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

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Abstract

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).

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Acknowledgements

We thank Dr. Tamara R. Ryabova, PhD, and Dr. Vadim A. Katkov who performed TTE examinations. We thank Dr. Ora Israel for her comments and suggestions.

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Authors and Affiliations

  1. Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia

    Vladimir V. Shipulin, Andrew V. Mochula, Alina N. Maltseva, Svetlana I. Sazonova & Konstantin V. Zavadovsky

  2. Cardiovascular Surgery Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia

    Sergey L. Andreev & Andrew S. Pryakhin

  3. Administrative Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia

    Vladimir M. Shipulin

  4. Department of Cardiology, Rambam HealthCare Campus, Haifa, Israel

    Samia Massalha

  5. Department of Nuclear Medicine, Rambam HealthCare Campus, Haifa, Israel

    Samia Massalha

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  1. Vladimir V. Shipulin
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Shipulin, V., Andreev, S., Pryakhin, A. et al. Low-dose dobutamine stress gated blood pool SPECT assessment of left ventricular contractile reserve in ischemic cardiomyopathy: a feasibility study. Eur J Nucl Med Mol Imaging 49, 2219–2231 (2022). https://doi.org/10.1007/s00259-022-05714-y

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