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Treadmill Exercise Produces Larger Perfusion Defects Than Dipyridamole Stress N-13 Ammonia Positron Emission Tomography

Benjamin J.W. Chow, MD, FRCPC, FACC^_*,,_*, Rob S. Beanlands, MD, FRCPC, FACC^_*,, Andrea Lee^_*, Jean N. DaSilva, PhD^_*, Robert A. deKemp, PhD^_*, Abdulkareem Alkahtani, MD^_* and Terrence D. Ruddy, MD, FRCPC, FACC^_*,

^_* Division of Cardiology, University of Ottawa Heart Institute
Division of Nuclear Medicine, Ottawa Hospital, Ottawa, Ontario, Canada

View larger version (13K): [in a new window]   Figure 1 Rest and stress N-13 ammonia positron emission tomography protocol.

View larger version (6K): [in a new window]   Figure 2 (A) Correlation of exercise and dipyridamole summed stress score (SSS). (B) Correlation of exercise and dipyridamole summed rest score (SRS). (C) Correlation of exercise and dipyridamole summed difference score (SDS).

View larger version (9K): [in a new window]   Figure 3 (A) Bland Altman SSS (treadmill exercise [TEX] vs. dipyridamole). (B) Bland Altman SRS (TEX vs. dipyridamole). (C) Bland Altman SDS (TEX vs. dipyridamole). SD = standard deviation; other abbreviations as in Figure 2.

View larger version (90K): [in a new window]   Figure 4 Larger stress defect with treadmill exercise than with dipyridamole stress. A mild (magenta) perfusion defect is present in the inferolateral wall and apex with dipyridamole stress. The size and severity (blue) of the defect is greater after exercise stress.