Poststress Measurements of Left Ventricular Function with Gated Perfusion SPECT: Comparison with Resting Measurements by Using a Same-Day Perfusion-Function Protocol

PURPOSE: To investigate the relationship between the development of ischemia during stress testing and the changes in left ventricular ejection fraction (LVEF) measurements obtained after stress and at rest with a same-day perfusion-function imaging protocol.

MATERIALS AND METHODS: One hundred twenty-six patients underwent a same-day rest-stress (61%) or stress-rest (39%) protocol and gated single photon emission computed tomography (SPECT). Perfusion analysis was performed with a 12-segment model. Defects were scored (0 = no defect, 1 = mild defect, 2 = moderate defect, and 3 = severe defect); differences between the summed stress and resting scores of greater than three indicated substantial ischemia.

RESULTS: Resting and poststress LVEFs correlated significantly (r = 0.97, P < .001); however, patients with and patients without ischemia had significant differences in poststress versus resting LVEFs (−4.0 vs 1.0, respectively; P < .01). In patients with ischemia versus patients without ischemia, subgroup analysis stress-rest (−2.5 vs 1.0, P = .047) and rest-stress (−4.0 vs 1.0, P = .006) protocols yielded similar results.

CONCLUSION: In patients with clinically important stress-induced perfusion abnormalities, the LVEF after stress was significantly lower than the LVEF at rest with same-day rest-stress and stress-rest imaging protocols. In the clinical setting, poststress LVEFs may be lower than true resting measurements, particularly in patients with moderate to severe stress-induced ischemia.

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Article History

Published in print: May 2000