Milan Kamínek, Otto Lang
This is a review of the interpretation of cardiac ECG-gated single photon emission computed tomography (gated SPECT). Quantification of the extent and severity of perfusion defects by means of a summed stress score (SSS) yields important information on decision concerning further therapy. In patients with the normal perfusion or with the mildly abnormal perfusion (SSS 4 - 8) the risk of heart death is low (< 1 % annually) and medicamentous therapy can be preferred. On the contrary, in patients with the moderate or severe abnormality of perfusion (SSS > 8) preference is given to the invasive strategy. In many patients with severe coronary artery disease, post-ischemic myocardial stunning occurs, which can affect left ventricular ejection fraction and regional wall motion on post-stress gated SPECT. In this setting, the study is interpreted as abnormal even if the stress perfusion is homogenous.