Quantitative evaluation of regional wall motion in stress gated blood pool study

Quantitative evaluation of regional wall motion measured at rest and peak exercise by gated blood pool study was attempted using temporal Fourier analysis (phase analysis) and regional ejection fraction method. The value of left ventricular ejection fraction (LVEF), regional ejection fraction (REF), and the standard deviation (SD) of the phase distribution histogram were basically and clinically evaluated. Reproducibility of the LVEF and the SD was excellent even in two-minutes-data acquisition (correlation coefficient between the two observers: LVEF; r = 0.96, REF; r = 0.91, and SD; r = 0.96). Five normal persons and 14 patients with angina pectoris without prior myocardial infarction were selected for gated blood pool study both at rest and during peak supine bicycle exercise. In all the normal persons, the LVEF was elevated and the SD was not changed indicating increased left ventricular contraction without significant asynchrony. On the contrary, in 13 of the 14 patients with angina, the LVEF was unchanged or decreased (sensitivity 91%). The SD was significantly elevated in 10 of the 14 cases (71%). Among the rest of the four cases, two showed abnormally high value of the SD at rest or during exercise. Thus, the phase distribution histogram indicated asynchrony in 12 of the 14 cases (sensitivity 86%). We conclude that phase analysis provides reliable and valuable informations in the detection of regional wall motion abnormality in stress gated blood pool study. (author)