Key result
Stress-induced LVEF drops ~1% normally, requiring an >11.6% fall to exceed standard variation.
Why the study?
The relationship between ischemia development during stress testing and changes in LVEF measured after stress versus at rest using a same-day perfusion-function protocol was unclear.
Comparison
Poststress LVEF versus resting LVEF in patients with and without ischemia
Design
Observational study using same-day perfusion-function imaging protocol
Authors
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Post-stress LVEF declines <11.6% may reflect normal variation in nonischemic patients; leaves open refined thresholds for ischemia detection in gated SPECT.
Observational (n=1,486)
No
Mean Difference: 1.2 (95% CI 0.8–1.6)
Absolute Event Rate: 61.2% vs 62.4%
p-value: p=<0.001
Borges‐Neto et al. (2000) conducted an observational in Suspected or known coronary artery disease (n=1,486). Stress testing during myocardial perfusion scintigraphy vs. Resting measurements was evaluated on Difference in left ventricular ejection fraction (LVEF) between rest and stress acquisitions in patients without inducible hypoperfusion (MD 1.2, 95% CI 0.8-1.6, p=<0.001). In patients without inducible ischemia, left ventricular ejection fraction was significantly lower after stress compared to rest (mean difference 1.2%, p<0.001), indicating that a fall of >11.6% is required to exceed normal intraindividual variation.