Poststress measurements of left ventricular function with gated perfusion SPECT: comparison with resting measurements by using a same-day perfusion-function protocol.
OBJECTIVE
To investigate the relationship between the development of ischemia during stress testing and the changes in left ventricular ejection fraction (LVEF) measurements obtained after stress and at rest with a same-day perfusion-function imaging protocol.


METHODS
One hundred twenty-six patients underwent a same-day rest-stress (61%) or stress-rest (39%) protocol and gated single photon emission computed tomography (SPECT). Perfusion analysis was performed with a 12-segment model. Defects were scored (0 = no defect, 1 = mild defect, 2 = moderate defect, and 3 = severe defect); differences between the summed stress and resting scores of greater than three indicated substantial ischemia.


RESULTS
Resting and poststress LVEFs correlated significantly (r = 0.97, P <.001); however, patients with and patients without ischemia had significant differences in poststress versus resting LVEFs (-4.0 vs 1.0, respectively; P <.01). In patients with ischemia versus patients without ischemia, subgroup analysis stress-rest (-2.5 vs 1.0, P =.047) and rest-stress (-4.0 vs 1.0, P =.006) protocols yielded similar results.


CONCLUSIONS
In patients with clinically important stress-induced perfusion abnormalities, the LVEF after stress was significantly lower than the LVEF at rest with same-day rest-stress and stress-rest imaging protocols. In the clinical setting, poststress LVEFs may be lower than true resting measurements, particularly in patients with moderate to severe stress-induced ischemia.
Borges-Neto
S
S
Departments of Radiology-Nuclear Medicine, Duke University Medical Center and Health Systems, Duke North Rm 1410, Durham, NC 27710, USA. borge001@mc.duke.edu
Javaid
A
A
Shaw
L K
LK
Kong
D F
DF
Hanson
M W
MW
Pagnanelli
R A
RA
Ravizzini
G
G
Coleman
R E
RE
D000241:Adenosine; D000318:Adrenergic beta-Agonists; D000368:Aged; D003326:Coronary Circulation / Q000502:physiology; D003327:Coronary Disease / Q000503:physiopathology; D004176:Dipyridamole; D004280:Dobutamine; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology; D005082:Physical Exertion / Q000502:physiology*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012146:Rest / Q000502:physiology; D016037:Single-Blind Method; D013318:Stroke Volume / Q000502:physiology*; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents; D016277:Ventricular Function, Left / Q000502:physiology*
D000318:Adrenergic beta-Agonists; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D004280:Dobutamine; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi; D000241:Adenosine