Usefulness of gated myocardial perfusion SPECT imaging soon after exercise to identify postexercise stunning in patients with single-vessel coronary artery disease.
BACKGROUND
This study determines the value of gated single photon emission computed tomography (SPECT) imaging soon after exercise to identify patients with single-vessel disease and exercise-induced prolonged myocardial dysfunction (ie, postischemic stunning).


RESULTS
We examined 19 normal individuals and 52 patients with single-vessel disease by use of 2-day technetium 99m tetrofosmin exercise/rest gated SPECT imaging. Sequential imaging was started 10, 30, and 50 minutes after exercise. The ejection fraction (EF) values were calculated with the Cedars-Sinai program. The participants were classified as follows: group A (normal individuals, n = 19), group B (individuals with coronary stenosis without Q-wave infarction, n = 18), group C (individuals with Q-wave infarction without myocardial ischemia, n = 15), and group D (individuals with Q-wave infarction and ischemia, n = 19). The post-stress EF values at 10 minutes (69.8% +/- 9.6% and 59.8% +/- 11.8%, respectively) were higher in groups A and C than those at 30 minutes (67.6% +/- 10.2% and 57.2% +/- 11.3%, respectively) ( P < .05) but were lower in group B (61.7% +/- 9.2%) than both the 30- and 50-minute values (64.2% +/- 9.5% and 64.6% +/- 9.4%, respectively; P < .05). The EF value did not significantly change in group D.


CONCLUSIONS
Tc-99m gated SPECT imaging soon after exercise is superior to conventional late imaging to discriminate patients with single-vessel disease and postexercise stunning.
Toba
Masahiro
M
Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo 113-8603, Japan. mtob@nms.ac.jp
Kumita
Shin-ichiro
S
Cho
Keiichi
K
Ibuki
Chikao
C
Kumazaki
Tatsuo
T
Takano
Teruo
T
D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D017682:Myocardial Stunning / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi