Vasodilator Stress Impairs the Left Ventricular Function Obtained With Gated Single-Photon Emission Computed Tomography in Patients With Known or Suspected Coronary Artery Disease

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概要

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• Background: Transient ischemic dilatation (TID) and post-stress dysfunction of the left ventricle (LV) are important markers of severe coronary artery disease (CAD). To clarify the effects of stressor type on TID and post-stress LV dysfunction, changes in LV measurements were compared between patients with exercise- or vasodilator-induced stress. Methods and Results: The 689 patients referred for technetium-99m tetrofosmin myocardial perfusion imaging were included. Patients were stressed with either a vasodilator (n=236) or exercise (n=453). LV measurements were obtained with ECG-gated SPECT. LV end-diastolic and end-systolic volume indexes (LVEDVI, LVESVI) increased and LV ejection fraction (LVEF) decreased after stress in the vasodilator-stress group. Vasodilator-stress and the summed difference score (SDS) were independent variables that decreased LVEF after stress. Even in patients without reversible defects, vasodilator-stress impaired LV function. There were no differences in the stress-to-rest ratios of LVEDVI (rEDV) and LVESVI (rESV) among patients with normal myocardial perfusion, fixed defects and reversible defects in the vasodilator-stress group, whereas in the exercise-stress group, rESV was significantly higher in the patients with reversible defects than in those without reversible defects. Within the vasodilator-stress group, neither rEDV nor rESV correlated with the SDS. Conclusions: Vasodilator-stress by itself decreases LVEF after stress. TID should be carefully interpreted when vasodilator-stress is used to detect severe CAD. (Circ J 2010; 74: 2666-2673)

• 2010-11-25

著者

• Ohnishi K

  Third Department Of Internal Medicine Hamamatsu University School Of Medicine

• Ohnishi Kazunori

  東北大学病院 血液･免疫科

• Odagiri Keiichi

  Division of Cardiology, Internal medicine III, Hamamtsu university School of Medicine

• Chin Ka

  Third Department of Internal Medicine

• Okayama Kenichi

  Department Of Internal Medicine Iii Hamamatsu University School Of Medicine

• Odagiri Keiichi

  浜松医科大学 救急医学

• Odagiri Keiichi

  Department Of Medicine Hamamatsu Red Cross Hospital

• KURATA Chinori

  YAMAHA Health Care Center

• Kurata Chinori

  Hamamatsu University School Of Medicine

• Ohshima Koichi

  First Department Of Pathology Fukuoka University

• Kurata Chinori

  Shizuoka Nuclear Cardiology Study Group

• Oshimi Kazuo

  Department Of Internal Medicine Hamamatsu University School Of Medicine

• Uehara Akihiko

  Divisions Of Cardiology Department Of Internal Medicine Iii

• Uehara Akihiko

  Department Of Internal Medicine Iii Hamamatsu University School Of Medicine

• Ohnishi Kazunori

  The "lung Injury By Bortezomib" Joint Committee Of The Japanese Society Of Hematology And

• Kurata Chinori

  Department Of Medicine Iii Hamamatsu University School Of Medicine

• Ohhashi Kyoichi

  Department Of Clinical Pharmacology And Therapeutics Hamamatsu University School Of Medicine

• Uehara Akihiko

  Yamaha Health Care Center

• Ohashi K

  Third Department Of Internal Medicine Hamamatsu University School Of Medicine

• Ohnishi Kazunori

  Cancer Center Hamamatsu University School Of Medicine

• Odagiri Keiichi

  Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine

• Uehara Akihiro

  3rd Department Of Internal Medicine Hamamatsu University

• Ohnishi Kazunori

  Shikoku National Hospital Matsuyama Jpn

• Ohmachi Ken

  Department Of Cell Pathology Graduate School Of Medical Sciences Kumamoto University

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