quantitative perfusion SPECT (QGS/QPS) software. Via the quantitative method, the patients were categorized into an SSS<4 group (normal LV perfusion) and an SSS≥4 group (abnormal LV perfusion).

There was no significant difference regarding the mean (±SD) hs-CRP level between normal (1.54±1.6 mg/L) and abnormal (1.88±2.61 mg/L) LV perfusions assessed by visual interpretation (P=0.493). However, by the quantitative (objective) method, the mean (±SD) hs-CRP level was significantly higher in the SSS≥ 4 group than in the SSS< 4 group (1.36±2.08 vs 2.37±2.37; P=0.04). Receiver operating characteristic curve analysis (cutoff value =1 mg/L) distinguished patients with an SSS of 4 or greater with a sensitivity of 69% and specificity of 70% (area under the curve =0.71; P=0.001).

The hs-CRP level had acceptable sensitivity and specificity to determine LV perfusion defects by the objective method but not by the subjective assessment (visual method) of LV perfusion defects. (Iranian Heart Journal 2021; 22(4): 90-100)