Dipyridamole stress and rest gated 99mTc-sestamibi myocardial perfusion SPECT: left ventricular function indices and myocardial perfusion findings

سال انتشار: 1386
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 282

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شناسه ملی سند علمی:

JR_IRJNM-15-1_001

تاریخ نمایه سازی: 27 فروردین 1399

چکیده مقاله:

  Introduction: We investigated the difference in left ventricular ejection fraction (LVEF) and end-systolic volume(ESV) measured by gated myocardial perfusion SPECT (GSPECT) in the post-dipyridamole stress and rest periods, and compared the results with the perfusion patterns found in the conventional non-gated tomograms. Methods: 297 consecutive patients were studied with post-stress and rest 99mTc-sestamibi GSPECT using a two-day protocol. Stress images were obtained 90 min after dipyridamole infusion and radiotracer injection. All acquisitions were analyzed visually, semi-quantitatively and quantitatively using QGS software. Results: Patients were divided into 4 groups according to the perfusion patterns: Group-1 = no perfusion defects (n= 129, 43.4%); Group-2 = reversible perfusion defects (n = 85, 28.6%); Group-3=Fixed defects (n =52, 17.5%); Group 4 = partially reversible perfusion defects (n =31, 10.4%). Differences between post-stress LVEF (SEF) and rest LVEF (REF) (DEF=SEF-REF) were +3.39, -6.45, -1.61, and -0.70 for groups 1, 2, 3 and 4 respectively. Post-stress stunning (> 5% decrease in LVEF) was present in 49 patients (16.5%). SEF was significantly more than REF in patients with summed difference score (SDS) <5 while patients with SDS≥5 had lower SEF (54.84) than REF (60.44). No statistical significant difference was seen between post-stress end-systolic volume (SESV) and rest end-systolic volume (RESV) in patients with SDS<5. In patients with SDS≥5, SESV was significantly more than RESV. Conclusion: LVEF as measured by GSPECT decreased slightly in post-stress period when an ischemic insult was present, while it has a mild tendency to increase when the myocardial perfusion is normal. Not only exercise stress but also dipyridamole can cause a transient decrease in LVEF in stunned patients. It was concluded that gated study be performed in both stress and rest phases of the procedure.

نویسندگان

Vahid Reza Dabbagh Kakhki

Department of Nuclear Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Hadi Jabari

Department of Statistics, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran