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European Journal of Nuclear Medicine and Molecular Imaging

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01-12-2012 | Original Article

Stress-induced myocardial ischemia is associated with early post-stress left ventricular mechanical dyssynchrony as assessed by phase analysis of ²⁰¹Tl gated SPECT myocardial perfusion imaging

Authors: Chien-Cheng Chen, Thau-Yun Shen, Ming-Che Chang, Guang-Uei Hung, Wan-Chen Chen, Chia-Hung Kao, Ji Chen

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2012

Abstract

Purpose

In ²⁰¹Tl SPECT myocardial perfusion imaging (MPI) data are acquired shortly after the stress injection to assess early post-stress left ventricle (LV) function. The purpose of this study was to use ²⁰¹Tl SPECT MPI to investigate whether stress-induced myocardial ischemia is associated with LV mechanical dyssynchrony.

Methods

Enrolled in the study were 75 patients who were referred for dipyridamole stress and rest ²⁰¹Tl gated SPECT MPI. The early post-stress scan was started 5 min after injection, and followed by the rest scan 4 h later. The patients were divided into three groups: ischemia group (N = 25, summed stress score, SSS, ≥5, summed rest score, SRS, <5), infarct group (N = 16, SSS ≥5, SRS ≥5) and normal group (N = 34, SSS <5, SRS <5). LV dyssynchrony parameters were calculated by phase analysis, and compared between the stress and rest images.

Results

In the ischemia group, LV dyssynchrony was significantly larger during stress than during rest. On the contrary, LV dyssynchrony during stress was significantly smaller than during rest in the normal and infarct groups. LV dyssynchrony during rest was significantly larger in the infarct group than in the normal and ischemia groups. There were no significant differences in LV dyssynchrony during rest between the normal and ischemia groups.

Conclusion

Stress-induced myocardial ischemia caused dyssynchronous contraction in the ischemic region, leading to a deterioration in LV synchrony. Normal myocardium had more synchronous contraction during stress. The different dyssynchrony pattern between ischemic and normal myocardium early post-stress may aid the diagnosis of coronary artery disease using ²⁰¹Tl gated SPECT MPI.

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Title: Stress-induced myocardial ischemia is associated with early post-stress left ventricular mechanical dyssynchrony as assessed by phase analysis of 201Tl gated SPECT myocardial perfusion imaging
Authors: Chien-Cheng Chen
Thau-Yun Shen
Ming-Che Chang
Guang-Uei Hung
Wan-Chen Chen
Chia-Hung Kao
Ji Chen
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2012
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-012-2208-7

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Stress-induced myocardial ischemia is associated with early post-stress left ventricular mechanical dyssynchrony as assessed by phase analysis of ²⁰¹Tl gated SPECT myocardial perfusion imaging

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

Purpose

Methods

Results

Conclusion

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