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Published in: Journal of Nuclear Cardiology 6/2016

01-12-2016 | Original Article

Quantitation of left ventricular ejection fraction reserve from early gated regadenoson stress Tc-99m high-efficiency SPECT

Authors: Yafim Brodov, MD, PhD, Mathews Fish, MD, Mathieu Rubeaux, PhD, Yuka Otaki, MD, PhD, Heidi Gransar, MD, CCRP, Mark Lemley, BS, Jim Gerlach, PhD, Daniel Berman, MD, Guido Germano, PhD, Piotr Slomka, PhD

Published in: Journal of Nuclear Cardiology | Issue 6/2016

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Abstract

Background

Ejection fraction (EF) reserve has been found to be a useful adjunct for identifying high risk coronary artery disease in cardiac positron emission tomography (PET). We aimed to evaluate EF reserve obtained from technetium-99m sestamibi (Tc-99m) high-efficiency (HE) SPECT.

Methods

Fifty patients (mean age 69 years) undergoing regadenoson same-day rest (8-11 mCi)/stress (32-42 mCi) Tc-99m gated HE SPECT were enrolled. Stress imaging was started 1 minute after sequential intravenous regadenoson .4 mg and Tc-99m injections, and was composed of five 2 minutes supine gated acquisitions followed by two 4 minutes supine and upright images. Ischemic total perfusion deficit (ITPD) ≥5 % was considered as significant ischemia.

Results

Significantly lower mean EF reserve was obtained in the 5th and 9th minute after regadenoson bolus in patients with significant ischemia vs patients without (5th minute: −4.2 ± 4.6% vs 1.3 ± 6.6%, P = .006; 9th minute: −2.7 ± 4.8% vs 2.0 ± 6.6%, P = .03).

