Acute beta-blockade reduces the extent and severity of myocardial perfusion defects with dipyridamole Tc-99m sestamibi SPECT imaging
Raymond Taillefer, MD, FRCP*,*,
Alan W. Ahlberg, MA ,
Yasmin Masood, MD,
C. Michael White, PharmD ,
Isabella Lamargese, MD, FRCP*,
Jeffrey F. Mather, MS,
Carol C. McGill, LPN and
Gary V. Heller, MD, PhD, FACC
* Department of Nuclear Medicine, Centre Hospitalier de l'Université de Montréal (pavillon Hotel-Dieu), Montréal, Canada
The Henry Low Heart Center, Division of Cardiology, Hartford Hospital, Hartford, Connecticut, USA
University of Connecticut School of Medicine, Farmington, Connecticut, USA
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Figure 1 Impact of acute beta blocker therapy upon summed stress score (SSS) and summed difference score (SDS) with dipyridamole Tc-99m sestamibi single-photon emission computed tomography imaging. *p < 0.05; **p < 0.01; ***p < 0.001.
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Figure 2 Individual data points comparing the summed difference score (SDS) on dipyridamole Tc-99m sestamibi single-photon emission computed tomography imaging after administration placebo and low-dose metoprolol and placebo and high-dose metoprolol. In both cases, the differences in the SDS between placebo and each dose of metoprolol were statistically significant.
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Figure 3 Multiple short-axis slices during dipyridamole Tc-99m sestamibi single-photon emission computed tomography (SPECT) imaging in a patient with coronary artery disease after administration of placebo, low-dose metoprolol, and high-dose metoprolol, as well as Tc-99m sestamibi SPECT imaging at rest. A large reversible anterolateral and inferolateral perfusion abnormality is shown with placebo, with at least 50% reduction in size and severity with either dose of metoprolol.
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Figure 4 Multiple short-axis slices during dipyridamole Tc-99m sestamibi single-photon emission computed tomography (SPECT) imaging in a patient with coronary artery disease after administration of placebo, low-dose metoprolol, and high-dose metoprolol, as well as Tc-99m sestamibi SPECT imaging at rest. A medium-sized anteroseptal, anteropical, and distal inferoapical perfusion abnormality is shown with placebo, with approximately 60% reduction is size and severity noted with both doses of metoprolol.
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Figure 5 Multiple short-axis slices during dipyridamole Tc-99m sestamibi single-photon emission computed tomography (SPECT) imaging in a patient with coronary artery disease after administration of placebo, low-dose metoprolol, and high-dose metoprolol, as well as Tc-99m sestamibi SPECT imaging at rest. Multiple perfusion abnormalities are present with placebo with marked reduction in size and severity with both doses of metoprolol.
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