open access

Vol 6, No 1 (2003)
Published online: 2003-01-03
Submitted: 2012-01-23
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The comparison of two gated SPET protocols: adenosine Tc-99m tetrofosmin and treadmill exercise Tc-99m MIBI

Mirosław A. Dziuk, Jacek Pietrzykowski, Ana L. Canizales, Keith E. Britton, Marian Cholewa
Nucl. Med. Rev 2003;6(1):11-15.

open access

Vol 6, No 1 (2003)
Published online: 2003-01-03
Submitted: 2012-01-23

Abstract

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 < 0.01). This was caused by the smaller post-stress ESV in the treadmill group 40 ± 20 v. 51 ± 34, p < 0.05. In non-ischaemic scans the LVEF was greater (61 ± 8 v. 51 ± 14, p < 0.01) and EDV and ESV smaller after both stress and rest.
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.

Abstract

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 < 0.01). This was caused by the smaller post-stress ESV in the treadmill group 40 ± 20 v. 51 ± 34, p < 0.05. In non-ischaemic scans the LVEF was greater (61 ± 8 v. 51 ± 14, p < 0.01) and EDV and ESV smaller after both stress and rest.
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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Keywords

gated SPET; adenosine; exercise; left ventricular function

About this article
Title

The comparison of two gated SPET protocols: adenosine Tc-99m tetrofosmin and treadmill exercise Tc-99m MIBI

Journal

Nuclear Medicine Review

Issue

Vol 6, No 1 (2003)

Pages

11-15

Published online

2003-01-03

Bibliographic record

Nucl. Med. Rev 2003;6(1):11-15.

Keywords

gated SPET
adenosine
exercise
left ventricular function

Authors

Mirosław A. Dziuk
Jacek Pietrzykowski
Ana L. Canizales
Keith E. Britton
Marian Cholewa

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