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

• DOI: 10.1007/s12350-016-0519-y
• Publication Date: 2016-07-07T18:31:39Z
• Authors: Yafim Brodov; Mathews Fish; Mathieu Rubeaux; Yuka Otaki; Heidi Gransar; Mark Lemley; Jim Gerlach; Daniel Berman; Guido Germano; Piotr Slomka
• Keywords: Male; Technetium Tc 99m Sestamibi; Vasodilator Agents; Clinical Sciences; Left; Coronary Artery Disease; Cardiorespiratory Medicine and Haematology; Cardiovascular; Cardiovascular medicine and haematology; Sensitivity and Specificity; Ventricular Dysfunction, Left; Computer-Assisted; Clinical Research; Image Interpretation, Computer-Assisted; Ventricular Dysfunction; image quality; Humans; Image Interpretation; Tomography; Heart Disease - Coronary Heart Disease; Aged; early stress imaging; Tomography, Emission-Computed, Single-Photon; Biomedical and Clinical Sciences; Reproducibility of Results; Stroke Volume; Image Enhancement; Regadenoson Tc-99m high-efficiency SPECT; 3. Good health; Heart Disease; left ventricular ejection fraction reserve; Cardiovascular System & Hematology; Purines; Exercise Test; Biomedical Imaging; Pyrazoles; Female; Emission-Computed; Radiopharmaceuticals; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; Single-Photon

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.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.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).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.