Comparison of post-exercise and post-vasodilator stress myocardial stunning as assessed by electrocardiogram-gated single-photon emission computed tomography.

Background: Exercise gated single-photon emission computed tomography (SPECT) using technetium-99m (99mTc)-sestamibi evaluates both myocardial perfusion during stress and wall motion >30 min after the stress, which has the potential to assess not only exercise-induced myocardial ischemia but also the development of myocardial stunning.

Methods And Results: To evaluate the incidence of post-stress myocardial stunning, as well as comparing the effects of different stress methods on the development of stunning, 179 consecutive patients with known or suspected coronary artery disease (CAD) underwent (99m)Tc-sestamibi SPECT with either exercise (n=135) or adenosine triphosphate disodium (ATP) (n=44). Electrocardiogram-gated SPECT images were acquired >30 min after the stress and again 4 h later, and perfusion and wall motion were evaluated.

Value of pharmacologic stress myocardial perfusion imaging for preoperative risk stratification for aortic surgery.

Background: Aortic surgery is an invasive, high-risk noncardiac procedure and the patients who require it have a high prevalence of coronary artery disease. Therefore, preoperative risk stratification for this subset is essential.

Methods And Results: To assess the perioperative risk for aortic surgery, pharmacologic stress single-photon emission computed tomography (SPECT) was performed in 302 patients: aortic dissection in 56, thoracic aortic aneurysm in 124, and abdominal aortic aneurysm in 122.

Diagnostic value of simultaneous brachial and ankle blood pressure measurements for the extent and severity of coronary artery disease as assessed by myocardial perfusion imaging.

Background: Although the simultaneous measurement of brachial and ankle blood pressure is a simple method of evaluating atherosclerosis, its diagnostic value for coronary artery disease (CAD) is undetermined.

Methods And Results: To evaluate the diagnostic value of ankle-brachial pressure index (ABI) and brachial-to-ankle pulse wave velocity (baPWV), 334 consecutive patients with suspected CAD were evaluated. Patients with a previous myocardial infarction or coronary intervention were not included.

Preoperative risk stratification for endovascular surgery using pharmacologic stress myocardial imaging.

To stratify perioperative cardiac risk for endovascular surgery, pharmacologic stress single-photon emission computed tomography (SPECT) was performed in 206 patients. Of 8 patients who had cardiac events, 7 occurred in 67 patients with positive SPECT results, whereas only 1 occurred in 139 patients with negative SPECT results (7 of 67 vs 1 of 139, p <0.002).