Comparison Of Left Ventricular Mechanical Dyssynchrony Parameters Between Exercise And Adenosine Triphosphate Stress Tests Using Gated Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging

BACKGROUND Left ventricular mechanical dyssynchrony (LVMD) can be induced after stress test. However, no studies have compared the influence of different stress-inducing methods on LVMD parameters.AIMS The aim of the study was to determine whether there is a difference between exercise and adenosine triphosphate (ATP) stress tests in terms of changes in LVMD parameters assessed using gated single-photon emission computed tomography myocardial perfusion imaging (GSPECT MPI).METHODS A total of 190 patients who underwent Tc-99m-sestamibi GSPECT MPI were consecutively enrolled. Treadmill exercise and ATP stress tests were performed in 95 patients each. Normal myocardial perfusion was defined as the summed stress score (SSS) <= 3 and summed rest score (SRS) <= 3, myocardial ischemia as SSS >3 and SRS <= 3, and myocardial infarction as SSS >3 and SRS >3. Parameters of LVMD, including phase standard deviation (PSD), phase bandwidth (PBW), skewness, and kurtosis were compared. Subtraction was made between values during stress and rest phases to acquire Delta PSD, Delta PBW, Delta skewness, and Delta kurtosis.RESULTS There were no differences in LVMD parameters between the exercise and ATP groups. The same results were obtained in the normal perfusion, ischemia, and infarction subgroups. Furthermore, no differences were observed in Delta PSD (median [interquartile range, IQR], 0.25 [-2.3 to 3.1] vs 0.42 (-1.7 to 3.1]; P = 0.73), Delta PBW (median [IQR], 1 [-7 to 11] vs 1 [- 6 to 11]; P = 0.95), Delta skewness (mean [SD], -0.06 [0.63] vs 0 [ 0.81]; P = 0.53), and Delta kurtosis (median [IQR], - 0.47 [- 4.2 to 4.3] vs -0.42 [-4.8 to 5.2]; P = 0.73) between the exercise and ATP stress-inducing methods.CONCLUSIONS There are no differences between the exercise and ATP stress tests in terms of changes in LVMD parameters. Thus, the 2 methods can be used alternatively.