T U E S D A Y

P M

A P R I L

20

$74 Abstracts Journal of Nuclear Cardiology Tuesday afternoon, April 20, 1999 January/February 1999, Part 2

35.50

DIRECT COMPARISON BETWEEN ADENOSINE AND ATP TL-201 MYOCARDIAL SPECT IN THE SAME SUBJECTS.

J Lee, SW Lee, KA Chun, DY Kang, IH Cho, SC Chae, KB Lee. Kyungpook and Youngnam University Hospital, Taegu, Korea. Although the diagnostic accuracy of TI-201(TI) SPECT with

adenosine(AD) or ATP infusion Is comparable for detecting coronary artery disease, there is no data defining agreement of myocardial TI-uptake between two tests. We have compared segmental TI-uptake in the same subjects. 22 patients(M/F=12/10) in stable condition underwent TI-SPECT with AD(0.14mg/kg/min for 6-min), followed by ATP(0.16mg/kg/min for 5-min) testing 2-7 days apart(mean=4.3 days). The left ventricle on tomographic images was divided into 18 segments and tracer uptake in each segment was visually graded as 0(normal), 1(mildly), 2(moderately), 3(severely decreased).

Gr-0(AD) Gr-I(AD) Gr-2(AD) Gr-3(AD) Gr-0(ATP) 245 20 5 1 Gr-I(ATP) 16 82 3 0 Gr-2(ATP) 1 5 16 1 Gr-3(ATP) 0 1 6 14 There was exact agreement in 337 of 396 se.gments(85.1%,

tau b=0.76, p<0.001), 1-grade difference m 51(12.9%), 2-grade in 7(1.8%) and 3-grade in 1(0.3%) between two stress images. Thus the degree of myocardial TI uptake was fairly comparable between two TI-SPECT.

35.52

COMPARISON OF SILENT WITH PAINFUL ISCHEMIA IN PATIENTS WITH CORONARY ARTERY STENOSES. DY Kang, J Lee, SW Lee, KA Chun, SC Chae, KB Lee. Kyungpook University Hospital, Taegu, Korea.

We compared scintigraphic and exercise ECG variables between silent and painful ischernia in patients with angiographically documented coronary artery disease(CAD). 69 patients diagnosed as CAD by angiography (luminal narrowing >50°%) were underwent symptom-limited exercise Tc-99m MIBI SPECT. 29 patients (Group P, 42%) complained exercise-induced chest pain, 40 patients (Group S, 58%) did not. Reversibility score defined as the sum of uptake score of all segments at stress minus the sum of uptake score of all segments at rest.

Multivessel disease(n] Ex. Duration(min) %MPHR achieved ST magnitude (mm) ischemia(ECG)(n) Ischemia(SPECT)(n) Reversibility score

Group S(n=40) Group P(n=29) t6(40%) t9(66%) 14±3 12±3 86±t4 84±14 0.6±1.0 1.3+1.7 12 (30%) t6 (55%) 27 (68%) 27 (93%) 4.3±4.4 6::4.1

~-value <0.05 <0.01 NS

<0,05 <0.05 <0.05 NS

Our results suggest that ischemic parameters on scintigraphy and exercise ECG seemed to be more severe in patients with chest pain.

35.51

GATED Tc-99m SESTAMIBI SPECT IN CAD: INCREMENTAL VALUE OF WALL MOTION AND THICKENING ON SPECIFICITY. E.Derebek, S.Giineri, G.~apa, O.Kranh, B.De~irmenci, E.Ozbilek, H.Durak. Dokuz Eyltil University Hosp, Izmir,Turkey.

The purpose of this study was to investigate the role of gated SPECT in discriminating soft tissue artefacts. Thirty-five patients (11 F, 24 M) with the suspicion of CAD were enrolled in the study. Same-day rest (8 mCi)-stress (23 mCi) gated imaging protocol was performed using dual-head gamma camera. Coronary angiography was performed in all patients (CAD in 21, normal in 14). Five observers interpreted non-gated and gated images in two different session, according to their own experiences. Wall motion/wall thickening was evaluated in each segment as normal (inward motion and at least 50% increment in ES image) and abnormal (no motion and less than 50% increment in ES image). Sensitivity and specificity of non-gated and gated SPECT in detecting CAD are:

Obs.1 Obs.2 Obs.3 Obs.4 Obs.5 Non-Gated Sens (%) 80 90 85 85 95

Spe (%) 53- 60 60 60 26 Gated Sens (%) 80 90 85 85 95

Spe (%) 60 86 66 86 80 Segmental uptake was %80-60 in 15, 60-80% in 19 and less than 40% in 27 MI related segments. Whereas in segments attributable to soft tissue attenuation, uptake of 80-60%, 60- 80% and less than 40% existed in 45, 4, and I segments, respectively. We conclude that gated SPECT rules out soft tissue artefacts, increasing the specificity of Tc-99m sestamibi myocardial perfusion imaging in detecting CAD.

35.53

LEFT VENTRICULAR FUNCTION AT REST AND DURING EXERCISE IN NORMAL SUBJECTS: ASSESSMENT BY ECG-GATED SPECT. S.Kumita, K.Cho, H.Nakajo, S.Mizumura, T.K~jima, T.Kumazaki, J.Sano, T.Shinada, K.Munakata, Nippon Medical School, Tokyo, Japan

Technetium-labeled myocardial per{us±on tracers allow simultaneous assessment of myocardial per{us±on and LV function using ECG-gated SPECT. The purpose of the present study was to evaluate LV performance during exercise by means of EOG-gated myocardial SPECT using short time (3 min) data collection. After administration of Tc-99m-tetrofosmin 555-740 MBq, eight healthy volunteers aged from 27 to 49 years were examined ECG-gated myocardial perfusion SPECT at rest and during supine submaximal exercise (75 and 125 watts). Each of ECG-gated data collection time was 3 min. Using EOG-gated SPECT data, LVEDV demonstrated a biphasic response during exercise. In contrast, LVESV decreased gradually and significantly during exercise(p<O.05), and LVEF continued to increase at higher work loads(p<0.01) despite a fall in LVEDV. There was a progressive increase in cardiac output during exercise which reached a peak of 7.2___0.9 I/min. ECG-gated myocardial per{usion SPECT can assess the left ventricular function during exercise and has a possibility to offer useful informations for the evaluation of patients with ischemic heart disease.