The comparison of two gated SPET protocols: adenosine Tc-99m tetrofosmin and treadmill exercise Tc-99m MIBI
2003
BACKGROUND: The effect of adenosine and exercise on gated
SPET left ventricular ejection fraction (LVEF), end diastolic
volume (EDV) and end systolic volume (ESV) has not been fully investigated. The aim of the study was to compare functional measurements obtained in one-day adenosine rest and two-day stress-rest protocols in relation to ischaemia. MATERIAL AND METHODS: Out of 226 consecutive patients examined with submaximal treadmill stress-rest 700 MBq Tc-99m MIBI, 26 were chosen to match those subjected to adenosine
(140 µg/kg/min) enhanced by a low level exercise protocol (300
MBq and 700 MBq Tc-99m tetrofosmin for stress and rest respectively).
All images were acquired on a double head system
and were gated using 8 frames, 25 s per frame. RESULTS: ED and ES volumes increased after adenosine but
decreased after treadmill resulting in the post-stress LVEF being
significantly greater than after adenosine, 60 ± 11 v. 51 ± 13%
(p CONCLUSIONS: The adenosine test may have an opposite influence
on the EDV and ESV in comparison to the submaximal treadmill test and therefore the left ventricular function measurements after adenosine infusion should be interpreted carefully and may not represent those acquired after physical exercise. In
the gated SPET scans showing ischaemia the post-stress EDV and ESV may be greater and the LVEF lower than at rest.
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