Conclusions

Negative EF reserve obtained between 5th and 9th minutes of regadenoson stress demonstrated best concordance with significant ischemia and may be a promising tool for detection of transient ischemic functional changes with Tc-99m HE-SPECT.
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Literature
1.
go back to reference Holly TA, Abbott BG, Al-Mallah M, Calnon DA, Cohen MC, DiFilippo FP, et al. Single photon-emission computed tomography. J Nucl Cardiol 2010;5:941-73.CrossRef Holly TA, Abbott BG, Al-Mallah M, Calnon DA, Cohen MC, DiFilippo FP, et al. Single photon-emission computed tomography. J Nucl Cardiol 2010;5:941-73.CrossRef
2.
go back to reference Berman DS, Kang X, Slomka PJ, Gerlach J, de Yang L, Hayes SW, et al. Underestimation of extent of ischemia by gated SPECT myocardial perfusion imaging in patients with left main coronary artery disease. J Nucl Cardiol 2007;4:521-8.CrossRef Berman DS, Kang X, Slomka PJ, Gerlach J, de Yang L, Hayes SW, et al. Underestimation of extent of ischemia by gated SPECT myocardial perfusion imaging in patients with left main coronary artery disease. J Nucl Cardiol 2007;4:521-8.CrossRef
3.
go back to reference Lima RS, Watson DD, Goode AR, Siadaty MS, Ragosta M, Beller GA, Samady H. Incremental value of combined perfusion and function over perfusion alone by gated SPECT myocardial perfusion imaging for detection of severe three-vessel coronary artery disease. J Am Coll Cardiol 2003;1:64-70.CrossRef Lima RS, Watson DD, Goode AR, Siadaty MS, Ragosta M, Beller GA, Samady H. Incremental value of combined perfusion and function over perfusion alone by gated SPECT myocardial perfusion imaging for detection of severe three-vessel coronary artery disease. J Am Coll Cardiol 2003;1:64-70.CrossRef
4.
go back to reference Sharir T, Germano G, Kavanagh PB, Lai S, Cohen I, Lewin HC, et al. Incremental prognostic value of post-stress left ventricular ejection fraction and volume by gated myocardial perfusion single photon emission computed tomography. Circulation 1999;10:1035-42.CrossRef Sharir T, Germano G, Kavanagh PB, Lai S, Cohen I, Lewin HC, et al. Incremental prognostic value of post-stress left ventricular ejection fraction and volume by gated myocardial perfusion single photon emission computed tomography. Circulation 1999;10:1035-42.CrossRef
5.
go back to reference Sharir T, Bacher-Stier C, Dhar S, Lewin HC, Miranda R, Friedman JD, et al. Identification of severe and extensive coronary artery disease by postexercise regional wall motion abnormalities in Tc-99m sestamibi gated single-photon emission computed tomography. Am J Cardiol 2000;11:1171-5.CrossRef Sharir T, Bacher-Stier C, Dhar S, Lewin HC, Miranda R, Friedman JD, et al. Identification of severe and extensive coronary artery disease by postexercise regional wall motion abnormalities in Tc-99m sestamibi gated single-photon emission computed tomography. Am J Cardiol 2000;11:1171-5.CrossRef
6.
go back to reference Abidov A, Bax JJ, Hayes SW, Cohen I, Nishina H, Yoda S, et al. Integration of automatically measured transient ischemic dilation ratio into interpretation of adenosine stress myocardial perfusion SPECT for detection of severe and extensive CAD. J Nucl Med 2004;12:1999-2007. Abidov A, Bax JJ, Hayes SW, Cohen I, Nishina H, Yoda S, et al. Integration of automatically measured transient ischemic dilation ratio into interpretation of adenosine stress myocardial perfusion SPECT for detection of severe and extensive CAD. J Nucl Med 2004;12:1999-2007.
7.
go back to reference Dorbala S, Vangala D, Sampson U, Limaye A, Kwong R, Di Carli MF. Value of vasodilator left ventricular ejection fraction reserve in evaluating the magnitude of myocardium at risk and the extent of angiographic coronary artery disease: an 82Rb PET/CT study. J Nucl Med 2007;3:349-58. Dorbala S, Vangala D, Sampson U, Limaye A, Kwong R, Di Carli MF. Value of vasodilator left ventricular ejection fraction reserve in evaluating the magnitude of myocardium at risk and the extent of angiographic coronary artery disease: an 82Rb PET/CT study. J Nucl Med 2007;3:349-58.
