Prognostic value of ECG-gated thallium-201 single-photon emission tomography in patients with coronary artery disease.
BACKGROUND
The phenomenon of reversible impairment in LV function has been well described and is known as myocardial stunning.


OBJECTIVE
Thallium-201 myocardial perfusion gated SPECT was used to evaluate myocardial stunning and its incremental prognostic value in patients with coronary artery disease.


METHODS
Fifty-six patients (aged 63+/-11 years) with coronary artery disease were included in this study. All subjects underwent exercise thallium scintigraphy. ECG-gated SPECT was obtained both at post-stress (10 minutes after the injection of 111 MBq of thallium at the time of peak exercise) and at rest (180 minutes). The left ventricular ejection fraction (LVEF) and end-systolic and end-diastolic volume (ESV, EDV) were determined by a quantitative gated SPECT (QGS) program.


RESULTS
Follow-up was complete in all patients (mean 569 days). The magnitude of the depression of post-stress LVEF relative to the rest LVEF was correlated with the severity of ischemia (p < 0.05). The group with a median LVEF of more than 45% had a significantly higher event-free rate (p < 0.01).


CONCLUSIONS
Assessment of post-stress left ventricular function by gated-SPECT provides incremental prognostic information and is useful in predicting cardiac events in patients with suspected or definite coronary artery disease.
Matsuo
Shinro
S
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Japan. smatsuo@belle.shiga-med.ac.jp
Matsumoto
Tetsuya
T
Nakae
Ichiro
I
Koh
Terue
T
Masuda
Daisuke
D
Takada
Masahiko
M
Murata
Kiyoshi
K
Horie
Minoru
M
D015984:Causality; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D018572:Disease-Free Survival; D004562:Electrocardiography / Q000706:statistics & numerical data; D005080:Exercise Test / Q000706:statistics & numerical data; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011379:Prognosis; D019275:Radiopharmaceuticals; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013793:Thallium; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*
D019275:Radiopharmaceuticals; C027549:thallium chloride; D013793:Thallium