Document Detail


Determinants of the response of left ventricular ejection fraction to vasodilator stress in electrocardiographically gated (82)rubidium myocardial perfusion PET.
MedLine Citation:
PMID:  17912523     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Myocardial perfusion imaging with (82)Rb PET allows for ECG-gated studies to be obtained early after radiotracer injection, capturing ventricular function close to peak pharmacologic action of dipyridamole. This is different from gated SPECT and may potentially provide additional diagnostic information. We sought to identify potential correlates of the PET-derived ejection fraction response to vasodilator stress. METHODS: One hundred ten consecutive patients undergoing (82)Rb PET myocardial perfusion imaging during evaluation for coronary artery disease were included. Using a GE Discovery STRx PET-CT scanner, ECG-gated images (eight bins) were obtained at rest and 4 min after dipyridamole infusion, 90 s after infusion of 1,480-2,220 MBq of (82)Rb. Summed rest, stress, and difference scores (SRS, SSS, and SDS) were determined using a five-point scoring system and 20-segment model. Ejection fraction was calculated using automated QGS software. RESULTS: Significant reversibility (SDS > or = 4) was found in 23 patients (21%). Mean LVEF in all patients was 47 +/- 13% at rest and 53 +/- 13% during dipyridamole. LVEF increased in 89 patients, and decreased in 17 patients during vasodilation. The change in LVEF was inversely correlated with SDS (r = -0.26; p = 0.007). Additionally, it was inversely correlated with resting LVEF (r = -0.20; p = 0.03) and SSS (r = -0.25; p = 0.009). No significant correlations were observed with SRS, heart rate, blood pressure, age, hypertension, hypercholesterolemia, or pretest likelihood of disease. At multivariate regression analysis, SDS was an independent predictor of the change in LVEF. CONCLUSIONS: Gated (82)Rb PET during pharmacologic stress allows for assessment of the functional response to vasodilation. The magnitude of LVEF increase is determined by stress perfusion/reversible perfusion defects. Functional response to hyperemia may thus be incorporated in future evaluations of diagnostic and prognostic algorithms based on (82)Rb PET.
Authors:
Tracy L Y Brown; Jennifer Merrill; Lana Volokh; Frank M Bengel
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Publication Detail:
Type:  Journal Article     Date:  2007-10-02
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  35     ISSN:  1619-7070     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-21     Completed Date:  2008-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  336-42     Citation Subset:  IM    
Affiliation:
Department of Radiology and Radiological Sciences, Division of Nuclear Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Coronary Artery Disease / complications,  radionuclide imaging*
Dipyridamole / diagnostic use*
Electrocardiography
Exercise Test / methods
Female
Gated Blood-Pool Imaging / methods*
Humans
Male
Middle Aged
Positron-Emission Tomography / methods*
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Rubidium Radioisotopes / diagnostic use*
Sensitivity and Specificity
Stroke Volume*
Vasodilator Agents / diagnostic use
Ventricular Dysfunction, Left / etiology,  radionuclide imaging*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Rubidium Radioisotopes; 0/Vasodilator Agents; 58-32-2/Dipyridamole

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


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