The significance of stress-induced ST segment depression in patients with inferior Q wave myocardial infarction
Abdou Elhendy, MD, PhDa,
Ron T. van Domburg, PhDa,
Jeroen J. Bax, MD, PhDa and
Jos R. T. C. Roelandt, MD, PhD, FACCa
a Thoraxcenter and the Department of Nuclear Medicine, University Hospital Rotterdam-Dijkzigt, Erasmus University, Rotterdam, The Netherlands
View larger version (14K):
[in a new window]
|
Figure 1 The prevalence of reversible perfusion abnormalities in patients with and without electrocardiographic changes during dobutamine stress test. Filled bars, yes; open bars, no.
|
|
View larger version (50K):
[in a new window]
|
Figure 2 A, 12-lead ECG at rest and at dobutamine stress (30 µg/kg/min) of a 57-year-old male patient studied 14 months after Q wave inferior myocardial infarction. The patient developed ST segment elevation in the inferior Q leads (II, III, aVF) and concomitant ST segment depression in the high lateral leads (I, aVL) during stress. B, Stress and rest tetrofosmin SPECT myocardial perfusion images from the short-axis (SA), vertical long-axis (VLA) and horizontal long-axis (HLA) views of the same patient, demonstrating a fixed perfusion defect in the postero-inferior wall (arrows) without reversibility (no scintigraphic evidence of ischemia).
|
|
View larger version (11K):
[in a new window]
|
Figure 3 Fixed perfusion defect (infarction) score as assessed by rest SPECT imaging in the presence and in absence of electrocardiographic changes during dobutamine stress test. Filled bars, yes; open bars, no.
|
|
View larger version (10K):
[in a new window]
|
Figure 4 Reversible perfusion defect (ischemic) score as assessed by stress and rest SPECT imaging in the presence and in absence of electrocardiographic changes during dobutamine stress test. Filled bars, yes; open bars, no.
|
|
|
