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Journal of Nuclear Medicine Technology Volume 34, Number 2, 2006 88-91
© 2006 by Society of Nuclear Medicine

Importance of Gated Imaging in Both Phases of Myocardial Perfusion SPECT: Myocardial Stunning After Dipyridamole Infusion

Vahidreza Dabbagh Kakhki, Seyed Rasoul Zakavi, Ramin Sadeghi and Ahmad Yousefi

Department of Nuclear Medicine, Emam Reza Hospital, Mashad University of Medical Sciences, Mashad, Iran

Correspondence: For correspondence or reprints contact: Vahidreza Dabbagh Kakhki, Department of Nuclear Medicine, Emam Reza Hospital, Mashad University of Medical Sciences, Mashad, Iran. E-mail: dvdkakh{at}yahoo.com

We present the case report of a 72-y-old woman who underwent 99mTc-sestamibi gated myocardial perfusion SPECT with a 2-d protocol. SPECT images revealed ischemia of the apical, anteroapical, apicoseptal, and septal walls. Postdipyridamole gated SPECT revealed significant deterioration in the left ventricular ejection fraction (LVEF), wall motion, and systolic wall thickening relative to the findings obtained with rest gated SPECT. Myocardial stunning is a lingering contractile dysfunction that occurs after a brief ischemic insult. Myocardial stunning after dynamic exercise or pharmacologic stress tests has been demonstrated. Thus, the use of gated SPECT in both phases of perfusion studies may add useful information about cardiac function, as a poststress study alone probably reflects stunned myocardium in some patients undergoing ischemic stress tests. The difference between poststress LVEF and rest LVEF may have a powerful impact on prognosis, as it seems to depend on the extent and severity of induced ischemia.

Key Words: myocardial stunning; gated SPECT; dipyridamole; myocardial perfusion






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Copyright © 2006 by the Society of Nuclear Medicine Technologist Section.