Objective This paper aimed at investigating left ventricular functional changes during adenosine stress and its relationship with myocardial ischemia evaluated with gated SPECT.
Methods 125 patients suspected or known CAD (coronary artery disease) underwent adenosine stress-rest protocol and gated single photon emission computed tomography (SPECT). Perfusion analysis was performed with a 17-segment model and 5-point scale system. Summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS = SSS-SRS) were calculated. DLVEF, DEDV and DESV were defined by changes in LVEF (left ventricular ejection fraction), ESV (end systolic volume), EDV (end diastolic volume) after stress.
Results Resting and poststress LVEFs correlated significantly. Patients with irreversible ischemia had lower rest and poststress LVEF than normal perfusion patients (t = 2.235, P = 0.028; t = 2.464, P = 0.016). In patients with reversible myocardial ischemia, poststress LVEFs were significantly depressed (t = 3.146, P = 0.002) which were mainly expressed as ESVs elevated (t = –2.215, P = 0.036), compared with rest. Patients with reversible ischemia showed significant changes in DLVEF and DESV, compared with patients with irreversible ischemia (t = 2.520, P = 0.014; t = –2.412, P = 0.019), or normal perfusion (t = 3.115, P = 0.002; t = –3.517, P = 0.001).
Conclusions Patients with fix defect had depressed LV functions at rest and after stress, while in patients with stress-induced ischemia, poststress LV functions were impaired, which were not happened in patients with fixed defect or without ischemia. In daily clinical practise, compared with visual myocardial perfusion alone, integration ofLVfunctional message enhanced the diagnostic ability of adenosine stress SPECT in patients with CAD.