Exercise-induced stunning continues for at least one hour: evaluation with quantitative gated single-photon emission tomography

Eur J Nucl Med. 1999 Apr;26(4):410-5. doi: 10.1007/s002590050405.


To elucidate the after-effect of exercise on left ventricular (LV) function, end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were evaluated at 1 h after exercise and at rest by technetium-99m tetrofosmin gated myocardial single-photon emission tomography (SPET) using an automated program in 53 subjects. The subjects were grouped as follows: normal scan (n = 16), ischaemia (n = 19) and infarction (n = 18), based on the interpretation of perfusion images. Postexercise LVEF did not differ from resting LVEF in the groups with normal scan and infarction. In patients with ischaemia, postexercise EDV (90+/-17 ml, mean +/-SD) and ESV (44+/-15 ml) were significantly higher than EDV (84+/-15 ml, P = 0.001) and ESV (36+/-14 ml, P<0.0005) at rest. LVEF was significantly depressed 1 h after exercise (53%+/-9% vs 58%+/-9%, P<0.0001). In ischaemic patients with depressed postexercise LVEF, LVEF difference between rest and postexercise showed a significant correlation with the sum of defect scores, which were reversible from exercise to rest perfusion images (r = 0.92, P<0.0001). These results indicate that exercise-induced LV dysfunction (myocardial stunning) continues for at least 1 h in ischaemic patients and that the extent of LVEF depression is determined by the severity of ischaemia.

Publication types

  • Clinical Trial

MeSH terms

  • Blood Volume / physiology
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / physiopathology*
  • Exercise / physiology*
  • Female
  • Gated Blood-Pool Imaging
  • Heart / diagnostic imaging*
  • Heart / physiopathology*
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Rest / physiology
  • Stroke Volume / physiology
  • Tomography, Emission-Computed, Single-Photon
  • Ventricular Function, Left / physiology


  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • technetium tc-99m tetrofosmin