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.

Better characterization of dipyridamole-induced myocardial stunning by systolic wall thickening. A gated perfusion SPECT study / A. Bestetti, B. Cuko, M. Gasparini, S. De Servi. - In: JOURNAL OF NUCLEAR CARDIOLOGY. - ISSN 1071-3581. - 27:1(2020 Feb), pp. 137-146. [10.1007/s12350-018-1340-6]

Better characterization of dipyridamole-induced myocardial stunning by systolic wall thickening. A gated perfusion SPECT study

A. Bestetti
Writing – Original Draft Preparation
;
B. Cuko;
2020

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.
cardiac single-photon emission computed tomography; Coronary artery disease; ischemic heart disease; myocardial stunning; Aged; Dipyridamole; Female; Humans; Male; Middle Aged; Myocardial Ischemia; Myocardial Stunning; Organophosphorus Compounds; Organotechnetium Compounds; Predictive Value of Tests; Radiopharmaceuticals; Vasodilator Agents; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography
Settore MED/36 - Diagnostica per Immagini e Radioterapia
giu-2018
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/866224
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