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Myocardial Contractile Reserve and Perfusion Defect Severity with Rest and Stress Dobutamine ^99mTc-Sestamibi SPECT in Canine Stunning and Subendocardial Infarction

¹ Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
² Centro di Studio per la Medicina Nucleare, CNR, Naples, Italy

View larger version (37K): [in a new window]   FIGURE 1. Defect severity in nongated and gated end-diastolic and gated end-systolic tomographic images. Asterisk indicates significant differences in resting end-systolic images: normal vs. stunned (P < 0.03) and normal vs. myocardial infarction (P < 0.05).

View larger version (14K): [in a new window]   FIGURE 2. SWI at baseline and during dobutamine infusion.

View larger version (44K): [in a new window]   FIGURE 3. Normal (healthy) control. (A) Short-axis midventricular SPECT slices. (Top) Resting end-diastolic (left) and resting end-systolic (right) images. (Bottom) Dobutamine end-diastolic (left) and dobutamine end-systolic (right) images. (B) SPECT analysis. (Top) Circumferential profiles of midventricular short-axis slice at rest (left) and during dobutamine infusion (right). (Bottom) Percentage SWI at rest and during dobutamine infusion.

View larger version (41K): [in a new window]   FIGURE 4. Stunned myocardium. (A) Short-axis midventricular SPECT slices. (Top) Resting end-diastolic (left) and resting end-systolic (right) images. (Bottom) Dobutamine end-diastolic (left) and dobutamine end-systolic (right) images. (B) SPECT analysis. (Top) Circumferential profiles of midventricular short-axis slice at rest (left) and during dobutamine infusion (right). (Bottom) Percentage SWI at rest and during dobutamine infusion.

View larger version (41K): [in a new window]   FIGURE 5. SEMI. (A) Short-axis midventricular SPECT slices. (Top) Resting end-diastolic (left) and resting end-systolic (right) images. (Bottom) Dobutamine end-diastolic (left) and dobutamine end-systolic (right) images. (B) SPECT analysis. (Top) Circumferential profiles of midventricular short-axis slice at rest (left) and during dobutamine infusion (right). (Bottom) Percentage SWI at rest and during dobutamine infusion.

View larger version (13K): [in a new window]   FIGURE 6. Correlation of SWI vs. MRI radial strain in anterior and anterolateral walls.