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

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

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.

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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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Acknowledgements

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

Bestetti, B. Cuko, M. Gasparini, and S. De Servi 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. Department of Nuclear Medicine, IRCCS MultiMedica Sesto San Giovanni, Milan, Italy

    Alberto Bestetti MD & Massimo Gasparini MD

  3. School of Specialty in Cardiac Surgery, University of Brescia, Brescia, Italy

    Besart Cuko MD

  4. Cardiovascular Department, IRCCS MultiMedica Sesto San Giovanni, Milan, Italy

    Stefano De Servi MD

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  1. Alberto Bestetti MD
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  2. Besart Cuko MD
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Correspondence to Alberto Bestetti MD.

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Bestetti, A., Cuko, B., Gasparini, M. et al. Better characterization of dipyridamole-induced myocardial stunning by systolic wall thickening. A gated perfusion SPECT study. J. Nucl. Cardiol. 27, 137–146 (2020). https://doi.org/10.1007/s12350-018-1340-6

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  • DOI: https://doi.org/10.1007/s12350-018-1340-6

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