Differential effects comparing exercise and pharmacologic stress on left ventricular function using gated Tc-99m sestamibi SPECT

• Published in: Annals of nuclear medicine Vol. 22; no. 3; pp. 185 - 190
• Main Authors: Ohtaki, Yuka, Chikamori, Taishiro, Igarashi, Yuko, Hida, Satoshi, Tanaka, Hirokazu, Hatano, Tsuguhisa, Usui, Yasuhiro, Miyagi, Manabu, Yamashina, Akira
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.04.2008; Springer Nature B.V
• Subjects: Adenosine Triphosphate - adverse effects; Aged; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; Exercise Test - adverse effects; Female; Gated Blood-Pool Imaging; Humans; Imaging; Male; Matched-Pair Analysis; Medicine; Medicine & Public Health; Middle Aged; Myocardial Stunning - diagnostic imaging; Myocardial Stunning - etiology; Myocardial Stunning - physiopathology; Nuclear Medicine; Original Article; Radiology; Radiopharmaceuticals; Rest; Retrospective Studies; Stress, Physiological - etiology; Stress, Physiological - physiopathology; Stroke Volume; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon; Ventricular Function, Left - drug effects; Normalcy; Myocardial stunning; Quantitative gated single-photon emission computed tomography; Transient ischemic dilation
• ISSN: 0914-7187; 1864-6433
• DOI: 10.1007/s12149-007-0106-z

Objective Although post-ischemic stunning has emerged as an important marker for severe coronary artery disease (CAD), differences in stress methods may have different effects on left ventricular (LV) volumes and function. Methods To assess differential effects comparing exercise and pharmacologic stress on the LV measurements, 99m Tc-sestamibi gated single-photon emission computed tomography (SPECT) acquired more than 30 min after stress and at rest was evaluated in 38 patients undergoing adenosine triphosphate (ATP) stress (ATP group) and 38 age-and sex-matched patients subjected to exercise stress (Ex group) among 268 patients with normal SPECT findings. Results Coronary risk factors and LV volumetric measurements at baseline were similar in the two groups. Compared with volumetric measurements at rest, enddiastolic volume (EDV) increased (72 ± 21 ml to 74 ± 21 ml; P = 0.01), end-systolic volume increased (25 ± 12 ml to 28 ± 13 ml; P = 0.001), and ejection fraction (EF) decreased after stress (66% ± 8% to 63% ± 9%; P < 0.002) in the ATP group. In the Ex group, by contrast, no such change was observed. In addition, changes in EDV (3 ± 6 vs. −1 ± 5 ml; P = 0.01) and the stress-to-rest ratio of EDV (1.04 ± 0.09 vs. 0.99 ± 0.08; P < 0.02) after stress were greater in the ATP than in the Ex group. Conclusions Differential effects of stress methods on LV volumes persist more than 30 min after the stress. These findings should be kept in mind when interpreting post-ischemic stunning.