Document Detail

Differential effects comparing exercise and pharmacologic stress on left ventricular function using gated Tc-99m sestamibi SPECT.
MedLine Citation:
PMID:  18498033     Owner:  NLM     Status:  MEDLINE    
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, end-diastolic 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.
Yuka Ohtaki; Taishiro Chikamori; Yuko Igarashi; Satoshi Hida; Hirokazu Tanaka; Tsuguhisa Hatano; Yasuhiro Usui; Manabu Miyagi; Akira Yamashina
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2008-05-23
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  22     ISSN:  0914-7187     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-05-23     Completed Date:  2008-07-23     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  185-90     Citation Subset:  IM    
Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, Japan.
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MeSH Terms
Adenosine Triphosphate / adverse effects*
Coronary Artery Disease / physiopathology,  radionuclide imaging
Exercise Test / adverse effects*
Gated Blood-Pool Imaging
Matched-Pair Analysis
Middle Aged
Myocardial Stunning / etiology,  physiopathology*,  radionuclide imaging
Radiopharmaceuticals / diagnostic use
Retrospective Studies
Stress, Physiological / etiology,  physiopathology
Stroke Volume
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon
Ventricular Function, Left / drug effects
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 56-65-5/Adenosine Triphosphate

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