Quantitative analysis of global and regional cardiac performance in normal subjects and patients with coronary artery disease by rest/exercise radionuclide blood-pool study.

This study was undertaken to assess regional and diastolic left ventricular (LV) function in relation to LV asynchronous contraction during exercise (Ex). Rest and serial Ex (25w-75w) gated blood-pool study (Tc-99m-RBC) of 6 normal subjects (N), 12 patients with stable angina pectoris (AP) and 8 with LV aneurysm (LVan) were evaluated in regional LV ejection fraction (EF) and Fourier analysis using higher-order harmonics. In the patients with Ex and regional EF showed various responses to Ex. Global LVEF in the patients with AP indicated almost no change during Ex and regional EF declined apparently in anteroseptal segment, corresponding to stenotic left anterior descending artery. Diastolic indices of regional and global cardiac performance, PFR (peak filling rate), TPF (time to PFR) and standard deviation (SD) of TPF histogram, were obtained by Fourier analysis using two-order harmonics. Patients with coronary artery disease (CAD) showed significantly lower PFR, longer TPF and higher SD of TPF than normal group, suggesting asynchronous relaxation. We conclude that regional EF response and diastolic indices of cardiac performance to exercise provide useful and sensitive information detecting the severity of CAD.