Detection of post-exercise stunning by early gated SPECT myocardial perfusion imaging: Results from the IAEA multi-center study

作者：Mut Fernando; Giubbini Raffaele^*; Vitola Joao; Lusa Lara; Sobic Saranovic Dragana; Peix Amalia; Bertagna Francesco; Dieu Hang Bui; Cunha Carlos; Obaldo Jerry; Rodella Carlo; Camoni Luca; Paez Diana; Dondi Maurizio

来源：Journal of Nuclear Cardiology, 2014, 21(6): 1168-1176.

DOI：10.1007/s12350-014-9983-4

• Left ventricular function
• gated SPECT
• exercise: stress testing
• ischemic myocardial dysfunction

Transient post-ischemic LV dysfunction due to myocardial stunning in patients with coronary artery disease can be missed by conventional gated SPECT (GSPECT) acquisitions. The aim of this IAEA-sponsored multi-center study was to determine whether early post-exercise imaging is more likely to detect stunning than conventional without adversely affecting image quality or perfusion information. %26lt;br%26gt;Patients undergoing exercise/rest GSPECT were enrolled in this international multicenter study. Post-exercise studies were acquired at 15 +/- A 5 minutes after radiotracer injection (Stress-1) and repeated at 60 +/- A 15 minutes (Stress-2). Rest studies (R) were acquired at 60 minutes post injection. A core laboratory quantitatively assessed perfusion pattern and LV blinded to the acquisition time. Ischemia was defined as summed stress score (SDS) a parts per thousand yen4, and stunning was defined as the difference between rest and post-stress LVEF (Delta-LVEF). In the 229 patients enrolled into the study, both image quality and perfusion information were similar between Stress-1 and Stress-2. Post-stress LVEF was associated with both ischemia and time of acquisition, with a significant correlation between SDS and Delta-LVEF, which was stronger at Stress-1 than Stress-2 in the ischemic compared to the non-ischemic population (r = 0.23 vs 0.08, P = 0.10). %26lt;br%26gt;Early post-exercise imaging is feasible, and can potentially improve the detection of post-ischemic stunning without compromising image quality and perfusion data.

• 出版日期2014-12