TY - JOUR
T1 - Poststress measurements of left ventricular function with gated perfusion SPECT
T2 - Comparison with resting measurements by using a same-day perfusion-function protocol
AU - Borges-Neto, Salvador
AU - Javaid, Aamir
AU - Shaw, Linda K.
AU - Kong, David F.
AU - Hanson, Michael W.
AU - Pagnanelli, Robert A.
AU - Ravizzini, Gregory
AU - Coleman, R. E.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2000
Y1 - 2000
N2 - PURPOSE: To investigate the relationship between the development of ischemia during stress testing and the changes in left ventricular ejection fraction (LVEF) measurements obtained after stress and at rest with a same- day perfusion-function imaging protocol. MATERIALS AND METHODS: One hundred twenty-six patients underwent a same-day rest-stress (61%) or stress-rest (39%) protocol and gated single photon emission computed tomography (SPECT). Perfusion analysis was performed with a 12-segment model. Defects were scored (0 = no defect, 1 = mild defect, 2 = moderate defect, and 3 = severe defect); differences between the summed stress and resting scores of greater than three indicated substantial ischemia. RESULTS: Resting and poststress LVEFs correlated significantly (r = 0.97, P < .001); however, patients with and patients without ischemia had significant differences in poststress versus resting LVEFs (-4.0 vs 1.0, respectively; P < .01). In patients with ischemia versus patients without ischemia, subgroup analysis stress-rest (-2.5 vs 1.0, P = .047) and rest-stress (-4.0 vs 1.0, P = .006) protocols yielded similar results. CONCLUSION: In patients with clinically important stress-induced perfusion abnormalities, the LVEF after stress was significantly lower than the LVEF at rest with same-day rest-stress and stress-rest imaging protocols. In the clinical setting, poststress LVEFs may be lower than true resting measurements, particularly in patients with moderate to severe stress-induced ischemia.
AB - PURPOSE: To investigate the relationship between the development of ischemia during stress testing and the changes in left ventricular ejection fraction (LVEF) measurements obtained after stress and at rest with a same- day perfusion-function imaging protocol. MATERIALS AND METHODS: One hundred twenty-six patients underwent a same-day rest-stress (61%) or stress-rest (39%) protocol and gated single photon emission computed tomography (SPECT). Perfusion analysis was performed with a 12-segment model. Defects were scored (0 = no defect, 1 = mild defect, 2 = moderate defect, and 3 = severe defect); differences between the summed stress and resting scores of greater than three indicated substantial ischemia. RESULTS: Resting and poststress LVEFs correlated significantly (r = 0.97, P < .001); however, patients with and patients without ischemia had significant differences in poststress versus resting LVEFs (-4.0 vs 1.0, respectively; P < .01). In patients with ischemia versus patients without ischemia, subgroup analysis stress-rest (-2.5 vs 1.0, P = .047) and rest-stress (-4.0 vs 1.0, P = .006) protocols yielded similar results. CONCLUSION: In patients with clinically important stress-induced perfusion abnormalities, the LVEF after stress was significantly lower than the LVEF at rest with same-day rest-stress and stress-rest imaging protocols. In the clinical setting, poststress LVEFs may be lower than true resting measurements, particularly in patients with moderate to severe stress-induced ischemia.
KW - Heart, ejection fraction
KW - Heart, function
KW - Myocardium, SPECT
KW - Myocardium, ischemia
KW - Myocardium, radionuclide studies
KW - Receiver operating characteristic (ROC) curve
KW - Single photon emission computed tomography
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U2 - 10.1148/radiology.215.2.r00ma13529
DO - 10.1148/radiology.215.2.r00ma13529
M3 - Article
C2 - 10796936
AN - SCOPUS:0033995716
SN - 0033-8419
VL - 215
SP - 529
EP - 533
JO - Radiology
JF - Radiology
IS - 2
ER -