title: Quantitation of left ventricular ejection fraction reserve from early gated regadenoson stress Tc-99m high-efficiency SPECT.
abstract: Ejection fraction (EF) reserve has been found to be a useful adjunct for identifying high risk coronary artery disease in cardiac positron emission tomography (PET). We aimed to evaluate EF reserve obtained from technetium-99m sestamibi (Tc-99m) high-efficiency (HE) SPECT.
  
  
  
  Fifty patients (mean age 69 years) undergoing regadenoson same-day rest (8-11 mCi)/stress (32-42 mCi) Tc-99m gated HE SPECT were enrolled. Stress imaging was started 1 minute after sequential intravenous regadenoson .4 mg and Tc-99m injections, and was composed of five 2 minutes supine gated acquisitions followed by two 4 minutes supine and upright images. Ischemic total perfusion deficit (ITPD) ≥5 % was considered as significant ischemia.
  
  
  
  Significantly lower mean EF reserve was obtained in the 5th and 9th minute after regadenoson bolus in patients with significant ischemia vs patients without (5th minute: -4.2 ± 4.6% vs 1.3 ± 6.6%, P = .006; 9th minute: -2.7 ± 4.8% vs 2.0 ± 6.6%, P = .03).
  
  
  
  Negative EF reserve obtained between 5th and 9th minutes of regadenoson stress demonstrated best concordance with significant ischemia and may be a promising tool for detection of transient ischemic functional changes with Tc-99m HE-SPECT.
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Yafim
authors.initials: Y
authors.lastname: Brodov
authors.affiliation: Nuclear Medicine Department, Oregon Heart and Vascular Institute, Sacred Heart Medical Center, Springfield, OR, USA.
authors.forename: Mathews
authors.initials: M
authors.lastname: Fish
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Rubeaux
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Otaki
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Gransar
authors.affiliation: Nuclear Medicine Department, Oregon Heart and Vascular Institute, Sacred Heart Medical Center, Springfield, OR, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Lemley
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Jim
authors.initials: J
authors.lastname: Gerlach
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Berman
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Guido
authors.initials: G
authors.lastname: Germano
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. piotr.slomka@cshs.org.|David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. piotr.slomka@cshs.org.
authors.forename: Piotr
authors.initials: P
authors.lastname: Slomka
mesh_terms: D000368:Aged; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D011687:Purines; D011720:Pyrazoles; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D011687:Purines; D011720:Pyrazoles; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; C430916:regadenoson; D017256:Technetium Tc 99m Sestamibi
keywords: Regadenoson Tc-99m high-efficiency SPECT; early stress imaging; image quality; left ventricular ejection fraction reserve