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Physiological effects of dipyridamole on left ventricular function: A MIBI gated SPECT study
Journal of Nuclear Cardiology Volume 6, Number 1, Part 2
Abstracts Tuesday morning, April 20, 1999
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TRANSIENT ISCHEMIC DILATATION RATIO BEFORE AND AFTER CABG IN PATIENTS WITH SEVERE CORONARY ARTERY DISEASE ASSESSED WITH STRESS/REINJECTION TL-201 ECG-GATED SPECT. S. Kubo, E. Tadamura, T. Kudoh, M. Inubushi, N. Hattori, T. Koshiji, K. Nishimura, M. Komeda, J. Konishi. Kyoto University Hospital, Kyoto, Japan It is reported that T1-201 ECG-gated SPECT (TI-gSPECT) can provide functional information if processed with the automated algorithm. Transient ischemic dilatation (TID) of left ventricle on stress / rest perfusion imaging is reported to be clinically useful for the identification of severe coronary artery disease (CAD). Therefore, the purpose of this study was to assess TID change before and after CABG using TI-g-SPECT. In addition, post-stress E F / R e s t - E F (P-R EF ratio) was also evaluated before and after CABG. Fourteen patients with severe coronary artery disease underwent stress / reinjection TI-g-SPECT before and after CABG. TID was larger before CABG than after CABG (1.05 + 0. t4 and 0.92 + 0.11, respectively, p<0.05), while P-R EF ratio did not differ significantly before and after CABG (1.01 + 0.14 and 0.99 + 0.11, respectively). These data indicated that LVEDV transiently increased after stress maintaining LVEF values in severe CAD. After revascularization, however, LVEDV decreased transiently in a post-stress condition preserving LVEF. Thus, stress/reinjection TI-gSPECT provides clinically useful functional information in addtion to the myocardial perfusion and viability.
PHYSIOLOGICALEFFECTSOF DIPYRIDAMOLEON LEFTVENTRICULAR FUNCTION: AMIBIGATEDSPECTSTUDY. PWeinmann JLMoretti AvicenneHospital,UFRL. De VinciPARIS13, Bobigny,France. The effects of dipyridamole (DIP) on myocardial function in healthy subjects have rarelybeen studiedby radionuclidetechniques. MIBIgated SPECTprovidesboth myocardialperfusionand LVEF.Image acquisitionis usuallystarted 60 min after DIP and MIBIinfusion. Therefore,we studied the amplitude and duration of change induced by DIP in 10 subjects (7 women, 3 men, mean age 60 -+ 5 yr) with low likelihoodof CAD.MIBI (740 MBq) was injected at rest, a provocating fatty meal was given and 3 consecutivegated SPECTwere performed 60 min after MIBIinjection : at rest (GS 1), 7 rain afterthe beginningof the infusionof 0.76 mg/kgDIPover a 4 min period(GS2), and 60 min afterthe DIP infusion(GS 3). No patient received aminophyllineafter DIP infusion. Heart rate (HR) and blood pressure (BP) were monitored for each patient. Results are as follows (mean ± sd): p GS1 GS2 GS1 vs GS2 GS3 LVEF '63.1+--9.1 73.2-9.6 <0.0001 62.5---8.1" ~R/ min 82+-12 95.7-+9:5 <0.005 83.9+-12.8' 137.5+16.2 / 132-+16.7/ 140-+23.8 / BPmmHg 81+-9.9 72-+9.8 NS 86-+14.5' * non-significant(NS) : GS 1vs GS3 It is concludedthat : 1) DIP increasesLVEFand HR and has no significant effect on BP in healthy subjects. 2) at 60 min,DIP effectis no morenoticeable. 3) therefore,DIPMIBIgated SPECTas performed in routine, provides a rest LVEF,unlessstunned myocardiumis present.
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THALLIUM 201 GATED SPECT FOR SIMULTANEOUS ASSESSMENT OF MYOCARDIAL PERFUSION, LEFT VENTRICULAR EJECTION FRACTION AND QUALITATIVE REGIONAL FUNCTION. Ph. Carpentier, H. Benticha, Ph. Gautier, Ch. Sulman. Centre Oscar Lambret, Lille, France.