8.
go back to reference Imbert L, Poussier S, Franken PR, Songy B, Verger A, Morel O, et al. Compared performance of high-sensitivity cameras dedicated to myocardial perfusion SPECT: A comprehensive analysis of phantom and human images. J Nucl Med 2012;12:1897-903.CrossRef Imbert L, Poussier S, Franken PR, Songy B, Verger A, Morel O, et al. Compared performance of high-sensitivity cameras dedicated to myocardial perfusion SPECT: A comprehensive analysis of phantom and human images. J Nucl Med 2012;12:1897-903.CrossRef
9.
go back to reference Sharir T, Slomka PJ, Hayes SW, DiCarli MF, Ziffer JA, Martin WH, et al. Multicenter trial of high-speed vs conventional single-photon emission computed tomography imaging: Quantitative results of myocardial perfusion and left ventricular function. J Am Coll Cardiol 2010;18:1965-74.CrossRef Sharir T, Slomka PJ, Hayes SW, DiCarli MF, Ziffer JA, Martin WH, et al. Multicenter trial of high-speed vs conventional single-photon emission computed tomography imaging: Quantitative results of myocardial perfusion and left ventricular function. J Am Coll Cardiol 2010;18:1965-74.CrossRef
10.
go back to reference Erlandsson K, Kacperski K, van Gramberg D, Hutton BF. Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology. Phys Med Biol 2009;9:2635-49.CrossRef Erlandsson K, Kacperski K, van Gramberg D, Hutton BF. Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology. Phys Med Biol 2009;9:2635-49.CrossRef
11.
go back to reference Iskandrian AE, Bateman TM, Belardinelli L, Blackburn B, Cerqueira MD, Hendel RC, et al. ADVANCE MPI Investigators. Adenosine vs regadenoson comparative evaluation in myocardial perfusion imaging: Results of the ADVANCE phase 3 multicenter international trials. J Nucl Cardiol 2007;5:645-58.CrossRef Iskandrian AE, Bateman TM, Belardinelli L, Blackburn B, Cerqueira MD, Hendel RC, et al. ADVANCE MPI Investigators. Adenosine vs regadenoson comparative evaluation in myocardial perfusion imaging: Results of the ADVANCE phase 3 multicenter international trials. J Nucl Cardiol 2007;5:645-58.CrossRef
12.
go back to reference Sharir T, Ben-Haim S, Merzon K, Prochorov V, Dickman D, Ben-Haim S, Berman DS. High-speed myocardial perfusion imaging. Initial clinical comparison with conventional dual detector Anger camera imaging. J Am Coll Cardiol Imaging 2008;1:156-63.CrossRef Sharir T, Ben-Haim S, Merzon K, Prochorov V, Dickman D, Ben-Haim S, Berman DS. High-speed myocardial perfusion imaging. Initial clinical comparison with conventional dual detector Anger camera imaging. J Am Coll Cardiol Imaging 2008;1:156-63.CrossRef
13.
go back to reference Patton J, Berman DS, Slomka P. Recent technological advances in nuclear cardiology. J Nucl Cardiol 2007;14:433-54.CrossRef Patton J, Berman DS, Slomka P. Recent technological advances in nuclear cardiology. J Nucl Cardiol 2007;14:433-54.CrossRef
14.
go back to reference Slomka PJ, Nishina H, Berman DS, Akincioglu C, Abidov A, Friedman JD, et al. Automated quantification of myocardial perfusion SPECT using simplified normal limits. J Nucl Cardiol 2005;1:66-77.CrossRef Slomka PJ, Nishina H, Berman DS, Akincioglu C, Abidov A, Friedman JD, et al. Automated quantification of myocardial perfusion SPECT using simplified normal limits. J Nucl Cardiol 2005;1:66-77.CrossRef
15.
go back to reference Xu Y, Kavanagh P, Fish M, Gerlach J, Ramesh A, Lemley M, et al. Automated quality control for segmentation of myocardial perfusion SPECT. J Nucl Med 2009;9:1418-26.CrossRef Xu Y, Kavanagh P, Fish M, Gerlach J, Ramesh A, Lemley M, et al. Automated quality control for segmentation of myocardial perfusion SPECT. J Nucl Med 2009;9:1418-26.CrossRef
16.
go back to reference Nishina H, Slomka PJ, Abidov A, Yoda S, Akincioglu C, Kang X, et al. Combined supine and prone quantitative myocardial perfusion SPECT: method development and clinical validation in patients with no known coronary artery disease. J Nucl Med 2006;1:51-8. Nishina H, Slomka PJ, Abidov A, Yoda S, Akincioglu C, Kang X, et al. Combined supine and prone quantitative myocardial perfusion SPECT: method development and clinical validation in patients with no known coronary artery disease. J Nucl Med 2006;1:51-8.
