Issn Print: 0143-3636
Publication Date: 2000/04/01
45. Low-dose dobutamine gated tetrofosmin SPET for the assessment of myocardial viability
P. J. Thorley; K. L. Sheard; U. M. Sivananthan
Excerpt
Low-dose dobutamine (LDD) gated SPET has been proposed as a method of assessing contractile reserve and hence myocardial viability. We have performed a prospective study to examine the effect of LDD gated SPET in a control group of 12 patients with normal perfusion and in 20 patients with severe coronary disease and fixed defects on stress/rest tetrofosmin perfusion imaging. Baseline gated SPET images were acquired at least one hour post stress injection and on a separate occasion LDD (5 μg/kg/min) was infused during gated SPET acquisition following tetrofosmin at rest. Wall motion and wall thickening were assessed on a 9 segment, 5 point score, model and ejection fraction (EF) calculated using Cedars-Sinai software. Mean EF showed no significant change either in the control group (63%) or patient group (24%) with LDD. However in the patient group 37 segments (33%) with moderate/severe fixed perfusion defects showed positive reserve (improvement of at least one point in either wall motion/wall thickening). In the normal group wall motion/thickening remained normal in all but 4 septal segments (in 2 patients). In conclusion LDD gated tetrofosmin SPET can be used to demonstrate viability in patients with severe coronary disease.
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