E F F E C T OF C O R O N A R Y A R T E R Y B Y P A S S SURGERY ON M Y O C A R D I A L PERFUSION AND FUNCTION ASSESSED BY M Y O C A R D I A L GATED SPECT J. Taki, T. Higuchi, K. Nakajima, I. Matsunari, E. Hwang, M. Kawasuji, N. Tonami. Kanazawa University School
This study investigates the faisability of Thallium 201 Gated SPECT and compare left ventricular ejection fraction (LVEF), regional wall motion, and perfusion obtained form Gated SPECT and from echography, radionuclide ventriculography and no gated Thallium SPECT. Method : We studied 40 patients with a Stress/rest Thallium 201 gated SPECT. Automatic quantification of LVEF and wall motion were accomplished using Germano's algorithm. Results : There is a good correlation between LVEF determined from Thallium 201 gated SPECT and from radionuclide ventriculography in all patients ( y = 0,853 x + 6,387 r = 0,934 p<0,05 n=40 ). In ischemic patient ( n= 19 ), the correlation was also good ( r = 0,933 ). Exact agreement between rest Thallium 201 gated-SPECT and echocardiography segmental motion was 88,8% ( Kappa = 0,64 p<0,05 ). Concerning perfusion defect observed at rest with gated SPECT and non gated SPECT the agreement was good (Kappa between 0.73 and 1) C o n c l u s i o n : Thallium 201 gated SPECT imaging can be performed to assess simultaneously both myocardial function and perfusion using one injection.
The aim of this study was to assess the change of myocardial perfusion and ventricular function before and after bypass surgery (CABG) using gated SPECT with Tc-99m-MIBI. 20 patients with chronic coronary artery disease underwent gated SPECT before and 1 month after CABG. Enddiastolic and end-systolic volumes (EDV, ESV), LVEF, global and regional systolic % wall thickening (WT), and regional perfusion (% uptake) were evaluated. For regional analysis, myocardium was divided into 16 segments on functional bull's eye map. Patients with preoperative EF with <50% showed larger decrease in EDV(-23+_21ml vs -8.9+7.3ml, p=.09) and ESV(-19+20ml vs -2.1+3.1ml, p<.05) and increase in global W T (6.1+11% vs -4.2_+10%, p<.05) after CABG than those with >50%. The segments with preoperative WT with <35% showed increase in W T (23+8.5% to 28+12%, p<.001) and perfusion (69+14% to 72+14%,.p<.001) after CABG. While, the segments with preoperatwe W T with >35% showed same perfusion (82+ 8.7% to 82+8.3%) and reduction in W T (55+14 to 51+ 16 %, p<.001). In conclusion, serial myocardial gated SPECT before and after CABG provides comprehensive information on changes in myocardial perfusion and function.
of Medicine, Kanazawa, Japan
Abstracts Tuesday morning, April 20, 1999
$39
23.5
23.7
TRANSIENT ISCHEMIC DILATATION RATIO BEFORE AND AFTER CABG IN PATIENTS WITH SEVERE CORONARY ARTERY DISEASE ASSESSED WITH STRESS/REINJECTION TL-201 ECG-GATED SPECT. S. Kubo, E. Tadamura, T. Kudoh, M. Inubushi, N. Hattori, T. Koshiji, K. Nishimura, M. Komeda, J. Konishi. Kyoto University Hospital, Kyoto, Japan It is reported that T1-201 ECG-gated SPECT (TI-gSPECT) can provide functional information if processed with the automated algorithm. Transient ischemic dilatation (TID) of left ventricle on stress / rest perfusion imaging is reported to be clinically useful for the identification of severe coronary artery disease (CAD). Therefore, the purpose of this study was to assess TID change before and after CABG using TI-g-SPECT. In addition, post-stress E F / R e s t - E F (P-R EF ratio) was also evaluated before and after CABG. Fourteen patients with severe coronary artery disease underwent stress / reinjection TI-g-SPECT before and after CABG. TID was larger before CABG than after CABG (1.05 + 0. t4 and 0.92 + 0.11, respectively, p<0.05), while P-R EF ratio did not differ significantly before and after CABG (1.01 + 0.14 and 0.99 + 0.11, respectively). These data indicated that LVEDV transiently increased after stress maintaining LVEF values in severe CAD. After revascularization, however, LVEDV decreased transiently in a post-stress condition preserving LVEF. Thus, stress/reinjection TI-gSPECT provides clinically useful functional information in addtion to the myocardial perfusion and viability.
