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Additional value of systolic wall thickening in myocardial stunning evaluated by stress-rest gated perfusion SPECT

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Aim and patients

The aim of the present study is to evaluate the additional value of systolic wall thickening to myocardial perfusion in diagnosing myocardial stunning in patients with angiography proven coronary artery disease. We selected 91 ischemic patients (82 males; mean age 59.7 ± 10.3) 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. Treadmill maximal exercise tests were performed on all patients.

Results

The post-stress LVEF was significantly lower than rest LVEF (48.1% ± 10.3% vs 50.3% ± 10.7%; P = .0001). The wall thickening summed difference score was 4.44 ± 4.13 (P = .0001). At a multivariate regression analysis, only WT-SDS as independent variable was significantly correlated with myocardial ischemia (SDS). We also 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, more than the depression in the global function (∆LVEF) of the left ventricle, correlates with the degree of ischemia and better identifies, when present, the stunning phenomenon.

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Abbreviations

CAD:

Coronary artery disease

SPECT:

Single-photon emission computed tomography

LVEF:

Left ventricular ejection fraction

SSS:

Summed stress score

SRS:

Summed rest score

SDS:

Summed difference score

WT-SSS:

Wall thickening summed stress score

WT-SRS:

Wall thickening summed rest score

WT-SDS:

Wall thickening summed difference score

ESV:

End-systolic volume

EDV:

End-diastolic volume

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Acknowledgments

The authors wish to recognize the valuable human and professional contribution of technical and nursing staff of nuclear medicine department. We are also grateful to Mrs. BV Maria for her invaluable assistance in this study.

Disclosure

Alberto Bestetti, Besart Cuko, Adriano Decarli, Alessio Galli, Federico Lombardi have nothing to disclose.

Author information

Authors and Affiliations

  1. Department of Clinical and Biomedical Sciences, University of Milan, Milan, Italy

    Alberto Bestetti MD

  2. Service of Nuclear Medicine, IRCCS Multimedica Sesto San Giovanni, Milan, Italy

    Alberto Bestetti MD

  3. School of Specialty in Nuclear Medicine, University of Milan, Milan, Italy

    Besart Cuko MD

  4. Department of Clinical and Community Sciences, University of Milan, Milan, Italy

    Adriano Decarli MD

  5. Cardiovascular Diseases Unit, IRCCS Ca’ Granda Major Hospital of Milan, University of Milan, Milan, Italy

    Alessio Galli MD & Federico Lombardi MD

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  1. Alberto Bestetti MD
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  2. Besart Cuko MD
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  5. Federico Lombardi MD
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Correspondence to Alessio Galli MD.

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Bestetti, A., Cuko, B., Decarli, A. et al. Additional value of systolic wall thickening in myocardial stunning evaluated by stress-rest gated perfusion SPECT. J. Nucl. Cardiol. 26, 833–840 (2019). https://doi.org/10.1007/s12350-017-1115-5

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  • DOI: https://doi.org/10.1007/s12350-017-1115-5

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