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(Chest. 1994;106:1725-1729.)
© 1994 American College of Chest Physicians

Exercise Echocardiographic Correlates of Transient Dilatation of the Left Ventricular Cavity on Exercise Thallium-201 SPECT Imaging

Andrew Van Tosh MD, FCCP1; Susan Hecht MD1; Marvin Berger MD, FCCP1; Roberto Roberti MD1; Evangeline Luna MD1; and Steven F. Horowitz MD1

1 From the Division of Cardiology, Department of Medicine, Beth Israel Medical Center, New York

Transient dilatation of the left ventricular cavity on exercise thallium perfusion imaging is recognized as a marker of significant coronary disease, but the mechanisms that produce this finding are not fully understood. We studied 32 patients who underwent exercise thallium imaging and exercise echocardiography to determine the changes in left ventricular cavity size that underlie transient dilatation. Left ventricular area from the apical four-chamber view was used to approximate left ventricular cavity size. There were 24 patients who did not have transient dilatation (group 1) and 8 patients who did have transient dilatation (group 2) on thallium imaging. Systolic area decreased from rest to exercise in group 1 patients but not in group 2 patients. There was no significant change in diastolic area from rest to exercise in either group 1 or group 2 patients. Thus, exercise-induced systolic dysfunction, manifested as a failure to decrease left ventricular systolic cavity size in exercise, may be an important mechanism in producing scintigraphic transient dilatation.

Key Words: exercise echocardiography • exercise stress testing • thallium scintigraphy

Submitted on June 14, 1993
Accepted on April 19, 1994




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