PHYSIOLOGICALEFFECTSOF DIPYRIDAMOLEON LEFTVENTRICULAR FUNCTION: AMIBIGATEDSPECTSTUDY. PWeinmann JLMoretti AvicenneHospital,UFRL. De VinciPARIS13, Bobigny,France. The effects of dipyridamole (DIP) on myocardial function in healthy subjects have rarelybeen studiedby radionuclidetechniques. MIBIgated SPECTprovidesboth myocardialperfusionand LVEF.Image acquisitionis usuallystarted 60 min after DIP and MIBIinfusion. Therefore,we studied the amplitude and duration of change induced by DIP in 10 subjects (7 women, 3 men, mean age 60 -+ 5 yr) with low likelihoodof CAD.MIBI (740 MBq) was injected at rest, a provocating fatty meal was given and 3 consecutivegated SPECTwere performed 60 min after MIBIinjection : at rest (GS 1), 7 rain afterthe beginningof the infusionof 0.76 mg/kgDIPover a 4 min period(GS2), and 60 min afterthe DIP infusion(GS 3). No patient received aminophyllineafter DIP infusion. Heart rate (HR) and blood pressure (BP) were monitored for each patient. Results are as follows (mean ± sd): p GS1 GS2 GS1 vs GS2 GS3 LVEF '63.1+--9.1 73.2-9.6 <0.0001 62.5---8.1" ~R/ min 82+-12 95.7-+9:5 <0.005 83.9+-12.8' 137.5+16.2 / 132-+16.7/ 140-+23.8 / BPmmHg 81+-9.9 72-+9.8 NS 86-+14.5' * non-significant(NS) : GS 1vs GS3 It is concludedthat : 1) DIP increasesLVEFand HR and has no significant effect on BP in healthy subjects. 2) at 60 min,DIP effectis no morenoticeable. 3) therefore,DIPMIBIgated SPECTas performed in routine, provides a rest LVEF,unlessstunned myocardiumis present.
23.6
23.8
THALLIUM 201 GATED SPECT FOR SIMULTANEOUS ASSESSMENT OF MYOCARDIAL PERFUSION, LEFT VENTRICULAR EJECTION FRACTION AND QUALITATIVE REGIONAL FUNCTION. Ph. Carpentier, H. Benticha, Ph. Gautier, Ch. Sulman. Centre Oscar Lambret, Lille, France.
E F F E C T OF C O R O N A R Y A R T E R Y B Y P A S S SURGERY ON M Y O C A R D I A L PERFUSION AND FUNCTION ASSESSED BY M Y O C A R D I A L GATED SPECT J. Taki, T. Higuchi, K. Nakajima, I. Matsunari, E. Hwang, M. Kawasuji, N. Tonami. Kanazawa University School
This study investigates the faisability of Thallium 201 Gated SPECT and compare left ventricular ejection fraction (LVEF), regional wall motion, and perfusion obtained form Gated SPECT and from echography, radionuclide ventriculography and no gated Thallium SPECT. Method : We studied 40 patients with a Stress/rest Thallium 201 gated SPECT. Automatic quantification of LVEF and wall motion were accomplished using Germano's algorithm. Results : There is a good correlation between LVEF determined from Thallium 201 gated SPECT and from radionuclide ventriculography in all patients ( y = 0,853 x + 6,387 r = 0,934 p<0,05 n=40 ). In ischemic patient ( n= 19 ), the correlation was also good ( r = 0,933 ). Exact agreement between rest Thallium 201 gated-SPECT and echocardiography segmental motion was 88,8% ( Kappa = 0,64 p<0,05 ). Concerning perfusion defect observed at rest with gated SPECT and non gated SPECT the agreement was good (Kappa between 0.73 and 1) C o n c l u s i o n : Thallium 201 gated SPECT imaging can be performed to assess simultaneously both myocardial function and perfusion using one injection.
The aim of this study was to assess the change of myocardial perfusion and ventricular function before and after bypass surgery (CABG) using gated SPECT with Tc-99m-MIBI. 20 patients with chronic coronary artery disease underwent gated SPECT before and 1 month after CABG. Enddiastolic and end-systolic volumes (EDV, ESV), LVEF, global and regional systolic % wall thickening (WT), and regional perfusion (% uptake) were evaluated. For regional analysis, myocardium was divided into 16 segments on functional bull's eye map. Patients with preoperative EF with <50% showed larger decrease in EDV(-23+_21ml vs -8.9+7.3ml, p=.09) and ESV(-19+20ml vs -2.1+3.1ml, p<.05) and increase in global W T (6.1+11% vs -4.2_+10%, p<.05) after CABG than those with >50%. The segments with preoperative WT with <35% showed increase in W T (23+8.5% to 28+12%, p<.001) and perfusion (69+14% to 72+14%,.p<.001) after CABG. While, the segments with preoperatwe W T with >35% showed same perfusion (82+ 8.7% to 82+8.3%) and reduction in W T (55+14 to 51+ 16 %, p<.001). In conclusion, serial myocardial gated SPECT before and after CABG provides comprehensive information on changes in myocardial perfusion and function.
of Medicine, Kanazawa, Japan