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  • KMH Cardiolite Reports Now Comprise Rest and Post-Stress Ejection Fraction*

    In keeping with progressive practices and recommendations from recent literature**, KMH has revised its protocol to provide additional information in its reports to referring physicians that will add further prognostic information. An added bonus for patients is the reduced testing period experienced during appointments; there is no break between the exercise and stress imaging thus reducing the appointment by one or two hours.

    Beneficial Results of the Test Procedure

    Specifically, obtaining an ejection fraction in the early post-stress period, in addition to the resting ejection fraction as part of the cardiolite exercise, persantine or dobutamine scan protocol, provides further prognostic information and increased sensitivity. For valid comparison with the ejection fraction of the resting images, the ejection fraction of the stress images are performed between 30 and 60 minutes, post-stress.

    If there is a significant drop in post-stress ejection fraction, when compared to rest ejection fraction, this indicates an even higher chance of suffering from myocardial infarction and sudden cardiac death.

    In selected patients, a significant drop in post-stress ejection fraction compared to rest ejection fraction can also result in enhanced detection of coronary artery disease.

    When there is no significant change, or an increase in post-stress ejection fraction when compared to rest ejection fraction, there is no pathological significance. As always, a written report will be sent to you upon completion of the test within 48 hours. Urgent results will be provided to you the same day or the next day.

    Referral Procedure

    Use the KMH Cardiology Requisition Form. Your office or your patient may call to book an appointment (905-855-1860 or 1-877-564-5227) at any of the eight KMH Cardiology & Diagnostic Centres in south-central Ontario. Patients may visit www.kmhlabs.com for the location most convenient for them.

    *Definition:

    Ejection Fraction is the proportion of the blood pumped out of the left ventricle from diastole to systole. Normal resting ejection fraction is generally greater than or equal to 50 per cent (plus or minus 5%).

    **References:

    Incremental Prognostic Value of Post-Stress Left Ventricular Ejection Fraction and Volume by Gated Myocardial Perfusion Single Photon Emission Computed Tomography;

    Tali Sharir, Guido Germano, Paul B. Kavanagh, Shenhan Lai, Ishac Cohen, Howard C. Lewin, John D. Friedman,Michael J. Zellweger and Daniel S. Berman; Circulation (published by the American Heart Association) 1999; 100; 1035-1042.

    Prediction of Myocardial Infarction versus Cardiac Death by Gated Myocardial Perfusion SPECT: Risk Stratification by the Amount of Stress-induced Ischemia and the Post-stress Ejection Fraction;

    Tali Sharir, Guido Germano, Xingping Kang, Howard C. Lewin, Romalisa Miranda, Ishac Cohen, Raluca D. Agafitei, John D. Friedman and Daniel S. Berman; The Journal of Nuclear Medicine, Vol. 42. No. 6; June 2001; 831 – 837.

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