17.
go back to reference Berman DS, Kang X, Tamarappoo B, Wolak A, Hayes SW, Nakazato R, et al. Stress thallium-201/rest technetium-99m sequential dual isotope high-speed myocardial perfusion imaging. JACC Cardiovasc Imaging 2009;3:273-82.CrossRef Berman DS, Kang X, Tamarappoo B, Wolak A, Hayes SW, Nakazato R, et al. Stress thallium-201/rest technetium-99m sequential dual isotope high-speed myocardial perfusion imaging. JACC Cardiovasc Imaging 2009;3:273-82.CrossRef
18.
go back to reference Askew JW, Miller TD, Ruter RL, Jordan LG, Hodge DO, Gibbons RJ, O’Connor MK. Early image acquisition using a solid-state cardiac camera for fast myocardial perfusion imaging. J Nucl Cardiol 2011;5:840-6.CrossRef Askew JW, Miller TD, Ruter RL, Jordan LG, Hodge DO, Gibbons RJ, O’Connor MK. Early image acquisition using a solid-state cardiac camera for fast myocardial perfusion imaging. J Nucl Cardiol 2011;5:840-6.CrossRef
19.
go back to reference Nakazato R, Slomka PJ, Fish M, Schwartz RG, Hayes SW, Thomson LE, et al. Quantitative high-efficiency cadmium-zinc-telluride SPECT with dedicated parallel-hole collimation system in obese patients: Results of a multi-center study. J Nucl Cardiol 2014;2:266-75. Nakazato R, Slomka PJ, Fish M, Schwartz RG, Hayes SW, Thomson LE, et al. Quantitative high-efficiency cadmium-zinc-telluride SPECT with dedicated parallel-hole collimation system in obese patients: Results of a multi-center study. J Nucl Cardiol 2014;2:266-75.
20.
go back to reference Hsiao E, Ali B, Blankstein R, Skali H, Ali T, Bruyere J Jr, et al. Detection of obstructive coronary artery disease using regadenoson stress and 82Rb PET/CT myocardial perfusion imaging. J Nucl Med 2013;10:1748-54.CrossRef Hsiao E, Ali B, Blankstein R, Skali H, Ali T, Bruyere J Jr, et al. Detection of obstructive coronary artery disease using regadenoson stress and 82Rb PET/CT myocardial perfusion imaging. J Nucl Med 2013;10:1748-54.CrossRef
21.
go back to reference Dorbala S, Hachamovitch R, Curillova Z, Thomas D, Vangala D, Kwong RY, Di Carli MF. Incremental prognostic value of gated Rb-82 positron emission tomography myocardial perfusion imaging over clinical variables and rest EF. JACC Cardiovasc Imaging 2009;7:846-54.CrossRef Dorbala S, Hachamovitch R, Curillova Z, Thomas D, Vangala D, Kwong RY, Di Carli MF. Incremental prognostic value of gated Rb-82 positron emission tomography myocardial perfusion imaging over clinical variables and rest EF. JACC Cardiovasc Imaging 2009;7:846-54.CrossRef
22.
go back to reference Slomka PJ, Berman DS, Germano G. New cardiac cameras: Single-photon emission CT and PET. Semin Nucl Med 2014;4:232-51.CrossRef Slomka PJ, Berman DS, Germano G. New cardiac cameras: Single-photon emission CT and PET. Semin Nucl Med 2014;4:232-51.CrossRef
23.
go back to reference Ben-Haim S, Murthy VL, Breault C, Allie R, Sitek A, Roth N, Fantony J, et al. Quantification of myocardial perfusion reserve using dynamic SPECT imaging in humans: A feasibility study. J Nucl Med 2013;6:873-9.CrossRef Ben-Haim S, Murthy VL, Breault C, Allie R, Sitek A, Roth N, Fantony J, et al. Quantification of myocardial perfusion reserve using dynamic SPECT imaging in humans: A feasibility study. J Nucl Med 2013;6:873-9.CrossRef
Metadata
Title
Quantitation of left ventricular ejection fraction reserve from early gated regadenoson stress Tc-99m high-efficiency SPECT
Authors
Yafim Brodov, MD, PhD
Mathews Fish, MD
Mathieu Rubeaux, PhD
Yuka Otaki, MD, PhD
Heidi Gransar, MD, CCRP
Mark Lemley, BS
Jim Gerlach, PhD
Daniel Berman, MD
Guido Germano, PhD
Piotr Slomka, PhD
Publication date
01-12-2016
Publisher
Springer US
Published in
Journal of Nuclear Cardiology / Issue 6/2016
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-016-0519-y

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