Alberto Bestetti1,2, Besart Cuko3, Adriano Decarli4, Alessio Galli5, Federico Lombardi6. 1. Department of Clinical and Biomedical Sciences, University of Milan, Milan, Italy. 2. Service of Nuclear Medicine, IRCCS Multimedica Sesto San Giovanni, Milan, Italy. 3. School of Specialty in Nuclear Medicine, University of Milan, Milan, Italy. 4. Department of Clinical and Community Sciences, University of Milan, Milan, Italy. 5. Cardiovascular Diseases Unit, IRCCS Ca' Granda Major Hospital of Milan, University of Milan, Milan, Italy. aleg170389@gmail.com. 6. Cardiovascular Diseases Unit, IRCCS Ca' Granda Major Hospital of Milan, University of Milan, Milan, Italy.
Abstract
AIM AND PATIENTS: The aim of the present study is to evaluate the additional value of systolic wall thickening to myocardial perfusion in diagnosing myocardial stunning in patients with angiography proven coronary artery disease. We selected 91 ischemic patients (82 males; mean age 59.7 ± 10.3) with CAD documented by angiography. Ischemia was defined as a summed difference score ≥5. All patients underwent a 2-day gated perfusion SPECT protocol. The patients received a dose of 740 MBq of 99mTc-tetrofosmin after stress and at rest. Treadmill maximal exercise tests were performed on all patients. RESULTS: The post-stress LVEF was significantly lower than rest LVEF (48.1% ± 10.3% vs 50.3% ± 10.7%; P = .0001). The wall thickening summed difference score was 4.44 ± 4.13 (P = .0001). At a multivariate regression analysis, only WT-SDS as independent variable was significantly correlated with myocardial ischemia (SDS). We also divided patients according to SDS in those with mild (SDS < 8) and severe (SDS ≥ 8) ischemia. WT-SDS, but not ∆LVEF, was significantly different between groups. CONCLUSIONS: WT-SDS, more than the depression in the global function (∆LVEF) of the left ventricle, correlates with the degree of ischemia and better identifies, when present, the stunning phenomenon.
AIM AND PATIENTS: The aim of the present study is to evaluate the additional value of systolic wall thickening to myocardial perfusion in diagnosing myocardial stunning in patients with angiography proven coronary artery disease. We selected 91 ischemicpatients (82 males; mean age 59.7 ± 10.3) with CAD documented by angiography. Ischemia was defined as a summed difference score ≥5. All patients underwent a 2-day gated perfusion SPECT protocol. The patients received a dose of 740 MBq of 99mTc-tetrofosmin after stress and at rest. Treadmill maximal exercise tests were performed on all patients. RESULTS: The post-stress LVEF was significantly lower than rest LVEF (48.1% ± 10.3% vs 50.3% ± 10.7%; P = .0001). The wall thickening summed difference score was 4.44 ± 4.13 (P = .0001). At a multivariate regression analysis, only WT-SDS as independent variable was significantly correlated with myocardial ischemia (SDS). We also divided patients according to SDS in those with mild (SDS < 8) and severe (SDS ≥ 8) ischemia. WT-SDS, but not ∆LVEF, was significantly different between groups. CONCLUSIONS: WT-SDS, more than the depression in the global function (∆LVEF) of the left ventricle, correlates with the degree of ischemia and better identifies, when present, the stunning phenomenon.
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