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Differential effects comparing exercise and pharmacologic stress on left ventricular function using gated Tc-99m sestamibi SPECT

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Abstract

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, 99mTc-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, enddiastolic 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.

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Authors and Affiliations

  1. Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Yuka Ohtaki, Taishiro Chikamori, Yuko Igarashi, Satoshi Hida, Hirokazu Tanaka, Tsuguhisa Hatano, Yasuhiro Usui, Manabu Miyagi & Akira Yamashina

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  1. Yuka Ohtaki
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  2. Taishiro Chikamori
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  3. Yuko Igarashi
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  4. Satoshi Hida
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  5. Hirokazu Tanaka
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  7. Yasuhiro Usui
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Correspondence to Taishiro Chikamori.

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Ohtaki, Y., Chikamori, T., Igarashi, Y. et al. Differential effects comparing exercise and pharmacologic stress on left ventricular function using gated Tc-99m sestamibi SPECT. Ann Nucl Med 22, 185–190 (2008). https://doi.org/10.1007/s12149-007-0106-z

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  • DOI: https://doi.org/10.1007/s12149-007-0106-z

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