913-118 Repeatability of Treadmill Exercise Ejection Fraction and Wall Motion Using Tc-99m Sestamibi First Pass Radionuclide Ventriculography

Tc-99m sestamibi peak treadmill exercise first pass (TmExFP) radionuclide ventriculography has been recently validated (Friedman et al J Nucl Cardiol 1994; 1:382–8). However, the repeatability of TmExFP assessment has not been previously reported. Therefore, we prospectively repeated TmExFP within 40 ± 51 days in a group of 27 clinically stable patients. The level of exercise achieved was similar (double product: 26357 ± 3877 vs. 26621 ± 4287, p = ns) and there was no interval change in clinical or treatment status. Also, to evaluate inter- and intra-observer agreement, we blindly analyzed a separate group of 20 patients with a broad range of LVEF. Results of repeatability, inter- and intra-observer agreement on LVEF are as follows: Download high-res image (85KB) Download full-size image Reproducibility of regional wall motion was visually interpreted by an expert observer in a blinded fashion using a 3 point score (3, 2, 1 = normal, hypo- and a/dyskinesis, respectively) to 5 left ventricular wall segments (S1–S5 = basal anterior, distal anterior, apical, distal inferior and basal inferior). Results of segmental score agreement between the first and second study were: Overall: 116/135 (86%, kappa = 0.74), Sl: 23/27(85%, kappa = 0,72), S2: 23/27 (85%, kappa = 0.84), S3: 25/27 (93%, kappa = 0,85), S4: 25/27 (93%, kappa = 0,80), S5: 18/27 (67%, kappa = 0,64). Conclusion TmExFP is a highly repeatable test with high degree of reproducibilityfor visual regional wall motion and quantitative LVEF and with high inter- and intra-observer agreement.