Low-dose dobutamine stress gated blood pool SPECT assessment of left ventricular contractile reserve in ischemic cardiomyopathy: a feasibility study.

Autor: Shipulin VV; Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia., Andreev SL; Cardiovascular Surgery Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia., Pryakhin AS; Cardiovascular Surgery Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia., Mochula AV; Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia., Maltseva AN; Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia., Sazonova SI; Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia., Shipulin VM; Administrative Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia., Massalha S; Department of Cardiology, Rambam HealthCare Campus, Haifa, Israel.; Department of Nuclear Medicine, Rambam HealthCare Campus, Haifa, Israel., Zavadovsky KV; Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia. konstzav@gmail.com.
Jazyk: angličtina
Zdroj: European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2022 Jun; Vol. 49 (7), pp. 2219-2231. Date of Electronic Publication: 2022 Feb 12.
DOI: 10.1007/s00259-022-05714-y
Abstrakt: Purpose: The purpose of the present study was to evaluate the feasibility of gated blood pool single-photon emission computed tomography (GBPS) with low-dose dobutamine (LDD) stress test, performed on a single-photon emission computed tomography (SPECT) camera equipped with cadmium-zinc-telluride (CZT) solid-state detectors, in assessing of left ventricle (LV) contractile reserve in patients with ischemic cardiomyopathy (ICM).
Methods: A total of 52 patients (age 59 ± 7.2 years, 47 men and 5 women) with ICM and a control group of 10 patients without obstructive coronary artery lesion underwent GBPS and transthoracic echocardiography (TTE) at rest and during LDD stress test (5, 10, 15 µg/kg/min). The duration of each GBPS step was 5 min. Stress-induced changes in LV ejection fraction (ΔLVEF), peak ejection rate, LV volumes, and mechanical dyssynchrony (phase histogram standard deviation, phase histogram bandwidth and entropy) obtained with GBPS were estimated.
Results: All GBPS indices except end-diastolic volume showed significant dynamics during stress test in both groups. The majority of parameters in ICM patients showed significant changes at a dobutamine dose of 10 µg/kg/min as compared to the rest study. Seventeen percent of ICM patients, but none from the control group, showed a decrease in LVEF during stress, accompanied by a significant increase in entropy. The intra- and inter-observer reproducibility was excellent for both rest and stress studies. There was a moderate correlation (r = 0.5, p = 0.01) between GBPS and TTE, with a mean difference value of - 1.7 (95% confidence interval - 9.8; 6.4; p = 0.06) in ΔLVEF.
Conclusion: Low-dose dobutamine stress GBPS performed with high-efficiency CZT-SPECT cameras can be performed for evaluating stress-induced changes in LV contractility and dyssynchrony with lower acquisition time. A dobutamine dose of 10 µg/kg/min can potentially suffice to detect stress-induced changes in patients with ICM during GBPS.
Trial Registration: ClinicalTrials.gov identifier: NCT04508608 (August 7, 2020).
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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