Risk stratification with electrocardiographic-gated dobutamine stress technetium-99m sestamibi single-photon emission tomographic imaging: value of heart rate response and assessment of left ventricular function.

Objectives: The purpose of this research was to evaluate the significance of heart rate response to dobutamine and the assessment of left ventricular (LV) function during risk stratification of patients undergoing dobutamine stress myocardial perfusion imaging (DSMPI).

Background: Dobutamine stress myocardial perfusion imaging has been shown to effectively risk stratify highly selected patients. However, based on perfusion alone, patients with normal and abnormal tests have twice the risk as comparable patients with exercise testing.

Comparison of risk stratification with pharmacologic and exercise stress myocardial perfusion imaging: a meta-analysis.

Background: Although pharmacologic stress myocardial perfusion imaging (MPI) and exercise stress MPI have comparable diagnostic accuracy, their comparative value for risk stratification of patients with known or suspected coronary disease is not known.

Methods And Results: The data of 14,918 patients were combined from 24 studies evaluating prognosis in patients undergoing either pharmacologic stress or exercise stress MPI. Studies were included if a 2 x 2 table for hard cardiac events (cardiac death and myocardial infarction [MI]) could be constructed from the data available.

Comparison of 16-frame and 8-frame gated SPET imaging for determination of left ventricular volumes and ejection fraction.

Electrocardiographic (ECG) gated single-photon emission tomography (SPET) allows for simultaneous assessment of myocardial perfusion and left ventricular (LV) function. Presently 8-frame per cardiac cycle ECG gating of SPET images is standard. The aim of this study was to compare the effect of 8-frame and 16-frame gated SPET on measurements of LV volumes and to evaluate the effects of the presence of myocardial perfusion defects and of radiotracer dose administered on the calculation of LV volumes.

Pharmacologic radionuclide myocardial perfusion imaging.

Pharmacologic stress testing with myocardial perfusion imaging has enabled patients who cannot complete adequate exercise to undergo diagnostic and prognostic evaluation for coronary artery disease. Pharmacologic stress agents belong to two groups: vasodilators (such as adenosine and dipyridamole), and inotropes (such as dobutamine). All have similar sensitivity (89%-91%) and specificity (78%-86%) for the diagnosis of coronary disease.