Document Detail


Adenosine-induced long-standing postischemic left ventricular dysfunction evaluated with gated SPECT.
MedLine Citation:
PMID:  15604961     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study was performed to determine the after-effects of pharmacologic stress (adenosine) on left ventricular (LV) function-end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (LVEF)-with Tl-201 and Tc-99m MIBI SPECT. METHODS: A total of 263 patients were grouped according to the time interval between isotope injection and imaging. Group A: within 1 hour (n = 99; men, n = 48; women, n = 51; mean age: 63.2 years), subgrouped as patients with no perfusion defect (NPD; n = 61), reversible defect (RD; n = 33), and fixed defect (FD; n = 5). Group B: 1 to 2 hours (n = 110; men, n = 66; woman, n = 44; mean age, 63 years), NPD (n = 64), RD (n = 26), and FD (n = 20). 3) Group C: 2 to 3 hours (n = 54; men, n = 30; women, n = 24; mean age, 62 years); NPD (n = 22), RD (n = 17), and FD (n = 15). All patients were in sinus rhythm during the study and had no prior history of myocardial infarction. RESULTS: In group A, in the patients with RD, poststress LVEF was significantly depressed after adenosine infusion (53.1 +/- 9.5% vs 58.3 +/- 10.2%, P < 0.001) and showed a wall motion abnormality, which was worse after stress than during rest. The mean difference in LVEF (DeltaLVEF) between rest and stress was 5.2%. The DeltaLVEF in those patients with RD was significantly higher than that in the NPD (0.9%, P < 0.01) or FD (2.1%, P < 0.05) subgroups. Twenty of the 33 patients (60.6%) with RD showed an increase in LVEF > or = 5% from poststress to rest, and the poststress ESV (43.3 +/- 19.0 mL) was significantly higher than the ESV (38.5 +/- 18.4 mL, P < 0.01) at rest, but there was no significant difference in the EDV (90.5 +/- 26.4 vs 89.7 +/- 26.2 mL). In group B, DeltaLVEF was 1.5%, 4.4%, and 1.2% in patients with NPD, RD, and FD respectively. In group C, DeltaLVEF was 2.5%, 3.2%, and 0.9% in patients with NPD, RD, and FD respectively, and there was no significant difference in DeltaLVEF among patients. In group C, 4 of 17 patients (23.5%) with RD showed an increase in LVEF > or = 5% from poststress to rest. CONCLUSION: These results showed that adenosine stress-induced postischemic LV dysfunction is well noted on early quantitative gated SPECT in patients with RD and can also be observed on delayed gated SPECT, even though the incidence of LV dysfunction is less than that in early gated SPECT.
Authors:
Kyung Ah Chun; Ihn Ho Cho
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  30     ISSN:  0363-9762     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-17     Completed Date:  2005-03-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  18-22     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, Yeungnam University Hospital, Daegu, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / diagnostic use*
Chronic Disease
Exercise Test / methods
Female
Gated Blood-Pool Imaging / methods*
Humans
Male
Middle Aged
Myocardial Ischemia / complications,  diagnosis,  radionuclide imaging*
Reproducibility of Results
Retrospective Studies
Risk Assessment / methods*
Risk Factors
Sensitivity and Specificity
Stroke Volume
Tomography, Emission-Computed, Single-Photon / methods*
Ventricular Dysfunction, Left / diagnosis,  etiology*,  radionuclide imaging*
Chemical
Reg. No./Substance:
58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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