Cor Vasa 2004, 45(4):188-192

Transient postischemic left ventricular stunning as measured by gated SPECT helps to identify patients with multivessel coronary artery disease

Milan Kamínek^1,*, Marcela Škvařilová², Jiří Ostřanský², Václav Hušák¹, Iva Metelková¹, Miroslav Mysliveček¹, Otto Lang³

¹ Klinika nukleární medicíny

² I. interní klinika, Fakultní nemocnice a Univerzita Palackého, Olomouc

³ Klinika nukleární medicíny, Fakultní nemocnice Královské Vinohrady a 3. lékařská fakulta Univerzity Karlovy, Praha, Česká republika

To analyze the diagnostic potential of left ventricular ejection fraction (LVEF), as measured by gated SPECT using 4D-MSPECT, a new quantitative software, to identify patients with multivessel coronary artery disease (CAD); 205 consecutive patients (139 men and 66 women, mean age 61 ± 8 years) underwent stress 201Tl or 99mTc-MIBI gated SPECT studies and coronary angiography. A summed stress score (SSS) of myocardial perfusion, and poststress and rest LVEF were obtained using 4D-MSPECT.


SSS rose with the number of diseased vessels:
SSS was equal to 8 in patients with one-vessel disease vs. SSS 15 and 16 in patients with two-and three-vessel disease, respectively. However, only 47 (48%) of 97 patients with multivessel CAD had reversible defects in multiple territories. The sensitivity of LVEF worsening by exercise for detection of multivessel CAD was 46% (45/97) and did not differ from that of perfusion data alone (p = NS). However, the sensitivity of the combination of perfusion and function data (i. e., multiple perfusion defects and/or worsening of LVEF ł 6%) was significantly greater than that of perfusion data alone (70% vs. 48%; p < 0.05).
A combination of perfusion data assessment, and LVEF worsening due to exercise was more sensitive than the assessment of perfusion data alone for the detection of multivessel CAD.

Keywords: Myocardial perfusion imaging; Multivessel coronary artery disease; Postischemic stunning

Published: April 1, 2004  Show citation