Myocardial Flow Reserve and 99mTc-DTPA Cardiac Dynamic SPECT

Feasibility of Dynamic Cardiac SPECT With 99mTc-diethylenetriaminepenta-acetate (DTPA) for the Assessment of Myocardial Flow Reserve Using a Cadmium-Zinc-Telluride (CZT) Camera

New CZT-based SPECT cameras are potentially capable of dynamic 3-D acquisition. Preliminary results suggested that dynamic acquisitions could allow the assessment of myocardial flow reserve using 99mTc-labelled perfusion tracers. The Flow-Heart study will assess the feasibility of myocardial flow reserve measurement by means of 99mTc-DTPA dynamic cardiac SPECT in 20 patients.

Inclusion Criteria:

• Age over 18 years
• Patient clinically stable with known or suspected coronary disease
• Patient referred to Caen University Hospital for a myocardial perfusion SPECT
• Patient who accept to undergo subsequent additional cardiac dynamic SPECT using 99mTc-DTPA at rest and during pharmacological stress
• Informed consent dated and signed
• Affiliation to a social security system

Exclusion Criteria:

• Contraindication to dipyridamole (asthma, chronic obstructive pulmonary disease , pulmonary hypertension)
• History of poor tolerance of dipyridamole injection
• Cardiac arrhythmia (atrial fibrillation or frequent premature ventricular complex)
• Left bundle branch block, cardiac pacemaker, or implantable automatic defibrillator
• Recent history of myocardial infarction or unstable angina
• Pregnancy or lactating women
• Known obstructive renal or urinary disease
• Age under 18 years or guardianship
• Patient with an acute coronary syndrome or a coronary revascularization occurring between the conventional perfusion SPECT and the subsequent 99mTc-DTPA dynamic SPECT