Diagnostic value of adenosine-induced left ventricular diastolic dysfunction for detecting coronary artery restenosis in patients undergoing stent implantation by stress ECG-gated myocardial perfusion SPECT - A pilot study

Yoshimochi Nakano, Naoya Matsumoto, Yasuyuki Suzuki, Masahiko Kato, Takaaki Miki, Jun Iida, Shunichi Yoda, Keiko Sugiyama, Yuichi Sato, Shu Kasama, Toshio Kushiro, Ken Nagao, Atsushi Hirayama

研究成果: ジャーナルへの寄稿記事査読

4 被引用数 (Scopus)

抄録

Background: Usefulness of diastolic dysfunction after adenosine stress for detecting coronary stenosis has not been defined. The diagnostic accuracy of a combination of myocardial perfusion and diastolic function, as defined by prolongation of time to peak-filling rate (TTPF)/R-R and myocardial perfusion alone for the detection of coronary restenosis, was evaluated. Methods and Results: We used rest 201Tl/ adenosine stress 99mTc-tetrofosmin myocardial perfusion singlephoton emission computed tomography (SPECT) in 70 patients. Patients were divided into the following 4 groups: 20 patients with normal SPECT without stent (Control group), 20 patients showing normal SPECT without coronary restenosis (Group 1), 16 patients showing significant coronary restenosis and myocardial ischemia (Group 2a) and 14 patients showing significant coronary restenosis without myocardial ischemia (Group 2b). The TTPF, which was calculated by quantitative gated SPECT (QGS)/R-R, was not different between after stress and at rest in Control group (0.18±0.02 vs 0.19±0.04, P=NS). The TTPF/R-R after stress was significantly lower than that at rest in Group 1 (0.17±0.02 vs 0.18±0.03, P<0.05), but TTPF/R-R after stress was significantly higher than that at rest in Groups 2a and 2b (0.22±0.03 vs 0.16±0.03, P<0.001 in Group 2a and 0.19±0.02 vs 0.16±0.02, P<0.001 in Group 2b, respectively). Diagnostic accuracy improved from 72% to 92% when prolongation of TTPF/R-R was taken into account (P<0.001). Conclusions: Diastolic dysfunction after stress was an accurate marker for detecting significant restenosis following stent implantation.

本文言語英語
ページ(範囲)2658-2665
ページ数8
ジャーナルCirculation Journal
74
12
DOI
出版ステータス出版済み - 2010

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