Transient Prolonged Stunning by Dipyridamole Stress Proved by Post-stress ( 1 hour ) and 24 hour Tc-99m-MIBI Gated SPECT .
- Author:
Chang Soon KOH
;
Myung Chul LEE
;
Jung Key CHUNG
;
Dong Soo LEE
;
Won Woo LEE
;
Seok Nam YOON
;
Myoung Mook LEE
- Publication Type:Original Article
- Keywords:
Gated myocardial SPECT;
Stunning;
Dipyridamole stress
- MeSH:
Coronary Vessels;
Dipyridamole*;
Humans;
Myocardial Stunning;
Perfusion;
Thorax;
Tomography, Emission-Computed, Single-Photon*
- From:Korean Journal of Nuclear Medicine
1997;31(1):57-66
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We performed 1st day Tc-99m-sestamibi gated SPECT with dipyridamole/rest T1-201 SPECT and 2nd day 24 hour delay T1-201 SPECT/rest Tc-99m-sestamibi gated SPECT in 27 patients with coronary artery disease(24) or having chest pain(3). Stress and rest Tc-99m- sestamibi gated SPECT was acquired at 60min post-injection. A 4-point scoring system(0 to 3 for normal to absent tracer uptake) for 17 segments was used. Wall motion was scored on another 4 point scale(0 to 3 for normal to dyskinesia) in the lst day post-stress gated and the 2nd day rest gated SPECT. Post-stress gated SPECT showed wall motion abnormality in 94 segments(20%). Fifty-five segments among these 94 showed the same wall motion between post-stress and rest gated SPECT:i.e. 1-1: 23 segments, 2-2: 29 segments, 3-3: 3 segments. Re-maining 39 segments (41.5%) showed different wall motion between post-stress and rest Tc-99m-sestamibi gated SFECT. Twenty one segments with wall motion abnormality had normal perfusion(rest:15 segments, 24 hour delay: 6 segments) at either rest or 24 hour delay. Fifteen among these 21 segments showed persistent post-stress and the 2nd day rest wall motion abnormality(persistent stunning). However, in 6 segments with prolonged (1 hour after stress) stunning, abnormal wall motion did improve in the 2nd day rest Tc-99m-sestamibi gated SPECT(transient prolonged stunning). These 6 segments had normal perfusion at rest(n=4) or at 24 hour delay(n=2). Post stress wall motions showed significantly higher scores in persistent stunning than in prolonged transient stunning(P value<0.05). It was concluded that we could find stunned myocardium with gated Tc-99m-sestamibi SPECT at either post-stress or rest and that some myocardial walls of post-stress 1 hour gated SPECT did not show truly rest wall motion. So, we should be cautious if we use post-stress Tc-99m-sestamibi wall motion to assess rest wall motion.
