Computer modeling of planar myocardial perfusion imaging: effect of heart rate and ejection fraction on wall thickness and chamber size.

Myocardial perfusion imaging is generally performed as a static acquisition without regard for dynamic changes in the cardiac cycle. The effect of heart rate and ejection fraction on the appearance of left ventricular chamber size and wall thickness as perceived in 201Tl scintigrams has not, to our knowledge, been previously studied. A dynamic computer model of the left ventricle was constructed, capable of varying the heart rate and ejection fraction. Parallel slices through the model were convolved with experimentally derived 201Tl point spread functions at corresponding depths to incorporate the effects of scatter and attenuation. Both gated and static left anterior oblique images were created at three clinically encountered heart rates and ejection fractions, with constant end-diastolic volume and left ventricular mass. Results of the study indicate that perceived and quantified wall thickness increases and chamber size decreases appreciably with increasing ejection fraction and (slightly) with increasing heart rate. Thus, evaluation of wall thickness and chamber size in planar images should take into account variations in heart rate and contractility. This is especially pertinent to estimates of left ventricular hypertrophy and chamber size, attempted from nongated myocardial perfusion images.