Alberto Bestetti1,2, Besart Cuko3, Massimo Gasparini4, Stefano De Servi5. 1. Department of Clinical and Biomedical Sciences, University of Milan, Milan, Italy. alberto.bestetti@unimi.it. 2. Department of Nuclear Medicine, IRCCS MultiMedica Sesto San Giovanni, Milan, Italy. alberto.bestetti@unimi.it. 3. School of Specialty in Cardiac Surgery, University of Brescia, Brescia, Italy. 4. Department of Nuclear Medicine, IRCCS MultiMedica Sesto San Giovanni, Milan, Italy. 5. Cardiovascular Department, IRCCS MultiMedica Sesto San Giovanni, Milan, Italy.
Abstract
AIM AND PATIENTS: The aim of the present study was to assess the additional value of systolic wall thickening to myocardial perfusion in diagnosing myocardial stunning induced by dipyridamole infusion. We selected 52 ischemic patients (43 males; mean age 65.5 ± 7.64), 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. RESULTS: The post-stress LVEF was significantly lower than rest LVEF (48.3% ± 14.5% vs. 50.7% ± 15%; P = 0.0001). The wall thickening summed difference score was 3.97 ± 3.84 (P = 0.0001). At a multivariate regression analysis, only WT-SDS as independent variable was significantly correlated with myocardial ischemia (SDS) (P = 0.001). We 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 showed a better correlation with the degree of ischemia than the depression in the global function of the left ventricle. It allowed to better identify the stunning phenomenon in patients submitted to pharmacological stress.
AIM AND PATIENTS: The aim of the present study was to assess the additional value of systolic wall thickening to myocardial perfusion in diagnosing myocardial stunning induced by dipyridamole infusion. We selected 52 ischemicpatients (43 males; mean age 65.5 ± 7.64), 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. RESULTS: The post-stress LVEF was significantly lower than rest LVEF (48.3% ± 14.5% vs. 50.7% ± 15%; P = 0.0001). The wall thickening summed difference score was 3.97 ± 3.84 (P = 0.0001). At a multivariate regression analysis, only WT-SDS as independent variable was significantly correlated with myocardial ischemia (SDS) (P = 0.001). We 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 showed a better correlation with the degree of ischemia than the depression in the global function of the left ventricle. It allowed to better identify the stunning phenomenon in patients submitted to pharmacological stress.
Authors: R Hachamovitch; D S Berman; L J Shaw; H Kiat; I Cohen; J A Cabico; J Friedman; G A Diamond Journal: Circulation Date: 1998-02-17 Impact factor: 29.690